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

<b><i>Design:</i></b> 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). <b><i>Setting:</i></b> Single-center study in the Department of Rehabilitation of Jinhua Hospital of TCM Affiliated to Zhejiang University of Traditional Chinese Medicine. <b><i>Participants:</i></b> Twenty-nine patients with DoC. <b><i>Intervention:</i></b> Systematic review of clinical records comparing ds-TMS (DLPFC + cerebellum) with conventional single-site DLPFC-rTMS. <b><i>Main Measures:</i></b> Coma Recovery Scale-Revised (CRS-R) scores, mismatch negativity (MMN) latency, P300 latency, Judson grade, and Hall grade. <b><i>Results:</i></b> 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. <b><i>Conclusions:</i></b> ds-TMS treatment may represent an effective therapeutic approach for DoC, with potential effects on consciousness recovery.