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SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
Published on: February 6, 2021
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Apomorphine for prolonged disorders of consciousness: a multimodal open-label study
Leandro R D Sanz1,2,3, Nicolas Lejeune1,2,4,5, Emilie Szymkowicz1,2
1Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium.
Eclinicalmedicine
|December 3, 2024
Summary
Apomorphine treatment significantly improved consciousness in patients with prolonged disorders of consciousness (PDoC). This study showed enhanced brain connectivity and metabolism, suggesting apomorphine as a potential therapy for PDoC.
Area of Science:
- Neuroscience
- Neurology
- Pharmacology
Background:
- Prolonged disorders of consciousness (PDoC) present significant challenges in neurorehabilitation.
- Apomorphine, a dopaminergic agent, is being investigated for its potential to improve recovery in PDoC.
- Previous studies showed behavioral improvements, but efficacy and neural mechanisms require further investigation.
Purpose of the Study:
- To investigate the efficacy and neural mechanisms of apomorphine in patients with PDoC.
- To assess behavioral and neurophysiological changes following apomorphine treatment.
- To evaluate the safety and feasibility of apomorphine therapy in a severely brain-injured population.
Main Methods:
- An open-label, controlled study involving 13 PDoC patients over 30 days.
- Apomorphine treatment group (n=6) received subcutaneous injections, while the control group (n=7) received standard care.
- Multimodal outcome measures included Coma Recovery Scale-Revised (CRS-R), electroencephalography (EEG), and fluorodeoxyglucose positron emission tomography (FDG-PET).
Main Results:
- Apomorphine treatment significantly improved behavioral diagnosis (CRS-R) compared to controls and baseline.
- Patients receiving apomorphine showed increased conscious behaviors, improved brain connectivity (alpha-band), and enhanced whole-brain metabolism.
- Apomorphine treatment was associated with higher DoC-feeling scores reported by families and medical staff.
Conclusions:
- Apomorphine treatment led to long-lasting improvements in consciousness for PDoC patients.
- Observed changes in brain connectivity and metabolism provide insights into neurophysiological mechanisms.
- Apomorphine is a feasible and safe therapeutic option for PDoC, warranting further clinical investigation.
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