Transcranial Direct Current Stimulation in Patients With Disorders of Consciousness (tDCS in DOC)
Transcranial Direct Current Stimulation in Patients With Disorders of Consciousness: a Sham-controlled Randomised Double Blind Study
研究概览
详细说明
Following severe brain damage and coma, some patients may remain in a vegetative state (VS) or minimally conscious state (MCS). At present, there are no evidence-based guidelines regarding the treatment of patients with disorders of consciousness (DOC).
Investigator aim to assess the effect of single session anodal (i.e., excitatory) transcranial direct current stimulation (tDCS) of the left dorsolateral prefrontal cortex (DLPF) on the level of consciousness in DOC patients in a double blind randomized sham controlled study.
tDCS is a form of safe non-invasive cortical stimulation, modulating cortical excitability at stimulation sites via weak polarizing currents, previously reported to transiently improve working memory and attention by stimulating the left DLPF in healthy subjects and patients with stroke, Parkinson's or Alzheimer's disease.
研究类型
注册 (实际的)
阶段
- 阶段2
联系人和位置
学习地点
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Liège、比利时、4000
- University Hospital of Liege
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- post-comatose patients
- patients in vegetative/unresponsive or minimally conscious state
- patients with stable cardiorespiratory parameters
- patients free of sedative drugs and Na+ or Ca++ channel blockers (e.g., carbamazepine) or NMDA receptor antagonists (e.g., dextromethorphan)
Exclusion Criteria:
- premorbit neurology antecedent
- patients in coma or <1week after the acute brain insult
- patients with a metallic cerebral implant or a pacemaker (in line with the safety criteria for tDCS in humans)
学习计划
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：交叉作业
- 屏蔽：三倍
武器和干预
参与者组/臂 |
干预/治疗 |
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有源比较器：Anodal tDCS
Patients received anodal tDCS (on DLPF cortex) during 20 minutes preceded and followed by a clinical assessment (Coma Recovery Scale-Revised)
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patients received anodal tDCS (on PFDL cortex) during 20 minutes preceded and followed by a behavioral assessment (Coma Recovery Scale Revised)
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假比较器：sham tDCS
Patient received a sham tDCS (5sec of stimulation).
The device runs during 20minutes and the anode was placed over the DLPF cortex.
A behavioral assessment preceded and followed the stimulation.
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Patient received a sham tDCS (5sec of stimulation).
The device runs during 20minutes and the anode was placed over the DLPF cortex.
A behavioral assessment preceded and followed the stimulation.
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研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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Change in CRS-R Total Scores
大体时间：Baseline and directly after the tDCS (20 minutes)
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At the group level, assess the modification of CRS-R total scores in anodal tDCS as compared to sham stimulation in VS/UWS and MCS populations The Coma Recovery Scale Revised (CRS-R) is a behavioral scale performed at the patient's bedside. It consists of 23 hierarchically arranged items that comprise 6 subscales addressing auditory, visual, motor, verbal, communication, and arousal functions. Scoring is based on the presence or absence of specific behavioral responses to sensory stimuli administered in a standardized manner. Maximum scores of each subscale are summed to obtain the total score (from 0 to 23). The lowest item on each subscale represents reflexive activity, whereas the highest items represent cognitively mediated behaviors. |
Baseline and directly after the tDCS (20 minutes)
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次要结果测量
结果测量 |
大体时间 |
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Influence of Diagnosis on the Results
大体时间：participants will be followed for the duration of 1 year
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participants will be followed for the duration of 1 year
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Influence of Etiology on the Results
大体时间：participants will be followed for the duration of 1 year
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participants will be followed for the duration of 1 year
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Influence of Time Since Insult on the Results
大体时间：participants will be followed for the duration of 1 year
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participants will be followed for the duration of 1 year
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合作者和调查者
调查人员
- 学习椅：Steven Laureys, MD, PhD、Coma Science Group, Cyclotron Research Centre, University and University Hospital of Liège
出版物和有用的链接
一般刊物
- Ferrucci R, Mameli F, Guidi I, Mrakic-Sposta S, Vergari M, Marceglia S, Cogiamanian F, Barbieri S, Scarpini E, Priori A. Transcranial direct current stimulation improves recognition memory in Alzheimer disease. Neurology. 2008 Aug 12;71(7):493-8. doi: 10.1212/01.wnl.0000317060.43722.a3. Epub 2008 Jun 4.
- Boggio PS, Ferrucci R, Rigonatti SP, Covre P, Nitsche M, Pascual-Leone A, Fregni F. Effects of transcranial direct current stimulation on working memory in patients with Parkinson's disease. J Neurol Sci. 2006 Nov 1;249(1):31-8. doi: 10.1016/j.jns.2006.05.062. Epub 2006 Jul 14.
- Fregni F, Boggio PS, Nitsche M, Bermpohl F, Antal A, Feredoes E, Marcolin MA, Rigonatti SP, Silva MT, Paulus W, Pascual-Leone A. Anodal transcranial direct current stimulation of prefrontal cortex enhances working memory. Exp Brain Res. 2005 Sep;166(1):23-30. doi: 10.1007/s00221-005-2334-6. Epub 2005 Jul 6.
- Nitsche MA, Liebetanz D, Lang N, Antal A, Tergau F, Paulus W. Safety criteria for transcranial direct current stimulation (tDCS) in humans. Clin Neurophysiol. 2003 Nov;114(11):2220-2; author reply 2222-3. doi: 10.1016/s1388-2457(03)00235-9. No abstract available.
- Multi-Society Task Force on PVS. Medical aspects of the persistent vegetative state (1). N Engl J Med. 1994 May 26;330(21):1499-508. doi: 10.1056/NEJM199405263302107.
- Giacino JT, Ashwal S, Childs N, Cranford R, Jennett B, Katz DI, Kelly JP, Rosenberg JH, Whyte J, Zafonte RD, Zasler ND. The minimally conscious state: definition and diagnostic criteria. Neurology. 2002 Feb 12;58(3):349-53. doi: 10.1212/wnl.58.3.349.
- Nitsche MA, Fricke K, Henschke U, Schlitterlau A, Liebetanz D, Lang N, Henning S, Tergau F, Paulus W. Pharmacological modulation of cortical excitability shifts induced by transcranial direct current stimulation in humans. J Physiol. 2003 Nov 15;553(Pt 1):293-301. doi: 10.1113/jphysiol.2003.049916. Epub 2003 Aug 29.
- Kang EK, Kim DY, Paik NJ. Transcranial direct current stimulation of the left prefrontal cortex improves attention in patients with traumatic brain injury: a pilot study. J Rehabil Med. 2012 Apr;44(4):346-50. doi: 10.2340/16501977-0947.
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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意识障碍的临床试验
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Swansea University完全的
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Scripps Translational Science Institute完全的
Anodal tDCS的临床试验
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Universidad de AlmeriaSecretaría General de Universidades, Investigación y Tecnología, Junta de Andalucía, Spain邀请报名
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University of North Carolina, Chapel HillNational Institute of Mental Health (NIMH)完全的
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Northeastern UniversityMassachusetts General Hospital; National Institute on Aging (NIA)未知
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Shirley Ryan AbilityLabNational Institute on Disability, Independent Living, and Rehabilitation Research招聘中
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University of California, Los AngelesNational Institute of Mental Health (NIMH)完全的