Effect of transcranial direct current stimulation for patients with disorders of consciousness: A systematic review and meta-analysis
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Updated: Aug 11, 2025
Transcranial Direct Current Stimulation and Simultaneous Functional Magnetic Resonance Imaging
Published on: April 27, 2014
Hui Ma1,2,3, Kehong Zhao1,2,3, Chengsen Jia1,3
1Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Introduction:
Transcranial direct current stimulation (tDCS) could potentially facilitate consciousness improvement in patients with disorders of consciousness (DOC). The aim of this study was to investigate the therapeutic efficacy of tDCS on consciousness recovery for patients with DOC.
Methods:
Eight databases were systematically searched from their inception to June 2022. Quality of included studies were assessed using PEDro score and Cochrane's risk of bias assessment. All statistical analyses were performed using RevMan software. Seventeen studies with 618 patients were identified eligible for this study, and fifteen studies with sufficient data were pooled in the meta-analysis.
Results:
The results of meta-analysis showed a significant effect on increasing GCS scores (MD = 1.73; 95% CI, 1.28-2.18; P < 0.01) and CRS-R scores (MD = 1.28; 95% CI = 0.56-2.00; P < 0.01) in favor of the real stimulation group as compared to sham. The results of subgroup analysis demonstrated that only more than 20 sessions of stimulation could significantly enhance the improvement of GCS scores and the CRS-R scores. Moreover, the effect of tDCS on CRS-R score improvement was predominant in patients with minimal conscious state (MCS) (MD = 1.84; 95% CI = 0.74-2.93; P < 0.01).
Conclusion:
Anodal tDCS with sufficient stimulation doses appears to be an effective approach for patients with MCS, in terms of CRS-R scores.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022336958.
