DBS therapy for a persistent vegetative state: ten years follow-up results

Area of Science:

• Neuroscience
• Neurology
• Neurosurgery

Background:

• Persistent vegetative state (PVS) is a severe condition resulting from brain damage.
• Current treatments for PVS have limited efficacy and prognosis is often poor.

Purpose of the Study:

• To evaluate the long-term efficacy of deep brain stimulation (DBS) in patients with persistent vegetative state (PVS).
• To identify neurophysiological predictors of outcome following DBS for PVS.

Main Methods:

• Twenty-one patients in PVS underwent DBS targeting the mesencephalic reticular formation or CM-pf complex.
• Neurological and electrophysiological assessments were performed, including EEG, ABR, and SEP.
• Patients were followed for over 10 years.

Main Results:

• Eight patients (38%) emerged from PVS, able to obey commands but remaining bedridden.
• Emerging patients showed EEG desynchronization and specific ABR/SEP wave characteristics.
• Mean survival was 6.1 years for emerging patients versus 3.1 years for others.
• Four patients (19%) survived over 10 years, a significant improvement over typical PVS survival.

Conclusions:

• DBS therapy can facilitate emergence from PVS in selected patients.
• Neurophysiological criteria are crucial for patient selection in DBS therapy for PVS.
• Long-term survival is notably improved in PVS patients treated with DBS.