长时程重复高精度经颅直流电刺激对微意识状态患者意识恢复的影响

郭永坤; 刘春颖; 杨艺; 李远清; 单峤; 谢井伟; 赵德枭; 何江弘; 付旭栋; 王新军

doi:10.16016/j.1000-5404.202102118

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长时程重复高精度经颅直流电刺激对微意识状态患者意识恢复的影响

专题报道：意识障碍的基础与临床研究 | 更新时间：2026-01-09

- 长时程重复高精度经颅直流电刺激对微意识状态患者意识恢复的影响
- Effect of long-lasting repeated high-definition transcranial direct current stimulation on consciousness recovery in minimally conscious state patients
- 第三军医大学学报 2021年43卷第15期页码：1454-1459
- 作者机构：
  
  1.450052 郑州，郑州大学第五附属医院神经外科
  2.450052 郑州，河南省颅脑损伤防治工程研究中心
  3.100070 北京，首都医科大学附属天坛医院神经外科
  4.510600 广州，华南理工大学自动化科学与工程学院
- 作者简介：
  
  [王新军，E-mail: wangxj@zzu.edu.cn WANG Xinjun, E-mail: wangxj@zzu.edu.cn
- 基金信息：
  
  国家自然科学基金青年科学基金项目(82001112);河南省医学科技攻关计划联合共建项目(LHGJ20190409);河南省高等学校重点科研项目(19A320041)
- DOI：10.16016/j.1000-5404.202102118
  中图分类号： R454.1;R741.05;R749.13
- 收稿：2021-02-22，
  
  修回：2021-06-07，
  
  纸质出版：2021-08-15
- 稿件说明：
移动端阅览
郭永坤, 刘春颖, 杨艺, 等. 长时程重复高精度经颅直流电刺激对微意识状态患者意识恢复的影响[J]. 第三军医大学学报, 2021,43(15):1454-1459.

Yongkun GUO, Chunying LIU, Yi YANG, et al. Effect of long-lasting repeated high-definition transcranial direct current stimulation on consciousness recovery in minimally conscious state patients[J]. Journal of Third Military Medical University, 2021, 43(15): 1454-1459.
郭永坤, 刘春颖, 杨艺, 等. 长时程重复高精度经颅直流电刺激对微意识状态患者意识恢复的影响[J]. 第三军医大学学报, 2021,43(15):1454-1459. DOI： 10.16016/j.1000-5404.202102118.

Yongkun GUO, Chunying LIU, Yi YANG, et al. Effect of long-lasting repeated high-definition transcranial direct current stimulation on consciousness recovery in minimally conscious state patients[J]. Journal of Third Military Medical University, 2021, 43(15): 1454-1459. DOI： 10.16016/j.1000-5404.202102118.

摘要

目的

探讨长时程重复高精度经颅直流电刺激(high-definition transcranial direct current stimulation，HD-tDCS)调控楔前叶对微意识状态(minimally conscious state，MCS)患者意识恢复的影响。

方法

采用前瞻性病例对照研究设计，共纳入40例MCS患者，HD-tDCS组20例，对照组20例。对照组给予常规治疗，HD-tDCS组在常规治疗基础上应用HD-tDCS的治疗，刺激靶点为楔前叶，刺激电流为2 mA，单次刺激时间为20 min，每日2次，14 d，共28次。记录所有入组患者的性别、年龄、昏迷时长，入组患者基线(T0)、单次刺激(T1)、刺激第7天(T2)、第14天(T3)的修订版昏迷恢复量表(Coma Recovery Scale-Revised

CRS-R)及子量表评分。

结果

与对照组相比，HD-tDCS组在T3时CRS-R评分明显高于对照组，差异有统计学意义(

0.05)。对照组内有2例MCS患者在T3时出现新的意识行为；与T0相比，CRS-R评分分值在T1、T2、T3均无明显提高。HD-tDCS组内有17例MCS患者HD-tDCS治疗后出现新的意识行为表现；与T0相比，HD-tDCS组MCS患者CRS-R评分分值在T1、T2、T3有不同程度的提高，差异有统计学意义(

0.05)，子量表中视觉、听觉、运动评分在T2、T3时显著升高，差异有统计学意义(

0.01)。

结论

长时程重复HD-tDCS调控楔前叶，可以促进MCS患者在调控第14天时的意识恢复，特别是在视觉、听觉、运动等意识行为方面有显著的恢复。

Abstract

Objective

To assess the efficacy of long-lasting repeated high-definition transcranial direct current stimulation (HD-tDCS) over the precuneus on consciousness recovery in patients with minimally conscious state (MCS).

Methods

A prospective case-control study was carried out on 40 MCS patients admitted in the Fifth Affiliated Hospital of Zhengzhou University from June 2018 to January 2021. They were randomly divided into HD-tDCS group (

=20) and control group (

=20). The patients in the control group received routine treatment

while those in the HD-tDCS group were treated with HD-tDCS protocol over the precuneus (at 2 mA

for 20 min per time

twice per day for 14 d

with totally 28 sessions) on the basis of routine treatment. Gender

age

duration of consciousness

Coma Recovery Scale-Revised (CRS-R) scores before (T0)

and at a single session (T1)

7 d (T2)

and 14 d (T3) were recorded and analyzed.

Results

The CRS-R score at T3 was significantly higher in the HD-tDCS group than the control group (

0.05). In the control group

2 MCS patients demonstrated a new sign of consciousness at T3

and the CRS-R scores at T1

T2 and T3 were not significantly changed than

those at T0. While in the HD-tDCS group

17 patients showed a new sign of consciousness

and the CRS-R scores at T1

and T3 were obviously increased when compared with those at T0 (

0.05). And the scores of visual

auditory and motor subscales at T3 were also statistically elevated than the scores at baseline (

0.01).

Conclusion

Long-lasting repeated HD-tDCS over the precuneus improves the recovery of consciousness in MCS patients at the 14th day of neuromodulation

especially in the visual

auditory and motor aspects of conscious behaviors.

关键词

Keywords

references

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