Observation On The Effect Of Transcranial Direct Current Stimulation On Minimal Consciousness After Traumatic Brain Injury

ObjectiveTranscranial direct current stimulation(tDCS)is a non-invasive brain stimulation technique.It can regulate cortical excitability and change resting membrane potential of neurons by applying weak direct current.Anodic stimulation depolarizes the membrane of neurons and increases the excitability of neurons,while cathodic stimulation leads to hyperpolarization and decreases the excitability of neurons.TDCS involves many fields,and has been recognized in the field of neural rehabilitation in recent years.It is found that patients with minimal consciousness have self-consciousness,including self cognition,self monitoring,self discovery and ontology perception.Stimulating the left dorsolateral prefrontal cortex can improve the level of consciousness of patients.This study mainly explores the curative effect of TDCS combined with traditional rehabilitation therapy on consciousness recovery of patients with minimal state of consciousness after traumatic brain injury,and observes the occurrence of adverse reactions,and explores the synergistic effect of TDCS combined with traditional rehabilitation therapy in the treatment of consciousness disorder,so as to provide relevant data basis for follow-up clinical rehabilitation treatment and research.Methods60 patients with minimal state of consciousness who met the inclusion and exclusion criteria in the Department of rehabilitation,Affiliated Hospital of Inner Mongolia Medical University from December 2018 to October 2020 were selected and randomly divided into control group(30 patients)and observation group(30patients in tDCS group).The observation group was treated with conventional treatment combined with transcranial direct current stimulation;the control group was treated with conventional treatment,transcranial direct current stimulator was installed,and the false stimulation mode was used.The main stimulation target was the dorsolateral prefrontal cortex(the main part of executive function and working memory).Except for different stimulation modes,stimulation intensity and stimulation current,the other stimulation time,treatment duration and stimulation site were the same in the two groups.At the same time,the revised coma recovery scale(crs-r),Glasgow Coma Score(GCS),activity of daily living index(Barthel)and total non responsiveness scale(four)of the two groups before and after rehabilitation treatment were recorded for observation and analysis.ResultsThere was no significant difference in the basic data between the two groups(P > 0.05),the CRS-R score before treatment(7.67 vs 7.33,P > 0.05)between the observation group and the control group,and the observation group was larger than the control group after treatment(13.13 vs 8.37,P < 0.05);the GCS score before treatment(6.57 vs 6.23,P> 0.05)between the two groups had no significant difference,and after treatment(11.27 vs 8.37,P < 0.05),there was no significant difference between the two groups The Barthel Index scores of the observation group and the control group after treatment were higher than those before treatment(P <0.05),the difference was statistically significant,the Barthel Index scores of the observation group and the control group before and after treatment had no statistical difference(P > 0.05);the FOUR score before treatment(11.30 vs 10.80,P > 0.05)had no difference between the two groups,after treatment(14.57 vs 11.80,P< 0.05),the observation group was larger than the control group.ConclusionTDCS combined with traditional rehabilitation therapy can effectively improve the awakening ability,self-care ability and quality of life of patients with minimal state of consciousness after traumatic brain injury,which is worthy of further clinical application.