Evidence map›Paper›PMID 40001220›Full record

Trial reportJournal of neuroengineering and rehabilitation2025

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, Baohu Liu, Guoping Duan, Qing Guo, Zelin Ye, Xu Zhang, Chaolu Wang, Dongyu Wu

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of neuroengineering and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Mingrui Liu *Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadijie, Chaoyang District, PO Box 100102, Beijing, China.
Yuanyuan Li *Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadijie, Chaoyang District, PO Box 100102, Beijing, China.
Jiayi ZhaoDepartment of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadijie, Chaoyang District, PO Box 100102, Beijing, China.
Baohu LiuDepartment of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadijie, Chaoyang District, PO Box 100102, Beijing, China.
Guoping DuanDepartment of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadijie, Chaoyang District, PO Box 100102, Beijing, China.
Qing GuoDepartment of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadijie, Chaoyang District, PO Box 100102, Beijing, China.
Zelin YeDepartment of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Xu ZhangDepartment of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadijie, Chaoyang District, PO Box 100102, Beijing, China. zhangxu112452@163.com.
Chaolu WangDepartment of Education, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadijie, Chaoyang District, PO Box 100102, Beijing, China. chaolu126@126.com.
Dongyu WuDepartment of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadijie, Chaoyang District, PO Box 100102, Beijing, China. wudongyu73@hotmail.com.

Funding

China Academy of Chinese Medical Sciences CI2021A01410National Natural Science Foundation of China 81171011Project of Wangjing Hospital of China Academy of Chinese Medical Sciences WJYY-YJKT-2022-12
6 · The paper itself

Abstract

Paroxysmal sympathetic hyperexcitation (PSH) refers to a clinical syndrome characterized by a sudden increase in sympathetic excitability caused by severe brain injury. This study aims to investigate the effectiveness and practicality of combining transcranial direct current stimulation (tDCS) with medication to treat PSH and employ non-linear electroencephalography (EEG) to assess changes in cortical activation post-intervention. 40 PSH patients were randomly assigned to receive either active tDCS or sham tDCS treatment over an 8-week period. The tDCS stimulation targeted the prefrontal area, left frontal-temporal-parietal cortex, right frontal-temporal-parietal cortex, and left dorsolateral prefrontal cortex. Both patient groups also underwent medication and other conventional therapies. The Paroxysmal Sympathetic Hyperactivity Assessment Measure (PSH-AM), Coma Recovery Scale-Revised (CRS-R), medication dosage, and approximate entropy (ApEn) index were assessed before and after treatment. The active tDCS group exhibited more substantial improvements in changes of PSH-AM, changes of CRS-R, and medication reduction ratios compared to the sham tDCS group after the treatment. After treatment and during follow-up, a significantly greater number of patients in the active tDCS group demonstrated clinically important differences compared to the sham tDCS group. The active tDCS group showed significantly higher ApEn indices in the less affected frontal lobe compared to the control group. No significant differences in ApEn indices were noted in the sham tDCS group before and after treatment. Regression analysis revealed that the group (active tDCS/sham tDCS) was the primary factor associated with improving PSH-AM. Therefore, we believe that in patients with PSH, combining tDCS with medication therapy demonstrated superior clinical efficacy compared to medication therapy alone. Electrophysiological results also indicated enhanced cortical excitability. Therefore, this single-center pilot study suggests that multi-target, multi-session tDCS combined with medication may be an effective treatment protocol for PSH.

Indexed as

Autonomic Nervous System DiseasesBrain InjuriesCortical ExcitabilityTranscranial Direct Current StimulationAdultDouble-Blind MethodElectroencephalographyFemaleHumansMaleMiddle AgedPilot ProjectsTreatment OutcomeYoung AdultAcquired brain injuryCortical activationDysautonomiaelectroencephalographNonlinear dynamicsStroke

Identifiers

PMID40001220
PMCPMC11852813

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.