Evaluating the Effect of Repetitive Transcranial Magnetic Stimulation on Disorders of Consciousness by Using TMS-EEG.
Background:The modulation efficacy of Transcranial magnetic stimulation (TMS) on consciousness improvement of patient with disorder of consciousness (DOC) has not been definitely confirmed.Objective:This study proposes TMS-EEG to assess effects of repetitive TMS (rTMS) on brain modulation of DOC.Methods:Twenty sessions of 10 Hz rTMS were applied over the dorsolateral prefrontal cortex for a patient with DOC. Measures of Coma Recovery Scale-Revised (CRS-R) score, TMS-evoked potential (TEP), perturbation complexity index (PCI), and global mean field power (GMFP) were used to evaluate the consciousness level of the patient at three intervals: before the rTMS protocol (T0), immediately after one session rTMS (T1), and immediately after 20 sessions (T2).Results:It was found that the patient was diagnosed of a minimally conscious state minus (MCS-) by means of CRS-R at the interval of T0, however the TEP and PCI indicated the patient was vegetative state (VS). At the interval of T1, there was not any clinical behavioral improvement in CRS-R, but we could find significant changes in TEP, PCI, and GMFP. At the interval of T2 there was a significant increase of consciousness level according by CRS-R score, PCI value, TEP, and GMFP after 20 sessions of 10 Hz rTMS on the patient with DOC.Conclusions:We demonstrated that TMS-EEG might be an efficient assessment tool for evaluating rTMS protocol therapeutic efficiency in DOC.
Department of Automation, Institute of Electrical Engineering, Yanshan University Qinhuangdao, China.
Yang
Y
Bai
Department of Neurosurgery, PLA Army General HospitalBeijing, China; Department of Biomedical Engineering, Medical School, Tsinghua UniversityBeijing, China.
Xiaoyu
X
Xia
Department of Biomedical Engineering, Institute of Electronic Information Engineering, Hebei University Baoding, China.
Jiannan
J
Kang
Department of Neurosurgery, PLA Army General Hospital Beijing, China.
Xiaoxiao
X
Yin
Department of Neurosurgery, PLA Army General Hospital Beijing, China.
Yi
Y
Yang
Department of Neurosurgery, PLA Army General Hospital Beijing, China.
Jianghong
J
He
State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal UniversityBeijing, China; Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal UniversityBeijing, China.
Xiaoli
X
Li
EEG; TMS-EEG; disorder of consciousness; perturbation complexity index; rTMS