Single tDCS session of motor cortex in patients with disorders of consciousness: a pilot study

peer reviewedPrimary Objective: Patients with disorders of consciousness (DOC) face a lack of treatments and risk ofmisdiagnosis, potentially due to motor impairment. Transcranial direct current stimulation (tDCS)showed promising results over the prefrontal cortex in DOC and over the primary motor cortex (M1)in stroke. Tis pilot study aimed at evaluating the behavioral effects of M1 tDCS in patients with DOC.Research Design: In this randomized double-blind sham-controlled crossover trial, we included 10patients (49 ± 22 years, 7 ± 13 months since injury, 4 unresponsive wakefulness syndrome, 6 minimallyconscious state, 5 traumatic etiologies).Methods and Procedures: One session of tDCS (2 mA for 20 min) and one session of sham tDCS wereapplied over M1 in a randomized order with a washout period of minimum 24 h and behavioral effectswere assessed using the CRS-R. At the group level, no treatment effect was identified on the total score(p= .55) and on the motor subscale (p= .75). Two patients responded to tDCS by showing a new sign ofconsciousness (visual pursuit and object localization).Conclusions: One session of M1 tDCS failed to improve behavioral responsiveness in patients with DOC.Other application strategies should be tested