PMID- 37693756
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230913
IS  - 1664-2295 (Print)
IS  - 1664-2295 (Electronic)
IS  - 1664-2295 (Linking)
VI  - 14
DP  - 2023
TI  - Effects of simultaneous transcutaneous auricular vagus nerve stimulation and 
      high-definition transcranial direct current stimulation on disorders of 
      consciousness: a study protocol.
PG  - 1165145
LID - 10.3389/fneur.2023.1165145 [doi]
LID - 1165145
AB  - BACKGROUND: Non-invasive brain stimulation (NIBS) techniques are now widely used 
      in patients with disorders of consciousness (DOC) for accelerating their recovery 
      of consciousness, especially minimally conscious state (MCS). However, the 
      effectiveness of single NIBS techniques for consciousness rehabilitation needs 
      further improvement. In this regard, we propose to enhance from bottom to top the 
      thalamic-cortical connection by using transcutaneous auricular vagus nerve 
      stimulation (taVNS) and increase from top to bottom cortical-cortical connections 
      using simultaneous high-definition transcranial direct current stimulation 
      (HD-tDCS) to reproduce the network of consciousness. METHODS/DESIGN: The study 
      will investigate the effect and safety of simultaneous joint stimulation (SJS) of 
      taVNS and HD-tDCS for the recovery of consciousness. We will enroll 84 MCS 
      patients and randomize them into two groups: a single stimulation group (taVNS 
      and HD-tDCS) and a combined stimulation group (SJS and sham stimulation). All 
      patients will undergo a 4-week treatment. The primary outcome will be assessed 
      using the coma recovery scale-revised (CRS-R) at four time points to quantify the 
      effect of treatment: before treatment (T0), after 1 week of treatment (T1), after 
      2 weeks of treatment (T2), and after 4 weeks of treatment (T3). At the same time, 
      nociception coma scale-revised (NCS-R) and adverse effects (AEs) will be 
      collected to verify the safety of the treatment. The secondary outcome will 
      involve an analysis of electroencephalogram (EEG) microstates to assess the 
      response mechanisms of dynamic brain networks to SJS. Additionally, CRS-R and AEs 
      will continue to be obtained for a 3-month follow-up (T4) after the end of the 
      treatment. DISCUSSION: This study protocol aims to innovatively develop a 
      full-time and multi-brain region combined neuromodulation paradigm based on the 
      mesocircuit model to steadily promote consciousness recovery by restoring 
      thalamocortical and cortical-cortical interconnections.
CI  - Copyright (c) 2023 Zhuang, Zhai, Li, Jiao, Ge, Rong and He.
FAU - Zhuang, Yutong
AU  - Zhuang Y
AD  - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, China.
AD  - Department of Neurosurgery, The Second Clinical College of Southern Medical 
      University, Guangzhou, China.
FAU - Zhai, Weihang
AU  - Zhai W
AD  - Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical 
      Sciences, Beijing, China.
FAU - Li, Qinghua
AU  - Li Q
AD  - College of Anesthesiology, Shanxi Medical University, Taiyuan, China.
FAU - Jiao, Haoyang
AU  - Jiao H
AD  - Institute of Documentation, Chinese Academy of Traditional Chinese Medicine, 
      Beijing, China.
FAU - Ge, Qianqian
AU  - Ge Q
AD  - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, China.
FAU - Rong, Peijing
AU  - Rong P
AD  - Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical 
      Sciences, Beijing, China.
FAU - He, Jianghong
AU  - He J
AD  - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, China.
LA  - eng
PT  - Journal Article
DEP - 20230824
PL  - Switzerland
TA  - Front Neurol
JT  - Frontiers in neurology
JID - 101546899
PMC - PMC10483839
OTO - NOTNLM
OT  - EEG microstate
OT  - disorders of consciousness
OT  - high-definition transcranial direct current stimulation
OT  - simultaneous stimulation
OT  - transcutaneous auricular vagus nerve stimulation
COIS- The authors declare that the research will be conducted in the absence of any 
      commercial or financial relationships that will be construed as a potential 
      conflict of interest.
EDAT- 2023/09/11 06:43
MHDA- 2023/09/11 06:44
PMCR- 2023/08/24
CRDT- 2023/09/11 04:59
PHST- 2023/03/15 00:00 [received]
PHST- 2023/08/08 00:00 [accepted]
PHST- 2023/09/11 06:44 [medline]
PHST- 2023/09/11 06:43 [pubmed]
PHST- 2023/09/11 04:59 [entrez]
PHST- 2023/08/24 00:00 [pmc-release]
AID - 10.3389/fneur.2023.1165145 [doi]
PST - epublish
SO  - Front Neurol. 2023 Aug 24;14:1165145. doi: 10.3389/fneur.2023.1165145. 
      eCollection 2023.