NeuroImage · 2026
Spinal cord stimulation improves brain connectivity and consciousness level in patients with disorders of consciousness.
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Aihemaitiniyazi Adilijiang, Li Tiemin, Zhang Huawei, Wei Da, Cai Pu, Wang Wei, Luan Guoming, Wang Yong, Liu Changqing
Аннотация
OBJECTIVE: Spinal cord stimulation (SCS) is an advanced neuromodulation technology in disorders of consciousness (DOC) field. However, research on the modulation effects and mechanisms of SCS is limited.
METHOD: We proposed a study design (SCS and sham) to study the short-term effects of 20 minutes' SCS, in which resting state EEG and Coma Recovery Scale-Revised (CRS-R) were used to measure the changes in neural and behavioral activity caused by SCS. We used the Genuine Permutation Cross Mutual Information(G_PCMI) to analyze EEG data and study changes in cortical connectivity during SCS. Finally, all patients' CRS-R results were obtained after 6 months' SCS treatment.
RESULTS: Short-term SCS (20 min) did not alter the patient's CRS-R score, but long-term SCS (6 months) can improve the CRS-R scores of all patients. EEG results show G_PCMI of the frontal and central brain regions significantly change before and after short-term SCS (p < 0.01) and PCMI of the F-P, F-O regions have significant differences before and after short-term SCS (p < 0.05). Besides, the G_PCMI changes in frontal, parietal, F-P and F-O regions show a significant positive correlation with CRS-R changes (r = 0.80, 0.66, 0.68 and 0.72; p < 0.05). However, the sham group showed no significant G_PCMI changes.
CONCLUSION: SCS can improve the awareness level of DOC patients. SCS improves cortical short- and long-distance connectivity of DOC patients may contribute the improvement of consciousness level.
METHOD: We proposed a study design (SCS and sham) to study the short-term effects of 20 minutes' SCS, in which resting state EEG and Coma Recovery Scale-Revised (CRS-R) were used to measure the changes in neural and behavioral activity caused by SCS. We used the Genuine Permutation Cross Mutual Information(G_PCMI) to analyze EEG data and study changes in cortical connectivity during SCS. Finally, all patients' CRS-R results were obtained after 6 months' SCS treatment.
RESULTS: Short-term SCS (20 min) did not alter the patient's CRS-R score, but long-term SCS (6 months) can improve the CRS-R scores of all patients. EEG results show G_PCMI of the frontal and central brain regions significantly change before and after short-term SCS (p < 0.01) and PCMI of the F-P, F-O regions have significant differences before and after short-term SCS (p < 0.05). Besides, the G_PCMI changes in frontal, parietal, F-P and F-O regions show a significant positive correlation with CRS-R changes (r = 0.80, 0.66, 0.68 and 0.72; p < 0.05). However, the sham group showed no significant G_PCMI changes.
CONCLUSION: SCS can improve the awareness level of DOC patients. SCS improves cortical short- and long-distance connectivity of DOC patients may contribute the improvement of consciousness level.