Noninvasive brain stimulation for patients with a disorder of consciousness: a systematic review and meta-analysis

Yali Feng, Jiaqi Zhang, Yi Zhou, Zhongfei Bai, Ying Yin

Research output: Journal article publicationJournal articleAcademic researchpeer-review

23 Citations (Scopus)


Noninvasive brain stimulation (NIBS) techniques have been used to facilitate the recovery from prolonged unconsciousness as a result of brain injury. The aim of this study is to systematically assess the effects of NIBS in patients with a disorder of consciousness (DOC). We searched four databases for any randomized controlled trials on the effect of NIBS in patients with a DOC, which used the JFK Coma Recovery Scale-Revised (CRS-R) as the primary outcome measure. A random-effects meta-analysis was conducted to pool effect sizes. Fourteen studies with 273 participants were included in this review, of which 12 studies with sufficient data were included in the meta-analysis. Our meta-analysis showed a significant effect on increasing CRS-R scores in favor of real stimulation as compared to sham (Hedges' g = 0.522; 95% confidence interval [CI], 0.318-0.726; P < 0.0001, I 2 = 0.00%). Subgroup analysis demonstrated that only anodal transcranial direct current stimulation (tDCS) of the left dorsolateral prefrontal cortex (DLPFC) significantly enhances the CRS-R scores in patients with a DOC, as compared to sham (Hedges' g = 0.703; 95% CI, 0.419-0.986; P < 0.001), and this effect was predominant in patients in a minimally conscious state (MCS) (Hedges' g = 0.815; 95% CI, 0.429-1.200; P < 0.001). Anodal tDCS of the left DLPFC appears to be an effective approach for patients with MCS.

Original languageEnglish
Pages (from-to)905-914
Number of pages10
JournalReviews in the Neurosciences
Issue number8
Publication statusPublished - 1 Dec 2020


  • disorder of consciousness
  • meta-analysis
  • noninvasive brain stimulation
  • transcranial direct current stimulation
  • transcranial magnetic stimulation

ASJC Scopus subject areas

  • General Neuroscience


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