ID 163 – Prefrontal transcranial direct current stimulation in patients with disorders of consciousness – A case series study

Disorders of consciousness (DOC) as a result of global anoxic damage affect the level of awareness and expression of goal-directed behaviors. However, recent experience suggests that noninvasive brain stimulation, in some individuals can lead to improving the level of consciousness impairment. The aim of this prospective case series study was to analyze the clinical and electrophysiologic markers of outcome after treatment with transcranial direct current stimulation (tDCS). Two patients (19 and 20 yrs) with minimally conscious state (MCS), duration longer than 12 months, and one in subacute coma (76 yrs), were treated with pre-frontal tDCS for three weeks, and followed up for two months. The rate of functional recovery on the JFK Coma Recovery Scale Revised, was estimated as well as quantitative EEG parameters. In two MCS patients during the follow-up period sustainable tDCS-related gain of 4 and 3 points on JFK CRS-R, respectively were recorded. The older patient who was initially comatose (GCS = 3) after treatment showed marked improvement (GCS = 13, JFK CRS-R = 26). Adverse effects of procedure were not observed. Consistent improvement of various magnitudes, which was recorded in the patients and the absence of adverse effects encourage further application of the pre-frontal tDCS in patients with disorders of consciousness.