TECHNOLOGY FOR CHANGE

Deep Brain Stimulation May Provide Return to Consciousness

Dave Greenfield | Date: 03-26-10 | Comments

A treatment involving electrical stimulation has restored consciousness, allowing a patient to speak and eat food orally for the first time in six years.

A patient lay in a hospital for more than six years after an assault left him with severe head injuries. In a deep coma in a long-term care facility, he was in a �minimally conscious� state, unable to follow commands consistently or follow communication. A treatment involving deep brain stimulation has restored consciousness, allowing the patient to speak and eat food orally for the first time in six years.

Researchers have been working on the issue of consciousness for more than a decade. Dr. Joseph J. Fins, co-author of the study involving the minimally conscious patient, says, �We�re seeing a recuperative capability of the brain that we assumed wasn�t there. But there is a capability there, and what we�ve done is try to harness it and accelerate it here, amplifying the circuits and accelerating the process.�

Patients like the one described above are often misdiagnosed�as often as 37 percent to 43 percent of the time�as being in a coma or nonresponsive vegetative state when they do in fact have minimal consciousness. Misdiagnosis, and the failure to adequately follow up acute care with more screenings, has led to improper treatment for these types of patients.

In this patient�s case, he was treated with thalamic deep brain stimulation. Here, a brain pacemaker is implanted in the brain, which sends electrical impulses to other parts of the brain. This can be effective in minimally conscious patients because they still have intact neural networks. The problem is that they are dormant. The electrical stimulation can cause them to, in essence, wake up.

Deep brain stimulation has been used in the treatment of Parkinson�s disease, Tourette syndrome and major depression. Whether or not deep brain stimulation can have as dramatic an effect on other minimally conscious patients is uncertain. The study reminds, �The behavioral improvements described in this report are notable, given their late emergence and potential functional significance. However, the generalizability of the results is unknown, and the expectations raised by this report should be tempered.�

Still, this is an exciting development and demonstration of the importance of correct diagnoses of those with severe brain injuries.