Impact of transcranial direct current stimulation combined with median nerve stimulation on CRS-R in patients with prolonged disorders of consciousness after cerebral hemorrhage: protocol for a randomized controlled trial

BackgroundProlonged disorders of consciousness (pDoC) resulting from intracerebral hemorrhage (ICH) significantly impair patients’ quality of life. This study aims to investigate the therapeutic effects of transcranial direct current stimulation (tDCS) combined with median nerve stimulation (MNS) in...

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Main Authors: Hanbo Chen, Shujuan Huang, Si Chen, Zitian Wang, Yong Luo, Yongliang Guo, Weifeng Wen, Jinfeng Liang, Yunhong Deng, Xiao Lv
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1497316/full
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author Hanbo Chen
Shujuan Huang
Si Chen
Zitian Wang
Yong Luo
Yongliang Guo
Weifeng Wen
Jinfeng Liang
Yunhong Deng
Xiao Lv
author_facet Hanbo Chen
Shujuan Huang
Si Chen
Zitian Wang
Yong Luo
Yongliang Guo
Weifeng Wen
Jinfeng Liang
Yunhong Deng
Xiao Lv
author_sort Hanbo Chen
collection DOAJ
description BackgroundProlonged disorders of consciousness (pDoC) resulting from intracerebral hemorrhage (ICH) significantly impair patients’ quality of life. This study aims to investigate the therapeutic effects of transcranial direct current stimulation (tDCS) combined with median nerve stimulation (MNS) in patients with pDoC 3–12 months post-ICH.MethodsThis prospective, double-blind, randomized controlled trial will enroll 138 eligible patients with pDoC following ICH. Participants will be randomly assigned to three groups of 27 each: (1) tDCS + MNS, (2) sham tDCS + MNS, and (3) tDCS + sham MNS. The intervention will last for 4 weeks, followed by a 6-month follow-up period. The primary outcome measure is the change in the Coma Recovery Scale-Revised (CRS-R) scores. Secondary outcomes include electrophysiological and neuroimaging data. Assessments will be conducted at baseline, after 4 weeks of treatment, and at 2 weeks, 4 weeks, 12 weeks, and 24 weeks post-intervention.DiscussionThe strengths of this study include the combined intervention approach of tDCS and MNS, as well as comprehensive outcome measures. This intervention may promote consciousness recovery through multiple mechanisms, including enhanced neuroplasticity and modulation of brain networks. This study aims to provide a novel approach for consciousness-promoting treatment in pDoC, potentially improving patient prognosis and quality of life.Clinical trial registrationhttps://www.chictr.org.cn/showproj.html?proj=203618, identifier ChiCTR2300075190.
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spelling doaj-art-e014363b416b427e8b2a354512cc5ca02025-08-20T02:34:15ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-06-011610.3389/fneur.2025.14973161497316Impact of transcranial direct current stimulation combined with median nerve stimulation on CRS-R in patients with prolonged disorders of consciousness after cerebral hemorrhage: protocol for a randomized controlled trialHanbo Chen0Shujuan Huang1Si Chen2Zitian Wang3Yong Luo4Yongliang Guo5Weifeng Wen6Jinfeng Liang7Yunhong Deng8Xiao Lv9Department of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital, Guangzhou, ChinaDepartment of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital, Guangzhou, ChinaDepartment of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital, Guangzhou, ChinaZhujiang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital, Guangzhou, ChinaDepartment of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital, Guangzhou, ChinaDepartment of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital, Guangzhou, ChinaDepartment of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital, Guangzhou, ChinaDepartment of Rehabilitation Therapy, Guangdong Sanjiu Brain Hospital, Guangzhou, ChinaDepartment of Rehabilitation Medicine, Guangdong Sanjiu Brain Hospital, Guangzhou, ChinaBackgroundProlonged disorders of consciousness (pDoC) resulting from intracerebral hemorrhage (ICH) significantly impair patients’ quality of life. This study aims to investigate the therapeutic effects of transcranial direct current stimulation (tDCS) combined with median nerve stimulation (MNS) in patients with pDoC 3–12 months post-ICH.MethodsThis prospective, double-blind, randomized controlled trial will enroll 138 eligible patients with pDoC following ICH. Participants will be randomly assigned to three groups of 27 each: (1) tDCS + MNS, (2) sham tDCS + MNS, and (3) tDCS + sham MNS. The intervention will last for 4 weeks, followed by a 6-month follow-up period. The primary outcome measure is the change in the Coma Recovery Scale-Revised (CRS-R) scores. Secondary outcomes include electrophysiological and neuroimaging data. Assessments will be conducted at baseline, after 4 weeks of treatment, and at 2 weeks, 4 weeks, 12 weeks, and 24 weeks post-intervention.DiscussionThe strengths of this study include the combined intervention approach of tDCS and MNS, as well as comprehensive outcome measures. This intervention may promote consciousness recovery through multiple mechanisms, including enhanced neuroplasticity and modulation of brain networks. This study aims to provide a novel approach for consciousness-promoting treatment in pDoC, potentially improving patient prognosis and quality of life.Clinical trial registrationhttps://www.chictr.org.cn/showproj.html?proj=203618, identifier ChiCTR2300075190.https://www.frontiersin.org/articles/10.3389/fneur.2025.1497316/fulltranscranial direct current stimulationmedian nerve stimulationprolonged disorders of consciousnessCRS-Rprotocol
spellingShingle Hanbo Chen
Shujuan Huang
Si Chen
Zitian Wang
Yong Luo
Yongliang Guo
Weifeng Wen
Jinfeng Liang
Yunhong Deng
Xiao Lv
Impact of transcranial direct current stimulation combined with median nerve stimulation on CRS-R in patients with prolonged disorders of consciousness after cerebral hemorrhage: protocol for a randomized controlled trial
Frontiers in Neurology
transcranial direct current stimulation
median nerve stimulation
prolonged disorders of consciousness
CRS-R
protocol
title Impact of transcranial direct current stimulation combined with median nerve stimulation on CRS-R in patients with prolonged disorders of consciousness after cerebral hemorrhage: protocol for a randomized controlled trial
title_full Impact of transcranial direct current stimulation combined with median nerve stimulation on CRS-R in patients with prolonged disorders of consciousness after cerebral hemorrhage: protocol for a randomized controlled trial
title_fullStr Impact of transcranial direct current stimulation combined with median nerve stimulation on CRS-R in patients with prolonged disorders of consciousness after cerebral hemorrhage: protocol for a randomized controlled trial
title_full_unstemmed Impact of transcranial direct current stimulation combined with median nerve stimulation on CRS-R in patients with prolonged disorders of consciousness after cerebral hemorrhage: protocol for a randomized controlled trial
title_short Impact of transcranial direct current stimulation combined with median nerve stimulation on CRS-R in patients with prolonged disorders of consciousness after cerebral hemorrhage: protocol for a randomized controlled trial
title_sort impact of transcranial direct current stimulation combined with median nerve stimulation on crs r in patients with prolonged disorders of consciousness after cerebral hemorrhage protocol for a randomized controlled trial
topic transcranial direct current stimulation
median nerve stimulation
prolonged disorders of consciousness
CRS-R
protocol
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1497316/full
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