Deep brain stimulation in the management of disorders of consciousness: a review of physiology, previous reports, and ethical considerations.
Patients suffering from disorders of consciousness constitute a population that exists largely outside of the daily practice patterns of neurosurgeons. Historically, treatment has focused on nursing and custodial issues with limited neurosurgical intervention. Recently, however, deep brain stimulation has been explored to restore cognitive and physical function to patients in minimally conscious states. In this article, the authors characterize the physiological mechanisms for the use of deep brain stimulation in persistently vegetative and minimally conscious patients, review published cases and associated ethical concerns, and discuss future directions of this technology.
Sen
Anish N
AN
Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Campbell
Peter G
PG
Yadla
Sanjay
S
Jallo
Jack
J
Sharan
Ashwini D
AD
D002540:Cerebral Cortex / Q000502:physiology; D003244:Consciousness Disorders / Q000628:therapy*; D046690:Deep Brain Stimulation / Q000941:ethics / Q000379:methods*; D006801:Humans; D009434:Neural Pathways / Q000502:physiology; D018458:Persistent Vegetative State / Q000628:therapy; D012154:Reticular Formation / Q000502:physiology; D013788:Thalamus / Q000502:physiology; D016896:Treatment Outcome