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Do Sensory Stimulation Programs Have an Impact on Consciousness Recovery?
Lijuan Cheng1, Daniela Cortese2, Martin M Monti3,4
1International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.
Frontiers in Neurology
|October 19, 2018
Summary
Sensory stimulation programs (SSP) may improve behavioral responsiveness in patients with minimally conscious state (MCS) but not vegetative state (VS). This study used a withdrawal design to assess SSP effects on consciousness disorders.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Clinical Neurology
Background:
- Sensory stimulation programs (SSP) are debated for treating disorders of consciousness (DOC).
- Previous efficacy studies were limited by small sample sizes and spontaneous recovery.
- A time-series design was employed to assess treatment-related changes in DOC patients.
Purpose of the Study:
- To evaluate the efficacy of SSP in patients with disorders of consciousness (vegetative state-VS and minimally conscious state-MCS).
- To assess treatment-related behavioral and functional changes using a time-series design.
Main Methods:
- A withdrawal (ABAB) design was utilized, alternating between SSP application (B phases) and no treatment (A phases).
- The Coma Recovery Scale-Revised (CRS-R) was administered weekly by an independent rater.
- Resting-state functional magnetic resonance imaging (fMRI) was conducted in a subset of patients.
Main Results:
- Patients in the minimally conscious state (MCS) group showed significantly higher CRS-R total scores, arousal, and oromotor subscores during SSP (B phases) compared to no treatment (A phases).
- No significant improvements were observed in the vegetative state (VS) group.
- fMRI data revealed treatment-related metabolic activity modulation in specific brain regions, including the middle frontal gyrus and thalamus.
Conclusions:
- SSP may not be sufficient to restore consciousness in patients with disorders of consciousness.
- SSP might enhance behavioral responsiveness, particularly arousal and oromotor functions, in MCS patients.
- Further research is needed to clarify the role and optimal application of SSP in DOC rehabilitation.
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