Current Status of Neuromodulatory Therapies for Disorders of Consciousness
Xiaoyu Xia1 • Yi Yang1 • Yongkun Guo2 • Yang Bai3 • Yuanyuan Dang1 • Ruxiang Xu1 • Jianghong He1,*
1Department of Neurosurgery, PLA Army General Hospital, Beijing 100700, China
2Department of Neurosurgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450007, China
3International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou 311121, China
Abstract
Treatment for disorders of consciousness (DOCs) is still a Gordian knot. Evidence-based guidelines on the treatment of DOC patients are not currently available, while neuromodulation techniques are seen as a potential treatment. Multiple neuromodulation therapies have been applied. This article reviews the most relevant studies in the literature in order to describe a clear picture of the current state of neuromodulation therapies that could be used to treat DOC patients. Both invasive and non-invasive brain stimulation is discussed. Significant behavioral improvements in prolonged DOCs under neuromodulation therapies are rare. The efficacy of various such therapies remains a matter of debate. Further clinical investigations of existing techniques in larger samples properly controlling for spontaneous recovery are needed, and new approaches are awaited.
Keywords
Disorder of consciousness; Neuromodulation; Deep brain stimulation; Spinal cord stimulation; Repetitive transcranial magnetic stimulation; Transcranial direct current stimulation
