经颅直流电刺激对意识障碍患者脑功能网络方向性连接的影响

doi:10.3969/j.issn.1006-9771.2025.09.008

《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (9): 1050-1056.doi: 10.3969/j.issn.1006-9771.2025.09.008

经颅直流电刺激对意识障碍患者脑功能网络方向性连接的影响

李红卫¹, 黄彬彬², 朱传花¹, 李伟¹()

¹ 滨州医学院附属医院/滨州医学院第一临床医学院，山东滨州市 256603
² 滨州医学院特殊教育与康复学院，山东烟台市 264003

收稿日期:2025-06-03 修回日期:2025-07-31 出版日期:2025-09-25 发布日期:2025-10-10
通讯作者: 李伟(1981-)，男，汉族，山东滨州市人，博士，教授，主要研究方向：重症康复、骨科康复，E-mail： yishengliwei@163.com。
作者简介:李红卫(1991-)，女，汉族，山东滨州市人，硕士，主要研究方向：重症康复。
基金资助:
1.山东省自然科学基金项目(ZR2022MH063);2.山东省中医药科技创新面上项目(M20244103)

Effect of transcranial direct current stimulation on α-band brain connectivity in disorders of consciousness

LI Hongwei¹, HUANG Binbin², ZHU Chuanhua¹, LI Wei¹()

¹ Binzhou Medical University Hospital/The First School of Clinical Medicine of Binzhou Medical University, Binzhou, Shandong 256603, China
² School of Special Education and Rehabilitation, Binzhou Medical University, Yantai, Shandong 264003, China

Received:2025-06-03 Revised:2025-07-31 Published:2025-09-25 Online:2025-10-10
Contact: LI Wei,E-mail: yishengliwei@163.com
Supported by:
Shandong Provincial Natural Science Foundation(ZR2022MH063);Shandong Provincial Fund for Science and Technology Innovation in Traditional Chinese Medicine (General)(M20244103)

摘要/Abstract

摘要：

目的探讨经颅直流电刺激(tDCS)对意识障碍患者α频段脑功能网络方向性信息流的调控特征。

方法 2023年10月至2024年10月，于滨州医学院附属医院招募意识障碍患者30例，分为微意识状态(MCS)组(n = 15)和无反应觉醒综合征(UWS)组(n = 15)。所有患者均接受常规康复和左侧背外侧前额叶tDCS，共4周。治疗前后采集患者脑电图10 min。

结果 MCS组脱落2例。治疗后，两组前额叶与顶叶区的格兰杰因果(GC)连接增强，尤其以双侧前额-顶叶、额中央区与顶叶之间连接最明显，其次是边缘-中央区连接；MCS组GC增强广泛且双向，UWS组GC增强单向且局限。

结论 tDCS可显著增强意识障碍患者双侧前额叶与顶叶的方向性信息流，实现促醒，MCS患者的网络可塑性高于UWS患者。

关键词: 意识障碍, 经颅直流电刺激, 脑电图, 格兰杰因果分析

Abstract:

Objective To investigate the modulatory effects of transcranial direct current stimulation (tDCS) on directional information flow within the α-band functional brain networks in patients with disorders of consciousness (DoC).

Methods From October, 2023 to October, 2024, 30 patients with DoC were recruited from Binzhou Medical University Hospital. They were assigned to minimally conscious state (MCS) group (n = 15) and unresponsive wakefulness syndrome (UWS) group (n = 15). All the patients received conventional rehabilitation and tDCS at left dorsolateral prefrontal cortex for four weeks. Ten-minute electroencephalography data were collected before and after treatment.

Results Two cases dropped out from MCS group. Granger causality (GC) connectivity between the prefrontal and parietal regions enhanced in both groups after treatment, particularly in bidirectional pathways between bilateral prefrontal and parietal regions, as well as between frontocentral and parietal regions, and limbic-central connections. GC connectivity was extensive and bidirectional in MCS group, and localized and unidirectional in UWS group.

Conclusion tDCS can enhance directional information flow between bilateral prefrontal and parietal regions in patients with DoC, for promoting recovery of consciousness. Neural plasticity was better in MCS patients than in UWS patients.

Key words: disorders of consciousness, transcranial direct current stimulation, electroencephalography, Granger causality analysis

中图分类号:

R741.041

李红卫, 黄彬彬, 朱传花, 李伟. 经颅直流电刺激对意识障碍患者脑功能网络方向性连接的影响[J]. 《中国康复理论与实践》, 2025, 31(9): 1050-1056.

LI Hongwei, HUANG Binbin, ZHU Chuanhua, LI Wei. Effect of transcranial direct current stimulation on α-band brain connectivity in disorders of consciousness[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(9): 1050-1056.

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组别	n	性别(男/女)/n	年龄/岁	病程/d
MCS组	13	10/3	59.46±8.64	45.38±12.81
UWS组	15	9/6	54.00±11.83	51.33±15.77
χ²/t值		0.914	1.376	-1.084
P值		0.435	0.431	0.288

经颅直流电刺激对意识障碍患者脑功能网络方向性连接的影响

Effect of transcranial direct current stimulation on α-band brain connectivity in disorders of consciousness

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