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Deep brain stimulation therapy for the vegetative state.

Takamitsu Yamamoto1, Yoichi Katayama

  • 1Department of Neurological Surgery and Division of Applied System Neuroscience, Nihon University School of Medicine, 30-1 Ohyaguchi Kamimachi, Itabashi-ku, Tokyo 173-8610, Japan. nusmyama@med.nihon-u.ac.jp

Neuropsychological Rehabilitation
|December 15, 2005
PubMed
Summary
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Deep brain stimulation (DBS) helped some patients emerge from a vegetative state (VS), but neurorehabilitation is crucial for recovery. DBS shows promise for improving consciousness in VS and minimally conscious state patients.

Area of Science:

  • Neuroscience
  • Neurology
  • Neurosurgery

Background:

  • Vegetative state (VS) and minimally conscious state (MCS) present significant challenges in patient recovery and prognostication.
  • Emergence from VS/MCS requires effective therapeutic interventions targeting brain function and consciousness.

Purpose of the Study:

  • To evaluate the efficacy of deep brain stimulation (DBS) in patients with vegetative state (VS).
  • To assess the long-term outcomes of DBS targeting the mesencephalic reticular formation or thalamic centre median-parafascicular (CM-pf) complex.
  • To explore the potential of DBS in improving consciousness and functional status in VS and MCS patients.

Main Methods:

  • Neurological and electrophysiological evaluations of 21 VS patients three months post-brain injury.

Related Experiment Videos

  • Treatment with deep brain stimulation (DBS) targeting either the mesencephalic reticular formation (2 cases) or thalamic CM-pf complex (19 cases).
  • Long-term follow-up exceeding 10 years.

    • Main Results:

    • Eight out of 21 patients (38%) emerged from the vegetative state, demonstrating the ability to obey verbal commands.
    • Most emerged patients remained bedridden, highlighting the need for adjunctive therapies.
    • Deep brain stimulation (DBS) showed potential for facilitating emergence from VS, contingent on appropriate neurophysiological candidate selection.

    Conclusions:

    • Deep brain stimulation (DBS) can be a viable therapeutic option for facilitating emergence from vegetative state (VS), particularly when guided by specific neurophysiological criteria.
    • A comprehensive neurorehabilitation system is essential for addressing the persistent bedridden state in VS patients post-DBS.
    • DBS therapy holds promise for enhancing discernible behavioral evidence of consciousness in minimally conscious state (MCS) patients and aiding their emergence from the bedridden state.