According to a new study, treatment may have “jump-started” the brains of two patients who were in minimal consciousness for months after a coma.
Both patients were severe Brain injury And for over a year, it showed only limited signs of consciousness.However, patients showed a sudden improvement in their condition, according to a study published in the journal on January 15, after receiving treatments that included ultrasound that “excited” cells in a region of the brain called the thalamus. Ta Brain stimulation.. For example, after treatment, one patient can move his head to answer a specific question and say “yes” or “no.”
Such rapid recovery is rare in patients with long-term minimal consciousness. That is, the person is awake, but shows only small signs of consciousness. In these patients, “recovery usually occurs slowly over months, and more generally years,” says Martin, a research co-author who is a professor of psychology and neurosurgery at the University of California, Los Angeles.・ Monty says. Said in a statement.. However, he said, these two patients made significant progress in just days to weeks.
Previous studies have shown that stimulating the thalamus with surgically implanted electrodes shows similar improvement, but the method is invasive and may not work in all patients. Dr. Neil Singhal, an assistant professor of neurology at the University of California, San Francisco, said. Francisco who was not involved in the study. Singhal called the new study “breakthrough” because the method is “non-invasive and may be applicable to a much wider range of patients than deep brain stimulation.”
However, the new findings are very preliminary and ultrasound may not be useful for all patients. The new study had a total of 3 patients. Of the two patients who benefited, one showed the first improvement, but later regressed, and the third patient did not.
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Sudden improvement
For research, doctors use a device like a saucer to give ultrasonic pulses brain.. In this case, researchers targeted the thalamus, a deep structure in the brain that acts as a hub for relaying sensory information to other parts of the brain. Researchers have targeted this area because coma often results in poor performance.
Three patients in this study received two 10-minute sessions using the device every other week.
One of the patients was a 56-year-old man who remained in minimal consciousness for the next 14 months. stroke.. After ultrasound treatment, the man showed that when he heard his name, he was able to consistently respond to commands such as dropping the ball and looking at pictures of his relatives. He was also able to nod “yes” and shake his head to mean “no” when asked about himself. And for the first time since my stroke, I was able to put the bottle in my mouth with a pen and paper. However, the man returned to a minimal state of consciousness after a few months.
The second patient was a 50-year-old woman who had minimal consciousness for 2.5 years after admission. Cardiac arrest.. She had previously been unresponsive to commands, but after treatment she responded to commands by consistently moving her head or fingers. She was also able to recognize objects such as pencils and combs for the first time in years. They said the woman maintained her improvement over a six-month follow-up period.
The third patient, a 58-year-old man, was almost unconscious for 5.5 years after the car accident, but the treatment had no effect.
Breakthrough discovery
In 2016, researchers in the same group used ultrasound therapy on a 25-year-old man who was in minimal consciousness for just a few weeks.In that case, the treatment also seemed to activate his brain — he quickly recovered completely. Consciousness And language understanding.
But then, the researchers warned that their discovery might have been just a coincidence — in other words, the man might have recovered spontaneously just as the researchers began treatment. According to Monty, the new report is “very unlikely” to recover spontaneously, given the duration of the two patients’ minimal consciousness.
As to why the third patient in the new study did not respond to treatment, researchers speculate that his thalamus is probably damaged or isolated from other brain regions. For that patient subgroup, this method may not help.
“For example, if someone has a” completely severed “thalamus, we can stimulate it as much as we need, and the brain networks needed for complex cognitive functions (and behaviors). Does not help reignite complex nets. Monti emailed Live Science.
The changes seen in this study are small but can have significant implications for patients and their families. “For our patients, even if they can communicate with their loved ones, in a limited way … regaining the social environment, the ability to become a part of their loved ones’ lives, means some recovery. Maybe. Personal autonomy. “
Researchers said they are investigating whether the dose and frequency of ultrasound exposure can affect the level and duration of benefits. “By further fine-tuning the stimulation protocol, patient selection, and device, this may have tangible benefits for patients with severe brain injury,” he said, currently to improve neurological recovery. There is no definitively effective treatment available.
The authors emphasized that ultrasound therapy is and is unlikely to be open to the public for several years.
Originally published in Live Science.
