Effect of transcranial direct current stimulation on paroxysmal sympathetic hyperexcitability with acquired brain injury and cortical excitability: a randomized, double-blind, sham-controlled pilot study.
Mingrui Liu, Yuanyuan Li, Jiayi Zhao and 7 others
PMID 40001220WHAT IT FOUND
Patients receiving tDCS plus medication showed a 19.8-point drop in PSH severity scores, compared to 6.9 points with sham plus medication.
This pilot study suggests tDCS may help reduce sympathetic hyperexcitability and medication needs in acquired brain injury.
Key findings
01The active tDCS group showed a mean reduction of 19.80 points in PSH-AM scores, significantly greater than the 6.90-point reduction in the sham group.
02All 20 patients in the active tDCS group achieved a clinically important difference in diagnosis, whereas none in the sham group did so immediately after treatment.
03Patients receiving active tDCS had a 95.63% reduction in clonazepam dosage and a 100% reduction in propranolol dosage, compared to 13.75% and 70% respectively in the sham group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was a pilot trial with a small sample size (40 patients) and single-center design, limiting generalizability. The follow-up period was short, and long-term effects on consciousness recovery and PSH recurrence were not assessed. The study did not evaluate the timing of treatment effects during the 8-week intervention, so it is unclear when improvements occurred. Subgroup analyses for TBI versus stroke were not pre-registered, and differences in response between these groups require further investigation.
Declared interests
The study was supported by the National Natural Science Foundation of China and the China Academy of Chinese Medical Sciences. The authors declared no competing interests.
The easy way to misread this
Do not interpret the 100% propranolol reduction as evidence that medication can be safely stopped without tDCS. The reduction was a result of the combined protocol, and the contribution of tDCS versus standard care cannot be fully separated in a pilot study of this size.