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Published on: August 20, 2019
Parietal rTMS Induced Changes in Cortical Excitability in Patients With Minimally Conscious State Using TMS-EEG
Ye Zhang1, Xiaoping Wan1, Yong Wang2
1Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, Beijing, China.
Objective:
To verify the effectiveness of the parietal repetitive transcranial magnetic stimulation (rTMS) and take advantage of TMS-EEG to assess cortical excitability in patients with minimally conscious states (MCS).
Methods:
We enrolled 10 MCS patients who received 10 sessions of 10 Hz rTMS on the parietal cortex for 10 consecutive days and then 10 days of sham stimulation after a 14-day wash-out period. The Coma Recovery Scale-Revised (CRS-R) and TMS-EEG were used to assess the levels of consciousness and cortical excitability before and after active and sham stimulation, respectively.
Results:
Compared to sham stimulation, the CRS-R revealed a significant improvement after receiving active rTMS. The amplitude of components of TMS-evoked potential after active stimulation significantly increased at 30, 60, and 180 ms, respectively; global brain power increased significantly. The PCIst values had a significant difference after active rTMS stimulation, and the CRS-R scores showed a significant correlation with PCIst values before and after active stimulation.
Conclusion:
High-frequency rTMS on the parietal cortex has therapeutic efficacy and can improve cortical excitability in MCS patients.
Significance:
Our results provide preliminary evidence to support the use of the parietal area as a potential therapeutic target for MCS patients in clinical practice.
