Parietal rTMS Induced Changes in Cortical Excitability in Patients With Minimally Conscious State Using TMS-EEG

IF 5 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2025-09-04 DOI:10.1111/cns.70583

Ye Zhang, Xiaoping Wan, Yong Wang, Xiaoli Li, Jubao Du, Xiao Yan, Zilong Zhu, Yanhua Li, Weiqun Song

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引用次数: 0

Abstract

Objective

To verify the effectiveness of the parietal repetitive transcranial magnetic stimulation (rTMS) and take advantage of TMS-EEG to assess cortical excitability in patients with minimally conscious states (MCS).

Methods

We enrolled 10 MCS patients who received 10 sessions of 10 Hz rTMS on the parietal cortex for 10 consecutive days and then 10 days of sham stimulation after a 14-day wash-out period. The Coma Recovery Scale-Revised (CRS-R) and TMS-EEG were used to assess the levels of consciousness and cortical excitability before and after active and sham stimulation, respectively.

Results

Compared to sham stimulation, the CRS-R revealed a significant improvement after receiving active rTMS. The amplitude of components of TMS-evoked potential after active stimulation significantly increased at 30, 60, and 180 ms, respectively; global brain power increased significantly. The PCIst values had a significant difference after active rTMS stimulation, and the CRS-R scores showed a significant correlation with PCIst values before and after active stimulation.

Conclusion

High-frequency rTMS on the parietal cortex has therapeutic efficacy and can improve cortical excitability in MCS patients.

Significance

Our results provide preliminary evidence to support the use of the parietal area as a potential therapeutic target for MCS patients in clinical practice.

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顶叶rTMS诱导最低意识状态患者皮质兴奋性的变化

目的验证顶叶重复经颅磁刺激（rTMS）的有效性，并利用TMS-EEG评估最低意识状态（MCS）患者的皮质兴奋性。方法10例MCS患者连续10天在顶叶皮层接受10次10hz rTMS，然后在14天的冲洗期后进行10天的假刺激。采用昏迷恢复量表（CRS-R）和TMS-EEG分别评估活动刺激和假刺激前后的意识水平和皮层兴奋性。结果与假刺激相比，主动rTMS后CRS-R有明显改善。主动刺激后的tms诱发电位各成分幅值分别在30、60和180 ms时显著升高；全球脑力显著增长。主动rTMS刺激后PCIst值存在显著差异，CRS-R评分与主动刺激前后PCIst值存在显著相关。结论顶叶高频rTMS对MCS患者的皮质兴奋性有改善作用。意义本研究结果为临床应用顶叶区作为MCS患者的潜在治疗靶点提供了初步证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.