300 Section - Short-term Efficacy of Repetitive Transcranial Direct Current Stimulation on Prolonged Disorders of Consciousness: A Single-blind Randomized Controlled Trial Comparing Left DLPFC and PPC Stimulation

Wednesday, May 20, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

YZ

Yuyao Zhu, MS

Ph.D. Candidate
Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center)
Shanghai, Shanghai, China (People's Republic)

Co-Author/Coautor(s)

CF

Chenhui Fu, MS

Ph.D. Candidate
Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center)
Shanghai, Shanghai, China (People's Republic)

Corresponding Author/Autor a quien dirigir la corr(s)

BY

Bin Yu, MD

Chief Physician
Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center)
Shanghai, Shanghai, China (People's Republic)

Objectives : Effective therapies for prolonged disorders of consciousness (pDOC) are lacking. This single-blind randomized controlled trial (RCT) aimed to evaluate the differential efficacy and safety of transcranial direct current stimulation (tDCS) targeting the left dorsolateral prefrontal cortex (DLPFC) versus the left posterior parietal cortex (PPC) in patients with pDOC.

Design: A total of 50 patients with pDOC were recruited from the Departments of Critical Care Rehabilitation and Neurological Rehabilitation at Shanghai Yangzhi Rehabilitation Hospital and randomized (1:1) to either the DLPFC group or the PPC group. Seven patients withdrew (3 vital sign deterioration, 4 lost to follow-up). The final per-protocol analysis included 43 patients (DLPFC group: n=22; PPC group: n=21). The intervention lasted for two weeks (10 sessions total). Primary endpoints (CRS-R, GCS) were assessed at baseline (T0), post-intervention (T1), and 1-month follow-up (T2). (Trial registration: ChiCTR2400088343).

Results: In per-protocol analysis (n=43), both groups showed significant improvements from T0 to T1. In DLPFC group (n=22), CRS-R scores improved (8.39±0.55 to 9.87±0.44; p< 0.001) and GCS scores improved (8.04±0.47 to 9.52±0.37; p=0.008). In the PPC group (n=21), CRS-R scores improved (8.30±0.41 to 10.00±0.29; p=0.002) and GCS scores improved (8.15±0.34 to 10.00±0.33; p=0.008). Crucially, repeated-measures ANOVA revealed no significant differential efficacy between the two stimulation sites (group × time interaction: p=0.698 for CRS-R; p=0.611 for GCS). At T2, scores in both groups reverted to near-baseline levels (all p >0.05 vs T0). Sleep efficiency and some autonomic metrics improved at T1 (p< 0.05), with no adverse events.

Conclusion: Repetitive anodal tDCS targeting either the left DLPFC or PPC can provide short-term improvements in the level of consciousness for pDOC patients with good safety. However, the efficacy was not sustained at the 1-month follow-up, and no significant difference was found between the two targets, highlighting the need for future research to explore strategies for prolonging therapeutic effects.