Deep Brain Stimulation Rouses Man In Minimally Conscious State

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Main Category: Neurology / Neuroscience
Also Included In: Medical Devices / Diagnostics
Article Date: 04 Aug 2007 - 12:00 PDT

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A man who could not speak, chew or swallow for six years can now do so after responding to deep brain stimulation, a type of treatment using electrical pulses in specific parts of the brain. In 1999 the man had been beaten up and left for dead while on his way home. His skull was severely crushed and his brain badly damaged. Doctors said that if he managed to survive he would spend the rest of his days living like a vegetable. Occasionally, during the last six years, he would show signs of being aware of things - he was able to move his eyes, and sometimes a thumb to communicate.

The family has requested that the patient remains unidentified. You can read a detailed report on this procedure in the journal Nature.

He was selected for a new pioneering type of treatment in which electrodes are place in specific parts of his brain. The patient's mother is amazed at the results. She says he can now eat without needing to have a feeding tube, he is able to watch a movie without falling asleep, he can drink from a cup, express pain, cry and laugh. His mother added "The most important part is he can say, Mommy and Pop. He can say, I love you, Mommy. I still cry every time I see my son, but it's tears of joy."

In order to fully asses how effective this type of treatment may be on a wider scale, experts say a large study with various participants is needed.

The man had not been in a coma, rather he had been in a minimally conscious state. This means he was most probably only aware of himself and his surroundings occasionally. A person who is in a coma shows no signs of being aware of anything. It is roughly estimated that up to one quarter of a million people in America might currently be in a minimally conscious state. So far, there have been no medications that can improve their conscious state.

Deep brain stimulation has been used with patients suffering from Parkinson's disease. The treatment attempts to activate areas of the brain with millimeter accuracy that deal with survival skills, such as speaking, eating and drinking.

This patient is now able to chew and swallow, he can now mimic the motions of brushing his teeth. His speech is still very limited - he responds to questions with one, two or three word answers. He can now turn his head. He can brush his hair - although with great difficulty, partly because his tendons have not moved for so long.

Doctors say he continues to improve. The electrodes are on for about twelve hours each day. He is also on amantadine, a drug administered to patients in a minimally conscious state. Doctors are not yet sure whether the brain stimulation is helping the amantadine work better, or whether the amantadine is helping the effect of the pulses.

Brain activity revived
Editor's Summary
Nature doi:10.1038/448522a

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Written by: Christian Nordqvist
Copyright: Medical News Today
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