FMRI-navigated rTMS original protocol for disorders of consciousness treatmentтезисы доклада

Дата последнего поиска статьи во внешних источниках: 8 февраля 2017 г.

Работа с тезисами доклада

[1] Fmri-navigated rtms original protocol for disorders of consciousness treatment / L. Legostaeva, E. Zmeykina, E. Kremneva et al. // European Journal of Neurology, Supplement 2. — Vol. 23. — Blackwell Publishing Inc United Kingdom, 2016. — P. 481. Background and aims: Navigated rTMS is a perspective tool for modulation of the cerebral networks activity, and resting FMRI allows estimating the neural networks activation that may indicate the target for precise stimulation. Patients after anoxia or trauma who survived coma, show selective activation of default mode network, particularly, gyrus angularis, as the level of consciousness increases. We studied effects of navigated rTMS on gyrus angularis as a new approach for DOC neurorehabilitation. Methods: We included 3 patients with post-anoxic VS (median age 24, CRS-R 4); 3 post-anoxic MCS-(median age 46, CRS-R 14, 16, and 18), and 2 traumatic MCS+ (median age 31, CRS-R 19, 20). RFMRI individual activation represented DMN including left gyrus angularis in MCS patients, with no DMN in VS patients. We provided standard rehabilitation program (motomed letto II-assisted mechanical therapy, massage, passive joints movements) high-frequency rTMS on the gyrus angularis (10 sessions of stimulation, 20Hz, 2400 stimulus 90% MT). Consciousness level was blind assessed with CRS-R scale. Results: CRS-R score increased in the patients with the residual signs of consciousness behaviour (i.e., MCS). Median increase in CRS-R score after neurorehabilitation course was 2 points. However, we found no change in clinical assessment in the VS. No side effects of rTMS were observed. CRS-R score in permanent disorders of consciousness before and after rTMS course on gyrus angularis Conclusion: The course of the high-frequency TMS on gyrus angularis is a potentially effective method of rehabilitation in permanent DOC. We obtained clinical effect for minimal signs of consciousness states, but not in VS. These results are advisable to continue researches in studies of this new protocol's effectiveness Disclosure: The study is supported by Russian Science Foundation, grant No 16-15-00274.

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