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Semin Neurol 2022; 42(03): 348-362
DOI: 10.1055/s-0042-1755562
Review Article

Noninvasive Brain Stimulation Therapies to Promote Recovery of Consciousness: Where We Are and Where We Should Go

Alice Barra 
1   Coma Science Group, GIGA Consciousness - GIGA Research, University of Liège, Liège, Belgium
2   Centre du Cerveau, University Hospital of Liège, Liège, Belgium
,
Martin Monti
3   Department of Psychology, University of California Los Angeles, Los Angeles, California
4   Department of Neurosurgery, UCLA Brain Injury Research Center, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
,
Aurore Thibaut
1   Coma Science Group, GIGA Consciousness - GIGA Research, University of Liège, Liège, Belgium
2   Centre du Cerveau, University Hospital of Liège, Liège, Belgium
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Abstract

Therapeutic options for patients with disorders of consciousness (DoC) are still underexplored. Noninvasive brain stimulation (NIBS) techniques modulate neural activity of targeted brain areas and hold promise for the treatment of patients with DoC. In this review, we provide a summary of published research using NIBS as therapeutic intervention for DoC patients, with a focus on (but not limited to) randomized controlled trials (RCT). We aim to identify current challenges and knowledge gaps specific to NIBS research in DoC. Furthermore, we propose possible solutions and perspectives for this field. Thus far, the most studied technique remains transcranial electrical stimulation; however, its effect remains moderate. The identified key points that NIBS researchers should focus on in future studies are (1) the lack of large-scale RCTs; (2) the importance of identifying the endotypes of responders; and (3) the optimization of stimulation parameters to maximize the benefits of NIBS.

Keywords

neuromodulation - brain injury - coma - vegetative state - minimally conscious state - tDCS - transcranial magnetic stimulation - traumatic brain injury


Publication History

Article published online:
13 September 2022

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