Short-Term Spinal Cord Stimulation Improves Consciousness Level in Prolonged Disorders of Consciousness

Area of Science:

• Neurology
• Neurosurgery
• Rehabilitation Medicine

Background:

• Prolonged disorders of consciousness (pDOC) present significant management challenges.
• Efficacy of short-term spinal cord stimulation (stSCS) for pDOC is debated due to limited controlled studies.
• This study addresses the need for robust evidence on stSCS effectiveness in pDOC.

Purpose of the Study:

• To evaluate the effectiveness of stSCS in patients with pDOC.
• To compare consciousness improvement rates between stSCS-treated and non-treated patients.
• To identify stSCS as a potential prognostic factor for improved outcomes.

Main Methods:

• Retrospective analysis of 186 pDOC patients (26 stSCS-treated, 160 controls).
• Propensity score matching (PSM) and inverse probability treatment weighting (IPTW) to control for baseline differences.
• Univariate logistic regression to determine independent prognostic factors.

Main Results:

• stSCS-treated patients showed significantly higher consciousness improvement rates at 3 months (IPTW OR 3.475, p=0.003; PSM OR 2.524, p=0.04).
• These benefits were sustained at 6 months (IPTW OR 2.666, p=0.029; PSM OR 2.789, p=0.038).
• stSCS was confirmed as an independent predictor of improved outcomes (p<0.05).

Conclusions:

• Preliminary evidence suggests stSCS may be efficacious for pDOC.
• Sustained benefits at 3 and 6 months indicate potential value of early stSCS intervention.
• Further validation in larger cohorts is warranted to confirm findings.