Dual-Site Transcranial Magnetic Stimulation Improves Consciousness in Patients with Disorders of Consciousness

Design: As the cerebellum has reciprocal communications with the frontal cortex, this retrospective cohort study examined the effects of dual-site repetitive transcranial magnetic stimulation (ds-rTMS: dorsolateral prefrontal cortex [DLPFC] + cerebellum) in disorders of consciousness (DoC). Setting: Single-center study in the Department of Rehabilitation of Jinhua Hospital of TCM Affiliated to Zhejiang University of Traditional Chinese Medicine. Participants: Twenty-nine patients with DoC. Intervention: Systematic review of clinical records comparing ds-TMS (DLPFC + cerebellum) with conventional single-site DLPFC-rTMS. Main Measures: Coma Recovery Scale-Revised (CRS-R) scores, mismatch negativity (MMN) latency, P300 latency, Judson grade, and Hall grade. Results: ds-TMS was associated with larger gains in consciousness (CRS-R scores) compared with DLPFC-rTMS in a retrospective cohort. Both interventions had comparable improvement in cognitive and somatosensory outcomes (MMN, P300, and Judson/Hall grades). Higher CRS-R scores correlated with shorter MMN latency and better Hall grades. Conclusions: ds-TMS treatment may represent an effective therapeutic approach for DoC, with potential effects on consciousness recovery.