Neuromodulation on cervical spinal cord combined with hyperbaric oxygen in comatose patients--a preliminary report.
BACKGROUND
Because both SCS and HBO therapy have shown some promise in treating patients with states of reduced consciousness, we evaluated the combination of therapies in a prospective trial in comatose patients.


METHODS
Twelve patients who had received median nerve stimulation for 3 months without improvement in consciousness received cSCS for 1 year combined with simultaneous HBO therapy for the first 3 months. Another group enrolled 12 patients who received median nerve stimulation only were served as control.


RESULTS
Six patients emerged from coma at 1 year (after conclusion of treatment). Glasgow Coma Scale score, SPECT imaging, and PVS scores (state and reaction subscores) of the 12 patients were all significantly increased at 1 year compared with enrollment (P < .05). Neither respirator nor tracheostomy was needed to assist respiration in any patient. Only 1 of 12 patients still needed nasogastric tube feeding at 1 year. By contrast, control patients (without cSCS and HBO therapy) showed no apparent improvement.


CONCLUSIONS
Increase of GCS score, cerebral blood perfusion, and PVS scores were observed in comatose patients treated with combined cSCS and HBO therapy.
Liu
Jung-Tung
JT
Department of Neurosurgery, Chung-Shan Medical University Hospital, Taichung 40201, Taiwan.
Lee
Jong-Kang
JK
Tyan
Yeu-Sheng
YS
Liu
Che-Yu
CY
Chen
Yung-Hsiang
YH
Lin
Tzer-Bin
TB
D000328:Adult; D015415:Biomarkers; D020201:Brain Hemorrhage, Traumatic / Q000150:complications / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D002574:Cervical Vertebrae / Q000601:surgery; D003128:Coma / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods; D004599:Electric Stimulation Therapy / Q000379:methods* / Q000706:statistics & numerical data; D004567:Electrodes, Implanted; D004750:Enteral Nutrition / Q000706:statistics & numerical data; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008475:Median Nerve / Q000502:physiology; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D013116:Spinal Cord / Q000502:physiology / Q000601:surgery*; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D055815:Young Adult
D015415:Biomarkers