Right Median Nerve Electrical Stimulation for Acute Traumatic Coma Patients

Area of Science:

• Neuroscience
• Neurology
• Rehabilitation Medicine

Background:

• Traumatic brain injury (TBI) frequently results in prolonged coma, posing significant challenges for patient recovery and long-term outcomes.
• The right median nerve offers a peripheral pathway to the central nervous system, suggesting potential for therapeutic intervention in TBI-induced coma.

Purpose of the Study:

• To evaluate the efficacy and safety of right median nerve electrical stimulation (RMNS) for promoting coma arousal in patients with severe TBI.
• To assess the impact of RMNS on the rate of consciousness recovery, proportion of patients in vegetative states, and functional independence at 6-month follow-up.

Main Methods:

• A cohort of 437 comatose patients with severe TBI were enrolled 2 weeks post-injury.
• Patients were randomized into two groups: RMNS group (n=221) receiving 2 weeks of electrical stimulation, and a control group (n=216) receiving standard management.
• Glasgow Coma Score, consciousness recovery rates, vegetative state proportions, and Functional Independence Measurement (FIM) scores were assessed.

Main Results:

• RMNS-treated patients showed a trend towards a more rapid increase in Glasgow Coma Score (p=0.0532).
• Significantly higher rates of consciousness recovery (59.8% vs. 46.2%, p=0.0073) and lower proportions of vegetative state (17.6% vs. 22.0%, p=0.0012) were observed in the RMNS group at 6 months.
• Patients regaining consciousness in the RMNS group achieved significantly higher FIM scores (91.45 ± 8.65 vs. 76.23 ± 11.02, p < 0.001).

Conclusions:

• Right median nerve electrical stimulation (RMNS) appears to be an effective and safe non-invasive technique for promoting recovery from traumatic coma.
• RMNS may enhance consciousness arousal, improve functional outcomes, and reduce the time spent in a vegetative state following severe TBI.
• The findings suggest RMNS as a potential early-phase intervention to improve TBI patient recovery trajectories.