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Updated: May 7, 2026
Simultaneous EEG Monitoring During Transcranial Direct Current Stimulation
Published on: June 17, 2013
Transcranial direct current stimulation effects in disorders of consciousness
Efthymios Angelakis1, Evangelia Liouta1, Nikos Andreadis2
1Hellenic Center for Neurosurgical Research "Prof. Petros Kokkalis," Athens, Greece; Evangelismos Hospital, Department of Neurosurgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
Objective:
To assess the efficacy of transcranial direct current stimulation (tDCS) on improving consciousness in patients with persistent unresponsive wakefulness syndrome (UWS) (previously termed persistent vegetative state [PVS]) or in a minimally conscious state (MCS).
Design:
Prospective, case series trial with follow-up at 12 months.
Setting:
General and research hospital.
Participants:
Inpatients in a PVS/UWS or MCS (N=10; 7 men, 3 women; age range, 19-62y; etiology: traumatic brain injury, n=5; anoxia, n=4; postoperative infarct, n=1; duration of PVS/UWS or MCS range, 6mo-10y). No participant withdrew because of adverse effects.
Intervention:
All patients received sham tDCS for 20 minutes per day, 5 days per week, for 1 week, and real tDCS for 20 minutes per day, 5 days per week, for 2 weeks. An anodal electrode was placed over the left primary sensorimotor cortex or the left dorsolateral prefrontal cortex, with cathodal stimulation over the right eyebrow. One patient in an MCS received a second round of 10 tDCS sessions 3 months after initial participation.
Main Outcome Measure:
JFK Coma Recovery Scale-Revised.
Results:
All patients in an MCS showed clinical improvement immediately after treatment. The patient who received a second round of tDCS 3 months after initial participation showed further improvement and emergence into consciousness after stimulation, with no change between treatments. One patient who was in an MCS for <1 year before treatment (postoperative infarct) showed further improvement and emergence into consciousness at 12-month follow-up. No patient showed improvement before stimulation. No patient in a PVS/UWS showed immediate improvement after stimulation, but 1 patient who was in a PVS/UWS for 6 years before treatment showed improvement and change of status to an MCS at 12-month follow-up.
Conclusions:
tDCS seems promising for the rehabilitation of patients with severe disorders of consciousness. Severity and duration of pathology may be related to the degree of tDCS' beneficial effects.
