title: Controlled clinical trial of repeated prefrontal tDCS in patients with chronic minimally conscious state.
abstract: To assess the effects of repeated transcranial direct current stimulation (tDCS) sessions on the level of consciousness in chronic patients in minimally conscious state (MCS).
  
  
  
  In this randomized double-blind sham-controlled crossover study, we enrolled 16 patients in chronic MCS. For 5 consecutive days, each patient received active or sham tDCS over the left prefrontal cortex (2 mA during 20 min). Consciousness was assessed with the Coma Recovery Scale-Revised (CRS-R) before the first stimulation (baseline), after each stimulation (day 1-day 5) and 1 week after the end of each session (day 12).
  
  
  
  A treatment effect (p = 0.013; effect size = 0.43) was observed at the end of the active tDCS session (day 5) as well as 1 week after the end of the active tDCS session (day 12; p = 0.002; effect size = 0.57). A longitudinal increase of the CRS-R total scores was identified for the active tDCS session (p < 0.001), while no change was found for the sham session (p = 0.64). Nine patients were identified as responders (56%).
  
  
  
  Our results suggest that repeated (5 days) left prefrontal tDCS improves the recovery of consciousness in some chronic patients in MCS, up to 1 week after the end of the stimulations.
authors.affiliation: a Coma Science Group, GIGA-research , University of Liège , Liège , Belgium.|b Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital , Harvard Medical School , Boston , MA , USA.
authors.forename: Aurore
authors.initials: A
authors.lastname: Thibaut
authors.affiliation: a Coma Science Group, GIGA-research , University of Liège , Liège , Belgium.
authors.forename: Sarah
authors.initials: S
authors.lastname: Wannez
authors.affiliation: c Biostatistics, Department of Public Health , University of Liège , Liège , Belgium.
authors.forename: Anne-Francoise
authors.initials: AF
authors.lastname: Donneau
authors.affiliation: a Coma Science Group, GIGA-research , University of Liège , Liège , Belgium.|d Laboratory for NeuroImaging of Coma and Consciousness , Massachusetts General Hospital , Boston , MA , USA.
authors.forename: Camille
authors.initials: C
authors.lastname: Chatelle
authors.affiliation: a Coma Science Group, GIGA-research , University of Liège , Liège , Belgium.
authors.forename: Olivia
authors.initials: O
authors.lastname: Gosseries
authors.affiliation: a Coma Science Group, GIGA-research , University of Liège , Liège , Belgium.
authors.forename: Marie-Aurélie
authors.initials: MA
authors.lastname: Bruno
authors.affiliation: a Coma Science Group, GIGA-research , University of Liège , Liège , Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Laureys
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D017397:Prefrontal Cortex / Q000502:physiology*; D011446:Prospective Studies; D065908:Transcranial Direct Current Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Clinical trial: NCT02019615; Minimally conscious state; brain injury; brain stimulation; disorders of consciousness; tDCS