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1.
Sci Rep ; 14(1): 10593, 2024 05 08.
Article En | MEDLINE | ID: mdl-38719939

Previous research on the neural correlates of consciousness (NCC) in visual perception revealed an early event-related potential (ERP), the visual awareness negativity (VAN), to be associated with stimulus awareness. However, due to the use of brief stimulus presentations in previous studies, it remains unclear whether awareness-related negativities represent a transient onset-related response or correspond to the duration of a conscious percept. Studies are required that allow prolonged stimulus presentation under aware and unaware conditions. The present ERP study aimed to tackle this challenge by using a novel stimulation design. Male and female human participants (n = 62) performed a visual task while task-irrelevant line stimuli were presented in the background for either 500 or 1000 ms. The line stimuli sometimes contained a face, which needed so-called visual one-shot learning to be seen. Half of the participants were informed about the presence of the face, resulting in faces being perceived by the informed but not by the uninformed participants. Comparing ERPs between the informed and uninformed group revealed an enhanced negativity over occipitotemporal electrodes that persisted for the entire duration of stimulus presentation. Our results suggest that sustained visual awareness negativities (SVAN) are associated with the duration of stimulus presentation.


Consciousness , Electroencephalography , Evoked Potentials , Visual Perception , Humans , Male , Female , Consciousness/physiology , Visual Perception/physiology , Adult , Young Adult , Evoked Potentials/physiology , Photic Stimulation , Awareness/physiology , Evoked Potentials, Visual/physiology
2.
Nat Commun ; 15(1): 3906, 2024 May 09.
Article En | MEDLINE | ID: mdl-38724511

Sleepwalking and related parasomnias result from incomplete awakenings out of non-rapid eye movement sleep. Behavioral episodes can occur without consciousness or recollection, or in relation to dream-like experiences. To understand what accounts for these differences in consciousness and recall, here we recorded parasomnia episodes with high-density electroencephalography (EEG) and interviewed participants immediately afterward about their experiences. Compared to reports of no experience (19%), reports of conscious experience (56%) were preceded by high-amplitude EEG slow waves in anterior cortical regions and activation of posterior cortical regions, similar to previously described EEG correlates of dreaming. Recall of the content of the experience (56%), compared to no recall (25%), was associated with higher EEG activation in the right medial temporal region before movement onset. Our work suggests that the EEG correlates of parasomnia experiences are similar to those reported for dreams and may thus reflect core physiological processes involved in sleep consciousness.


Dreams , Electroencephalography , Parasomnias , Humans , Dreams/physiology , Dreams/psychology , Male , Female , Adult , Parasomnias/physiopathology , Young Adult , Consciousness/physiology , Mental Recall/physiology , Sleep, REM/physiology , Middle Aged , Sleep/physiology
3.
Cogn Sci ; 48(5): e13453, 2024 05.
Article En | MEDLINE | ID: mdl-38742274

"Autonomous Sensory Meridian Response" (ASMR) refers to a sensory-emotional experience that was first explicitly identified and named within the past two decades in online discussion boards. Since then, there has been mounting psychological and neural evidence of a clustering of properties common to the phenomenon of ASMR, including convergence on the set of stimuli that trigger the experience, the properties of the experience itself, and its downstream effects. Moreover, psychological instruments have begun to be developed and employed in an attempt to measure it. Based on this empirical work, we make the case that despite its nonscientific origins, ASMR is a good candidate for being a real kind in the cognitive sciences. The phenomenon appears to have a robust causal profile and may also have an adaptive evolutionary history. We also argue that a more thorough understanding of the distinctive type of phenomenal experience involved in an ASMR episode can shed light on the functions of consciousness, and ultimately undermine certain "cognitive" theories of consciousness. We conclude that ASMR should be the subject of more extensive scientific investigation, particularly since it may also have the potential for therapeutic applications.


Consciousness , Humans , Consciousness/physiology , Emotions/physiology , Sensation/physiology
4.
PLoS Comput Biol ; 20(5): e1011350, 2024 May.
Article En | MEDLINE | ID: mdl-38701063

A fundamental challenge in neuroscience is accurately defining brain states and predicting how and where to perturb the brain to force a transition. Here, we investigated resting-state fMRI data of patients suffering from disorders of consciousness (DoC) after coma (minimally conscious and unresponsive wakefulness states) and healthy controls. We applied model-free and model-based approaches to help elucidate the underlying brain mechanisms of patients with DoC. The model-free approach allowed us to characterize brain states in DoC and healthy controls as a probabilistic metastable substate (PMS) space. The PMS of each group was defined by a repertoire of unique patterns (i.e., metastable substates) with different probabilities of occurrence. In the model-based approach, we adjusted the PMS of each DoC group to a causal whole-brain model. This allowed us to explore optimal strategies for promoting transitions by applying off-line in silico probing. Furthermore, this approach enabled us to evaluate the impact of local perturbations in terms of their global effects and sensitivity to stimulation, which is a model-based biomarker providing a deeper understanding of the mechanisms underlying DoC. Our results show that transitions were obtained in a synchronous protocol, in which the somatomotor network, thalamus, precuneus and insula were the most sensitive areas to perturbation. This motivates further work to continue understanding brain function and treatments of disorders of consciousness.


Brain , Computer Simulation , Consciousness Disorders , Magnetic Resonance Imaging , Models, Neurological , Humans , Magnetic Resonance Imaging/methods , Brain/physiopathology , Brain/diagnostic imaging , Consciousness Disorders/physiopathology , Consciousness Disorders/diagnostic imaging , Male , Female , Computational Biology , Adult , Middle Aged , Consciousness/physiology , Brain Mapping/methods , Aged
5.
Sci Rep ; 14(1): 10130, 2024 05 02.
Article En | MEDLINE | ID: mdl-38698150

While consciousness is typically considered equivalent to mental contents, certain meditation practices-including open monitoring (OM)-are said to enable a unique conscious state where meditators can experience mental content from a de-reified perspective as "ongoing phenomena." Phenomenologically, such a state is considered as reduction of intentionality, the mental act upon mental content. We hypothesised that this de-reified state would be characterised by reduced mental actional processing of affording objects. We recruited two groups of participants, meditators with long-term experience in cultivating a de-reified state, and demographically-matched novice meditators. Participants performed a task with images in two configurations-where objects did (high-affordance) and did not imply actions (low-affordance)-following both a baseline and OM-induced de-reified state, along with EEG recordings. While long-term meditators exhibited preferential processing of high-affordance images compared to low-affordance images during baseline, such an effect was abolished during the OM state, as hypothesised. For novices, however, the high-affordance configuration was preferred over the low-affordance one both during baseline and OM. Perceptual durations of objects across conditions positively correlated with the degree of µ-rhythm desynchronization, indicating that neural processing of affordance impacted perceptual awareness. Our results indicate that OM styles of meditation may help in mentally decoupling otherwise automatic cognitive processing of mental actions by affording objects.


Consciousness , Electroencephalography , Meditation , Humans , Male , Female , Adult , Meditation/psychology , Consciousness/physiology , Middle Aged , Mental Processes/physiology , Brain/physiology , Young Adult
6.
Sci Transl Med ; 16(745): eadj4303, 2024 May.
Article En | MEDLINE | ID: mdl-38691619

Consciousness is composed of arousal (i.e., wakefulness) and awareness. Substantial progress has been made in mapping the cortical networks that underlie awareness in the human brain, but knowledge about the subcortical networks that sustain arousal in humans is incomplete. Here, we aimed to map the connectivity of a proposed subcortical arousal network that sustains wakefulness in the human brain, analogous to the cortical default mode network (DMN) that has been shown to contribute to awareness. We integrated data from ex vivo diffusion magnetic resonance imaging (MRI) of three human brains, obtained at autopsy from neurologically normal individuals, with immunohistochemical staining of subcortical brain sections. We identified nodes of the proposed default ascending arousal network (dAAN) in the brainstem, hypothalamus, thalamus, and basal forebrain. Deterministic and probabilistic tractography analyses of the ex vivo diffusion MRI data revealed projection, association, and commissural pathways linking dAAN nodes with one another and with DMN nodes. Complementary analyses of in vivo 7-tesla resting-state functional MRI data from the Human Connectome Project identified the dopaminergic ventral tegmental area in the midbrain as a widely connected hub node at the nexus of the subcortical arousal and cortical awareness networks. Our network-based autopsy methods and connectivity data provide a putative neuroanatomic architecture for the integration of arousal and awareness in human consciousness.


Brain Stem , Consciousness , Magnetic Resonance Imaging , Wakefulness , Humans , Brain Stem/diagnostic imaging , Brain Stem/physiology , Wakefulness/physiology , Consciousness/physiology , Magnetic Resonance Imaging/methods , Multimodal Imaging/methods , Connectome , Neural Pathways/physiology , Male , Female , Diffusion Magnetic Resonance Imaging , Adult , Arousal/physiology
7.
Med Sci Monit ; 30: e943802, 2024 May 14.
Article En | MEDLINE | ID: mdl-38741355

BACKGROUND The thalamocortical tract (TCT) links nerve fibers between the thalamus and cerebral cortex, relaying motor/sensory information. The default mode network (DMN) comprises bilateral, symmetrical, isolated cortical regions of the lateral and medial parietal and temporal brain cortex. The Coma Recovery Scale-Revised (CRS-R) is a standardized neurobehavioral assessment of disorders of consciousness (DOC). In the present study, 31 patients with hypoxic-ischemic brain injury (HI-BI) were compared for changes in the TCT and DMN with consciousness levels assessed using the CRS-R. MATERIAL AND METHODS In this retrospective study, 31 consecutive patients with HI-BI (17 DOC,14 non-DOC) and 17 age- and sex-matched normal control subjects were recruited. Magnetic resonance imaging was used to diagnose HI-BI, and the CRS-R was used to evaluate consciousness levels at the time of diffusion tensor imaging (DTI). The fractional anisotropy (FA) values and tract volumes (TV) of the TCT and DMN were compared. RESULTS In patients with DOC, the FA values and TV of both the TCT and DMN were significantly lower compared to those of patients without DOC and the control subjects (p<0.05). When comparing the non-DOC and control groups, the TV of the TCT and DMN were significantly lower in the non-DOC group (p<0.05). Moreover, the CRS-R score had strong positive correlations with the TV of the TCT (r=0.501, p<0.05), FA of the DMN (r=0.532, p<0.05), and TV of the DMN (r=0.501, p<0.05) in the DOC group. CONCLUSIONS This study suggests that both the TCT and DMN exhibit strong correlations with consciousness levels in DOC patients with HI-BI.


Cerebral Cortex , Coma , Consciousness , Diffusion Tensor Imaging , Hypoxia-Ischemia, Brain , Thalamus , Humans , Female , Male , Middle Aged , Thalamus/physiopathology , Thalamus/diagnostic imaging , Hypoxia-Ischemia, Brain/physiopathology , Hypoxia-Ischemia, Brain/diagnostic imaging , Adult , Consciousness/physiology , Diffusion Tensor Imaging/methods , Cerebral Cortex/physiopathology , Cerebral Cortex/diagnostic imaging , Retrospective Studies , Coma/physiopathology , Coma/diagnostic imaging , Magnetic Resonance Imaging/methods , Default Mode Network/physiopathology , Default Mode Network/diagnostic imaging , Consciousness Disorders/physiopathology , Consciousness Disorders/diagnostic imaging , Aged
8.
Neurosci Biobehav Rev ; 161: 105670, 2024 Jun.
Article En | MEDLINE | ID: mdl-38615851

Consciousness science is marred by disparate constructs and methodologies, making it challenging to systematically compare theories. This foundational crisis casts doubts on the scientific character of the field itself. Addressing it, we propose a framework for systematically comparing consciousness theories by introducing a novel inter-theory classification interface, the Measure Centrality Index (MCI). Recognizing its gradient distribution, the MCI assesses the degree of importance a specific empirical measure has for a given consciousness theory. We apply the MCI to probe how the empirical measures of the Global Neuronal Workspace Theory (GNW), Integrated Information Theory (IIT), and Temporospatial Theory of Consciousness (TTC) would fare within the context of the other two. We demonstrate that direct comparison of IIT, GNW, and TTC is meaningful and valid for some measures like Lempel-Ziv Complexity (LZC), Autocorrelation Window (ACW), and possibly Mutual Information (MI). In contrast, it is problematic for others like the anatomical and physiological neural correlates of consciousness (NCC) due to their MCI-based differential weightings within the structure of the theories. In sum, we introduce and provide proof-of-principle of a novel systematic method for direct inter-theory empirical comparisons, thereby addressing isolated evolution of theories and confirmatory bias issues in the state-of-the-art neuroscience of consciousness.


Consciousness , Consciousness/physiology , Humans , Information Theory , Brain/physiology , Brain/physiopathology , Psychological Theory
10.
Sci Rep ; 14(1): 9316, 2024 04 23.
Article En | MEDLINE | ID: mdl-38654027

Floatation-REST (Reduced Environmental Stimulation Therapy) minimizes stimulation of the nervous system by immersing subjects in an environment without sound or light while they effortlessly float in thermoneutral water supersaturated with Epsom salt. Here we investigated the relationship between altered states of consciousness (ASC) and its association with the affective changes induced by Floatation-REST. Using a within-subject crossover design, 50 healthy subjects were randomized to 60 min of Floatation-REST or 60 min of Bed-REST (an active control condition that entailed lying supine on a warm waterbed in a dark and quiet room). Following Floatation-REST, subjects felt significantly more relaxed, less anxious, and less tired than after Bed-REST. Floatation-REST also induced significantly more pronounced ASC characterized by the dissolution of body boundaries and the distortion of subjective time. The loss of body boundaries mediated the loss of anxiety, revealing a novel mechanism by which Floatation-REST exerts its anxiolytic effect.


Consciousness , Humans , Male , Female , Adult , Consciousness/physiology , Anxiety , Young Adult , Cross-Over Studies , Bed Rest , Rest/physiology
11.
Neuroscience ; 546: 143-156, 2024 May 14.
Article En | MEDLINE | ID: mdl-38574798

Identifying the neural correlates of consciousness (NCCs) is an important way to understand the fundamental nature of consciousness. By recording event-related potentials (ERPs) using EEG, researchers have found three potential electrophysiological NCCs: early positive correlate of consciousness (enhanced P1), visual awareness negativity (VAN), and late positivity (LP). However, LP may reflect post-perceptual processing associated with subjective reports rather than consciousness per se. The present experiment investigated the relationship between LP and subjective reports. We adopted two subjective reporting tasks that differed in the requirement for subjective reports. In the low-frequency reporting task, participants needed to report whether they saw the target picture in 25% of trials, whereas in the high-frequency reporting task, participants needed to report whether they saw the target picture in each trial. Behavioral results showed that the hit rates were lower and false alarm rates were higher on reporting trials in low-frequency reporting tasks than on reporting trials in high-frequency reporting tasks. Unexpectedly, VAN was larger on reporting trials in the low-frequency reporting task than on reporting trials in the high-frequency reporting task. Importantly, our ERP results showed that LP was larger on reporting trials in the high-frequency reporting task than on reporting trials in the low-frequency reporting task. Thus, our findings indicated that when the frequency of reports was increased, the task relevance of the stimuli increased, which led to larger LP amplitudes. These findings suggest that LP correlates with subjective reports.


Electroencephalography , Evoked Potentials , Humans , Female , Male , Electroencephalography/methods , Young Adult , Evoked Potentials/physiology , Adult , Consciousness/physiology , Visual Perception/physiology , Photic Stimulation/methods , Brain/physiology , Awareness/physiology
12.
Anesthesiology ; 140(6): 1221-1231, 2024 Jun 01.
Article En | MEDLINE | ID: mdl-38603803

The near-death experience has been reported since antiquity and is often characterized by the perception of light, interactions with other entities, and life recall. Near-death experiences can occur in a variety of situations, but they have been studied systematically after in-hospital cardiac arrest, with an incidence of 10 to 20%. Long attributed to metaphysical or supernatural causes, there have been recent advances in understanding the neurophysiologic basis of this unique category of conscious experience. This article reviews the epidemiology and neurobiology of near-death experiences, with a focus on clinical and laboratory evidence for a surge of neurophysiologic gamma oscillations and cortical connectivity after cardiac and respiratory arrest.


Brain , Consciousness , Death , Humans , Consciousness/physiology , Brain/physiology , Brain/physiopathology , Heart Arrest/physiopathology , Brain Death/physiopathology , Brain Death/diagnosis
13.
J Exp Psychol Gen ; 153(5): 1268-1280, 2024 May.
Article En | MEDLINE | ID: mdl-38647479

One central question in the scientific and philosophical study of consciousness is regarding the scope of human consciousness. There is a lively debate as to whether high-level information integration is necessarily dependent on consciousness. This study presents a new form of unconscious integration based on the facingness between two individuals. Using a breaking continuous flash suppression paradigm, Experiments 1-3 found that two facing human heads got a privilege in breaking into awareness compared to nonfacing pairs. Experiments 4 and 5 demonstrated that the breakthrough difference between facing and nonfacing pairs could not be attributed to low-level or mid-level factors. Experiments 6, 7a, and 7b showed that the unconscious priority of facing pairs was significantly diminished when the holistic processing of the two agents was disrupted. Experiments 8-11 demonstrated that the advantage of facing pairs was only observable for human agents and not for daily objects, directional arrows, or nonhuman animals. These findings have critical implications for better understanding the scope of human consciousness and the origins of social vision. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Consciousness , Humans , Male , Female , Adult , Consciousness/physiology , Young Adult , Unconscious, Psychology , Awareness
14.
Proc Natl Acad Sci U S A ; 121(18): e2322157121, 2024 Apr 30.
Article En | MEDLINE | ID: mdl-38648473

Affective touch-a slow, gentle, and pleasant form of touch-activates a different neural network than which is activated during discriminative touch in humans. Affective touch perception is enabled by specialized low-threshold mechanoreceptors in the skin with unmyelinated fibers called C tactile (CT) afferents. These CT afferents are conserved across mammalian species, including macaque monkeys. However, it is unknown whether the neural representation of affective touch is the same across species and whether affective touch's capacity to activate the hubs of the brain that compute socioaffective information requires conscious perception. Here, we used functional MRI to assess the preferential activation of neural hubs by slow (affective) vs. fast (discriminative) touch in anesthetized rhesus monkeys (Macaca mulatta). The insula, anterior cingulate cortex (ACC), amygdala, and secondary somatosensory cortex were all significantly more active during slow touch relative to fast touch, suggesting homologous activation of the interoceptive-allostatic network across primate species during affective touch. Further, we found that neural responses to affective vs. discriminative touch in the insula and ACC (the primary cortical hubs for interoceptive processing) changed significantly with age. Insula and ACC in younger animals differentiated between slow and fast touch, while activity was comparable between conditions for aged monkeys (equivalent to >70 y in humans). These results, together with prior studies establishing conserved peripheral nervous system mechanisms of affective touch transduction, suggest that neural responses to affective touch are evolutionarily conserved in monkeys, significantly impacted in old age, and do not necessitate conscious experience of touch.


Consciousness , Macaca mulatta , Magnetic Resonance Imaging , Touch Perception , Animals , Consciousness/physiology , Touch Perception/physiology , Male , Touch/physiology , Biological Evolution , Somatosensory Cortex/physiology , Brain/physiology , Aging/physiology , Female , Gyrus Cinguli/physiology
15.
Trends Cogn Sci ; 28(5): 454-466, 2024 May.
Article En | MEDLINE | ID: mdl-38485576

Which systems/organisms are conscious? New tests for consciousness ('C-tests') are urgently needed. There is persisting uncertainty about when consciousness arises in human development, when it is lost due to neurological disorders and brain injury, and how it is distributed in nonhuman species. This need is amplified by recent and rapid developments in artificial intelligence (AI), neural organoids, and xenobot technology. Although a number of C-tests have been proposed in recent years, most are of limited use, and currently we have no C-tests for many of the populations for which they are most critical. Here, we identify challenges facing any attempt to develop C-tests, propose a multidimensional classification of such tests, and identify strategies that might be used to validate them.


Consciousness , Humans , Consciousness/physiology , Animals , Artificial Intelligence , Brain/physiology
16.
Trends Cogn Sci ; 28(5): 397-399, 2024 May.
Article En | MEDLINE | ID: mdl-38514282

The sense of agency, which refers to the subjective feeling of control, is an essential aspect of self-consciousness. We argue that distinguishing between the sensitivity and criterion of this feeling is important for discussing individual differences in the sense of agency and its connections with other cognitive functions.


Consciousness , Humans , Consciousness/physiology , Individuality , Self Concept
17.
Neurol Res ; 46(5): 479-486, 2024 May.
Article En | MEDLINE | ID: mdl-38497232

BACKGROUND: The Glasgow coma score (GCS) is a clinical tool used to measure level of consciousness in traumatic brain injury and other settings. Despite its widespread use, there are many inaccuracies in its reporting. One source of inaccuracy is confounding factors which affect consciousness as well as each sub-score of the GCS. The purpose of this article was to create a comprehensive list of confounding factors in order to improve the accuracy of the GCS and ultimately improve decision-making. METHODS: An English language literature search was conducted discussing GCS and multiple other keywords. Ultimately, 64 out of 3972 articles were included for further analysis. RESULTS: A multitude of confounding factors were identified which may affect consciousness or GCS sub-scores including the eye exam, motor exam and the verbal response. CONCLUSIONS: An up-to-date comprehensive list of confounding factors has been created that may be used to aide in GCS recording in hopes of improving its accuracy and utility.


Brain Injuries, Traumatic , Glasgow Coma Scale , Humans , Brain Injuries, Traumatic/diagnosis , Consciousness/physiology
18.
Nat Commun ; 15(1): 2171, 2024 Mar 11.
Article En | MEDLINE | ID: mdl-38462641

A central challenge of neuroscience is to elucidate how brain function supports consciousness. Here, we combine the specificity of focal deep brain stimulation with fMRI coverage of the entire cortex, in awake and anaesthetised non-human primates. During propofol, sevoflurane, or ketamine anaesthesia, and subsequent restoration of responsiveness by electrical stimulation of the central thalamus, we investigate how loss of consciousness impacts distributed patterns of structure-function organisation across scales. We report that distributed brain activity under anaesthesia is increasingly constrained by brain structure across scales, coinciding with anaesthetic-induced collapse of multiple dimensions of hierarchical cortical organisation. These distributed signatures are observed across different anaesthetics, and they are reversed by electrical stimulation of the central thalamus, coinciding with recovery of behavioural markers of arousal. No such effects were observed upon stimulating the ventral lateral thalamus, demonstrating specificity. Overall, we identify consistent distributed signatures of consciousness that are orchestrated by specific thalamic nuclei.


Anesthetics , Propofol , Animals , Consciousness/physiology , Brain/diagnostic imaging , Propofol/pharmacology , Cerebral Cortex , Primates , Thalamus/diagnostic imaging , Anesthetics/pharmacology
19.
Sleep Med Rev ; 74: 101908, 2024 Apr.
Article En | MEDLINE | ID: mdl-38417380

Sleep is typically considered a state of disconnection from the environment, yet instances of external sensory stimuli influencing dreams have been reported for centuries. Explaining this phenomenon could provide valuable insight into dreams' generative and functional mechanisms, the factors that promote sleep continuity, and the processes that underlie conscious awareness. Moreover, harnessing sensory stimuli for dream engineering could benefit individuals suffering from dream-related alterations. This PRISMA-compliant systematic review assessed the current evidence concerning the influence of sensory stimulation on sleep mentation. We included 51 publications, of which 21 focused on auditory stimulation, ten on somatosensory stimulation, eight on olfactory stimulation, four on visual stimulation, two on vestibular stimulation, and one on multimodal stimulation. Furthermore, nine references explored conditioned associative stimulation: six focused on targeted memory reactivation protocols and three on targeted lucid reactivation protocols. The reported frequency of stimulus-dependent dream changes across studies ranged from 0 to ∼80%, likely reflecting a considerable heterogeneity of definitions and methodological approaches. Our findings highlight a lack of comprehensive understanding of the mechanisms, functions, and neurophysiological correlates of stimulus-dependent dream changes. We suggest that a paradigm shift is required for meaningful progress in this field.


Dreams , Sleep , Humans , Dreams/physiology , Cognition/physiology , Consciousness/physiology
20.
Brain Inj ; 38(2): 68-75, 2024 01 28.
Article En | MEDLINE | ID: mdl-38329075

OBJECTIVES: To investigate the effects of long-term repetitive transcranial direct current stimulation on patients with DOC in the subacute phase. METHODS: In a randomized, double-blind, controlled study, 33 patients were randomly assigned to the active or sham group, and 28 patients completed the study. Patients in the active group received anodal stimulation over the DLPFC, while patients in the sham group received placebo stimulation (20 min/day, 5 days/week, for 4 weeks). The level of consciousness among patients was assessed with the Coma Recovery Scale-Revised (CRS-R) at baseline and at the end of every week from the first to the fourth week. RESULTS: The CRS-R scores of both the active and sham groups showed a consistent increasing trend over time; however, the treatment effect of the active group was better than that of the sham group. In addition, there was a statistically significant difference in the total CRS-R score between the two groups at weeks 1, 2, 3 and 4. Moreover, 10 patients (71.4%) in the active group and 3 patients (21.4%) in the sham group were regarded as responders. CONCLUSION: Long-term tDCS could improve the level of consciousness of patients with DOC in the subacute stage.


Transcranial Direct Current Stimulation , Humans , Coma , Consciousness/physiology , Consciousness Disorders/therapy , Treatment Outcome , Double-Blind Method
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