Dual-Site Transcranial Magnetic Stimulation Improves Consciousness in Patients with Disorders of Consciousness.

Design

As the cerebellum has reciprocal communications with the frontal cortex, this retrospective cohort study examined the effects of dual-site repetitive transcranial magnetic stimulation (ds-rTMS: dorsolateral prefrontal cortex [DLPFC] + cerebellum) in disorders of consciousness (DoC).

Setting

Single-center study in the Department of Rehabilitation of Jinhua Hospital of TCM Affiliated to Zhejiang University of Traditional Chinese Medicine.

Participants

Twenty-nine patients with DoC. Intervention: Systematic review of clinical records comparing ds-TMS (DLPFC + cerebellum) with conventional single-site DLPFC-rTMS. Main Measures: Coma Recovery Scale-Revised (CRS-R) scores, mismatch negativity (MMN) latency, P300 latency, Judson grade, and Hall grade.

Results

ds-TMS was associated with larger gains in consciousness (CRS-R scores) compared with DLPFC-rTMS in a retrospective cohort. Both interventions had comparable improvement in cognitive and somatosensory outcomes (MMN, P300, and Judson/Hall grades). Higher CRS-R scores correlated with shorter MMN latency and better Hall grades.

Conclusions

ds-TMS treatment may represent an effective therapeutic approach for DoC, with potential effects on consciousness recovery.