Behavioral and Neurophysiological Effects of Repetitive Transcranial Magnetic Stimulation on the Minimally Conscious State
- 20 July 2010
- journal article
- case report
- Published by SAGE Publications in Neurorehabilitation and Neural Repair
- Vol. 25 (1), 98-102
- https://doi.org/10.1177/1545968310369802
Abstract
Background. In 2007, Schiff et al reported a patient in a minimally conscious state (MCS) who responded to deep brain stimulation (DBS), but clinicians cannot predict which patients might respond prior to the implantation of electrodes. Methods. A patient in a MCS for 5 years participated in an ABA design alternating between repetitive transcranial magnetic stimulation (rTMS) and peripheral nerve stimulation. rTMS (condition A) involved the delivery of 10 trains of 100 stimuli at 20 Hz using a stimulator with a 70-mm figure-of-eight coil to elicit a contraction of the abductor pollicis brevis. Condition B used median nerve electrical stimulation. Results. After peripheral stimulation, the patient did not exhibit clinical, behavioral, or electroencephalographic (EEG) changes. The frequency of specific and meaningful behaviors increased after rTMS, along with the absolute and relative power of the EEG δ, β, and α bands. Conclusion. These results suggest that rTMS may improve awareness and arousal in MCS. If these results are reproducible, rTMS may identify subgroups of MCS patients who might benefit from DBS.Keywords
This publication has 27 references indexed in Scilit:
- Cortical sources of resting-state alpha rhythms are abnormal in persistent vegetative state patientsClinical Neurophysiology, 2009
- Disorders of consciousness: further pathophysiological insights using motor cortex transcranial magnetic stimulationArts and The Brain: Psychology and Physiology Beyond Pleasure, 2009
- Repetitive transcranial magnetic stimulation-associated neurobehavioral gains during coma recoveryBrain Stimulation, 2009
- Brain function in the minimally conscious state: A quantitative neurophysiological studyClinical Neurophysiology, 2008
- Modulation of cortical oscillatory activity during transcranial magnetic stimulationHuman Brain Mapping, 2007
- Modulation of cortical oscillatory activities induced by varying single-pulse transcranial magnetic stimulation intensity over the left primary motor area: A combined EEG and TMS studyNeuroImage, 2005
- Neurophysiological correlates of persistent vegetative and minimally conscious statesNeuropsychological Rehabilitation, 2005
- Functional relationship between human rolandic oscillations and motor cortical excitability: an MEG studyEuropean Journal of Neuroscience, 2005
- The minimally conscious stateNeurology, 2002
- EEG alpha and theta oscillations reflect cognitive and memory performance: a review and analysisBrain Research Reviews, 1999