Dynamic Changes of Brain Activity in Patients With Disorders of Consciousness During Recovery of Consciousness

The disorder of brain activity dynamics is one of the main characteristics leading to disorders of consciousness (DOC). However, few studies have explored whether the dynamics of brain activity can be modulated, and whether the dynamics of brain activity can help to evaluate the state of consciousness and the recovery progress of consciousness. In current study, 20 patients with minimally conscious state (MCS) and 13 patients with vegetative state (VS) were enrolled, and resting state electroencephalogram (EEG) data and the coma recovery scale-revised (CRS-R) scores were collected three times before and after high-definition transcranial direct current stimulation (HD-tDCS) treatment. The patients were divided into the improved group and the unimproved group according to whether the CRS-R scores were improved after the treatment, and the dynamic changes of resting state EEG microstate parameters during treatment were analyzed. The results showed the occurrence per second (OPS) of microstate D was significantly different between the MCS group and VS group, and it was positively correlated with the CRS-R before the treatment. After 2 weeks of the treatment, the OPS of microstate D improved significantly in the improved group. Meanwhile, the mean microstate duration (MMD), ratio of time coverage (Cov) of microstate C and the Cov of microstate D were significantly changed after the treatment. Compared with the microstates parameters before the treatment, the dynamic changes of parameters with significant difference in the improved group showed a consistent trend after the treatment. In contrast, the microstates parameters did not change significantly after the treatment in the unimproved group. The results suggest that the dynamics of EEG brain activity can be modulated by HD-tDCS, and the improvement in brain activity dynamics is closely related to the recovery of DOC, which is helpful to evaluate the level of DOC and the progress of recovery of consciousness.