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Disorder of ConsciousnessCONTEST_3NCT03576248

CONsciousness Transcranial Electric STimulation

A study testing In-phase 6 Hz prefronto-parietal tACS and 2 mA left prefrontal tDCS in people with Disorder of Consciousness, run by Institut National de la Santé Et de la Recherche Médicale, France at 1 site in France.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The aim of this study is to investigate the effect of transcranial Alternating Current Stimulation (tACS) at theta frequency and the the effect of transcranial Direct Current Stimulation (tDCS) on the conscious state of non-communicating patients. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Disorder of Consciousness
What is being tested?
In-phase 6 Hz prefronto-parietal tACS and 2 mA left prefrontal tDCS
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
20 participants
Where
1 siteFrance
Study dates
19 Nov 2018to 3 Jan 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age between 18 and 80 years
  • Non communicative patients with disorder of consciousness diagnosed by CRS-R (VS, MCS, exitMCS)
  • Patients with stable clinical examination (even in intensive care)
  • Brain injury confirmed by cerebral imaging (MRI or TDM)
  • French social security affiliation
  • Signed and informed consent by the patient or by a legal representant

Who cannot join

  • Status epilepticus or uncontrolled epilepsy
  • Severely neurodegenerative illnesses (Alzheimer disease, Lewy Body Dementia)
  • Electrical stimulation contraindication (metallic intra-cranial implants, pacemaker or implantable cardioverter-defibrillator, cranial prosthesis)
  • Pregnant, parturient or breastfeeding women- Patients underage

Trial locations and contacts

1 site in 1 country.

France1 site
  • Institut du Cerveau et de la Moelle - CR-ICM U 975 / UMRS INSERM 1127

    Paris, 75013

Other trials in France

About this study

Official title: Effect of Transcranial Electrical Stimulation on the Consciousness of Non-communicating Patients.

The aim of this study is to investigate the effect of transcranial Alternating Current Stimulation (tACS) at theta frequency and the the effect of transcranial Direct Current Stimulation (tDCS) on the conscious state of non-communicating patients. tACS and tDCS are non-invasive stimulation techniques that are used to induce brain oscillations at certain frequency or to increase the brain activity in applied region.

Limited treatments are available to improve consciousness in severely brain injured patients. Transcranial Direct Current stimulation (tDCS) is one of the few therapeutics that showed evidence of efficacy to increase level of consciousness and functional communication in some Minimally Conscious State (MCS) patients, and in some Vegetative State (VS) patients. However the optimal intensity of electrical current stimulation remains unknown and transcranial Alternative Current Stimulation (tACS), with the ability to stimulate cortex at specific frequencies and to manipulate phase-synchrony between regions is a promising techniques to improve patients' consciousness.

In this study, the investigators will use prefrontal tDCS and theta tACS to improve patients consciousness level.

Read the detailed description

This study is constituted of two independent sub-studies investigating two types of stimulation (tDCS and tACS) with the same cross-over design

Study design The study design is composed of two experimental sessions, one active stimulation and one sham comparator. Sessions will be randomized in a double-blind randomized crossover design (neither the participant nor the experimenter knows which session includes which stimulation type), with at least 2 days of interval between them.

In these sessions, the patients' state of consciousness participants will first be determined using the dedicated Coma Recovery Scale - Revised (Giacino, Neurology 2002) (CRS-R) scale before stimulation. Resting state brain activity EEG and cognitive auditory paradigm (local-global paradigm, Bekinschtein, PNAS 2009) will also be recorded before stimulation.

Twenty minutes stimulation will then be performed (see below). CRS-R, resting state EEG and local-global paradigm will be repeated after stimulation.

Outcome measures will be the same in the two studies. The primary outcome will be the change of CRS-R between before and after stimulation. Secondary outcomes will be the neurophysiological correlates of consciousness in resting state EEG and during the local global paradigm.

tACS stimulation During tACS sessions, 6 Hz stimulation (1000 μA) will be applied simultaneously over the left prefrontal dorso-lateral cortex (F3 of the 10-20 international scalp EEG system) and the left parietal cortex (P3) using an 8-channels stimulator (Starstim NE, Neuroelectrics, Barcelona, Spain) with small round sponge electrodes (25 cm2 surface, maximal current density of 0.06 μA/cm2), controlled via Bluetooth. In the in-phase condition, the phase difference between the two stimulation sites will be 0° which will entrain synchronization between sites. In the sham condition, the stimulation will start with a current intensity of 1000 μA lasting for 30 seconds. Afterwards, the intensity will progressively decrease over 20 seconds until cessation. Each stimulation session will take 20 minutes and the positions of stimulation electrodes and the duration of the stimulation will be kept identical for all conditions.

tDCS stimulation During tDCS session, 2000 μA stimulation will be applied over the left prefrontal dorso-lateral cortex (F3 of the 10-20 international scalp EEG system) (Starstim NE, Neuroelectrics, Barcelona, Spain) with small round sponge electrodes (25 cm2 surface, maximal current density of 0.06 μA/cm2), controlled via Bluetooth. In the sham condition, the stimulation will start with a current intensity of 2000 μA lasting for 30 seconds. Afterwards, the intensity will progressively decrease over 20 seconds until cessation. Each stimulation session will take 20 minutes and the positions of stimulation electrodes and the duration of the stimulation will be kept identical for all conditions.

Being tested
In-phase 6 Hz prefronto-parietal tACS, Sham prefronto-parietal tACS, 2 mA left prefrontal tDCS, Sham left prefrontal tDCS
Keywords
State of consciousness, tACS, tDCS, Global neuronal workspace, Brain injury
Medical subject headings
Consciousness Disorders, Brain Injuries

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • In-phase 6 Hz prefronto-parietal tACSDevice

    tACS is a non-invasive stimulation technique that works by delivering a weak sinusoidally oscillating electrical current to the surface of the skull to entrain oscillations in the brain.

  • Sham prefronto-parietal tACSDevice

    tACS is a non-invasive stimulation technique that works by delivering a weak sinusoidally oscillating electrical current to the surface of the skull to entrain oscillations in the brain.

  • 2 mA left prefrontal tDCSDevice

    tDCS is a form of neuromodulation method where very low levels of constant current are delivered to specifically targeted areas of the brain

  • Sham left prefrontal tDCSDevice

    tDCS is a form of neuromodulation method where very low levels of constant current are delivered to specifically targeted areas of the brain

Study groups in NCT03576248
Study groupRoleWhat they receive
In-phase 6 Hz prefronto-parietal tACSExperimental6 Hz stimulation (1000 μA) with transcranial Alternative Current Stimulation (tACS) will be applied simultaneously over the left prefrontal dorso-lateral cortex (F3 of the 10-20 international scalp EEG system) and the left parietal cortex (P3 of the 10-20 international scalp EEG system, with a return electrode in Cz) for 20 minutes. The phase difference between the two stimulation sites will be 0°.
Receives: Device: In-phase 6 Hz prefronto-parietal tACS
Sham prefronto-parietal tACSSham comparatorThe same stimulation as in in-phase transcranial Alternative Current Stimulation tACS (6 Hz F3 and P3 stimulation with 0° phase difference) will start with a current intensity of 1000 μA lasting for 30 seconds. Afterwards, the intensity will progressively decrease over 20 seconds until cessation. The whole session duration is 20 minutes.
Receives: Device: Sham prefronto-parietal tACS
2 mA left prefrontal tDCSExperimental2000 μA anodal transcranial Direct Current Stimulation (tDCS) will be applied over the left prefrontal dorso-lateral cortex (F3 of the 10-20 international scalp EEG system with a right supraorbital return electrode (Fp2 of the 10-20 international scalp EEG system) during 20 minutes.
Receives: Device: 2 mA left prefrontal tDCS
Sham left prefrontal tDCSSham comparatorThe same stimulation as active transcranial Direct Current Stimulation (tDCS) (anodal F3 and return in Fp2) will start at 2 mA intensity for 30 seconds. Afterwards, the intensity will progressively decrease over 20 seconds until cessation. The whole session duration is 20 minutes.
Receives: Device: Sham left prefrontal tDCS

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. State of consciousness

    Change of the Coma Recovery Scale-Revised scores (CRS-R, Giacino et al. Neurology 2002 and Kalmar et al., Neuropsychol Rehabil 2005) between before and after stimulation (CRS-R post stimulation - CRS-R before stimulation). The CRS-R score is a qualitative and quantitative scales ranking predefined behaviors elicited by the patients in the following six subscales, auditory function, visual function, motor function, verbal and oromotor function, communication and wakefulness, the sum of which give a total score ranging from 0 to 23. Higher values of the scale mean a better state of consciousness. This change in state of consciousness will be compared between active stimulation and sham stimulation

    Measured: Two time points: immediately before (baseline) and immediately after stimulation (post-stimulation)

Secondary outcomes (2)
  1. Evoked response potential during local-global paradigm

    Change of the ERPS recorded during the "local global" auditory paradigm (Bekinschtein et al., PNAS 2009)

    Measured: Two time points: immediately before (baseline) and immediately after stimulation (post-stimulation)

  2. Resting state EEG

    Change from baseline of the multivariate automatic classification of conscious state from EEG (Sitt et al., Brain et al. 2014)

    Measured: Two time points: immediately before (baseline) and immediately after stimulation (post-stimulation)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Jul 2018
  2. Study start19 Nov 2018
  3. Primary completion31 Oct 2022
  4. Study completion3 Jan 2024

Why it stopped: Expected number of patients unreached because of COVID19 pandemics. Inclusion stopped at N=20 patients (lower expected number of patients).

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Model description
This study is composed of two independent sub-studies, one exploring the effects of tACS and the other the effects of tDCS, with different participants assigned to the two sub-studies. There will be 2 arms in tACS group and 2 arms in tDCS group. Among each sub-study, all participants will participate in all arms (hence the cross-over design).
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03576248
Sponsor's protocol ID
C17-56
Other IDs
2017-A02763-50
Acronym
CONTEST_3
Status last verified
Jan 2019
First submitted
11 Jun 2018
Last updated
23 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Thibaut A, Bruno MA, Ledoux D, Demertzi A, Laureys S. tDCS in patients with disorders of consciousness: sham-controlled randomized double-blind study. Neurology. 2014 Apr 1;82(13):1112-8. doi: 10.1212/WNL.0000000000000260. Epub 2014 Feb 26.

    PubMed 24574549
  • Polania R, Nitsche MA, Korman C, Batsikadze G, Paulus W. The importance of timing in segregated theta phase-coupling for cognitive performance. Curr Biol. 2012 Jul 24;22(14):1314-8. doi: 10.1016/j.cub.2012.05.021. Epub 2012 Jun 7.

    PubMed 22683259
  • Giacino JT, Ashwal S, Childs N, Cranford R, Jennett B, Katz DI, Kelly JP, Rosenberg JH, Whyte J, Zafonte RD, Zasler ND. The minimally conscious state: definition and diagnostic criteria. Neurology. 2002 Feb 12;58(3):349-53. doi: 10.1212/wnl.58.3.349.

    PubMed 11839831
  • Kalmar K, Giacino JT. The JFK Coma Recovery Scale--Revised. Neuropsychol Rehabil. 2005 Jul-Sep;15(3-4):454-60. doi: 10.1080/09602010443000425.

    PubMed 16350986
  • Sangare A, Munoz-Musat E, Hermann B, Herault C, Belloli L, Breton M, Borden A, Ben Salah A, Valente M, Demeret S, Rohaut B, Sitt JD, Naccache L. Prefrontal tDCS modulates behavioural and neural signatures associated with consciousness. Neuroimage. 2026 Aug 1;336:122015. doi: 10.1016/j.neuroimage.2026.122015. Epub 2026 May 22.

    PubMed 42176825

Questions about this trial

What is this clinical trial studying?

A study testing In-phase 6 Hz prefronto-parietal tACS and 2 mA left prefrontal tDCS in people with Disorder of Consciousness, run by Institut National de la Santé Et de la Recherche Médicale, France at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 23 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: Expected number of patients unreached because of COVID19 pandemics. Inclusion stopped at N=20 patients (lower expected number of patients).). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

State of consciousness (time frame: Two time points: immediately before (baseline) and immediately after stimulation (post-stimulation)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03576248, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Sep 2026.

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