DBS therapy for the vegetative state and minimally conscious state.
Twenty-one cases of a vegetative state (VS) and 5 cases of a minimally conscious state (MCS) caused by various kinds of brain damage were evaluated neurologically and electrophysiologically at 3 months after brain injury. These cases were treated by deep brain stimulation (DBS) therapy, and followed up for over 10 years. The mesencephalic reticular formation was selected as a target in 2 cases of VS, and the CM-pf complex was selected as a target in the other 19 cases of VS and 5 cases of MCS. Eight of the 21 patients emerged from the VS, and became able to obey verbal commands. However, they remained in a bedridden state except for 1 case. Four of the 5 MCS patients emerged from the bedridden state, and were able to enjoy their life in their own home. DBS therapy may be useful for allowing patients to emerge from the VS, if the candidates are selected according to appropriate neurophysiological criteria. Also, a special neurorehabilitation system may be necessary for emergence from the bedridden state in the treatment of VS patients. Further, DBS therapy is useful in MCS patients to achieve consistent discernible behavioral evidence of consciousness, and emergence from the bedridden state.
Department of Neurological Surgery and Division of Applied System Neuroscience, Nihon University School of Medicine, Tokyo, Japan. nusmyama@med.nihon-u.ac.jp
T
T
Yamamoto
K
K
Kobayashi
M
M
Kasai
H
H
Oshima
C
C
Fukaya
Y
Y
Katayama
D000293:Adolescent; D000328:Adult; D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000145:classification / Q000175:diagnosis* / Q000534:rehabilitation*; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome