TBI Clinical Trial
Official title:
Transcranial Direct Current Stimulation (tDCS) Effects in Patients With Chronic Consciousness Disorders
Chronic consciousness disorders have high level of impact on public health and its costs.
Consciousness disorders have high impact on society and national health system. One of these
disorders is vegetative condition in which, as in coma, there isn't any self or
environmental consciousness but there is alertness, whereas in minimal state of
consciousness at least part of awareness is conserved.
In Emilia Romagna region about 80 people per million of inhabitants are hospitalized after
cerebral damage, and after discharge about 1/5 of patients are stabilized in a consciousness
disorder.
The diagnosis of these disorders is based on neurobehavioural tests, for example JFK Coma
Recovery Scale Revised (CRS-R).
In these patients recovery of state of consciousness is one of the main challenges. There
are very little evidences about treatment, it has been proposed the use of therapies that
could modulate central nervous system activity, like specific drugs, neuroimaging and
neuromodulation techniques such as transcranial magnetic stimulation and repetitive
transcranial current stimulation.
A non invasive neuromodulation technique is transcranial direct current stimulation (tDCS)
which can modulate cortical excitability: cathodic current reduces excitability whereas
anodic current increases it.
In conclusion, tDCS is an easy technique to use, it's not invasive and it's an efficient
tool for the modulation of cortical excitability that demonstrated reliable results in
healthy subjects.
As the tDCS can modulate cortical excitability it is likely that the combination of this
stimulation tool with transcranial magnetic stimulation for the registration of cortical
excitability could give important information about cerebral damage in patients with
consciousness disorders and to test new treatments. It is also likely that the modification
of cortical excitability could induce neurobehavioural changes.
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