title: Deep brain stimulation and spinal cord stimulation for vegetative state and minimally conscious state.
abstract: OBJECTIVE
  On the basis of the findings of the electrophysiological evaluation of vegetative state (VS) and minimally conscious state (MCS), the effect of deep brain stimulation (DBS) was examined according to long-term follow-up results. The results of spinal cord stimulation (SCS) on MCS was also examined and compared with that of DBS.
  
  
  METHODS
  One hundred seven patients in VS and 21 patients in MCS were evaluated neurologically and electrophysiologically over 3 months after the onset of brain injury. Among the 107 VS patients, 21 were treated by DBS. Among the 21 MCS patients, 5 were treated by DBS and 10 by SCS.
  
  
  RESULTS
  Eight of the 21 patients recovered from VS and were able to follow verbal instructions. These eight patients showed desynchronization on continuous electroencephalographic frequency analysis. The Vth wave of the auditory brainstem response and N20 of somatosensory evoked potential were recorded even with a prolonged latency, and pain-related P250 was recorded with an amplitude of more than 7 μV. In addition, DBS and SCS induced a marked functional recovery in MCS patients who satisfied the electrophysiological inclusion criteria.
  
  
  CONCLUSIONS
  DBS for VS and MCS patients and SCS for MCS patients may be useful, when the candidates are selected on the basis of the electrophysiological inclusion criteria. Only 16 (14.9%) of the 107 VS patients and 15 (71.4%) of the 21 MCS patients satisfied the electrophysiological inclusion criteria.
authors.affiliation: Division of Applied System Neuroscience, Nihon University School of Medicine, Tokyo, Japan. Electronic address: yamamoto.takamitsu@nihon-u.ac.jp.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Katayama
authors.forename: Toshiki
authors.initials: T
authors.lastname: Obuchi
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Oshima
authors.forename: Chikashi
authors.initials: C
authors.lastname: Fukaya
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000379:methods*; D004558:Electric Stimulation; D004569:Electroencephalography; D055724:Electrophysiological Phenomena; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000523:psychology / Q000601:surgery*; D020127:Recovery of Function; D012154:Reticular Formation / Q000502:physiology; D062187:Spinal Cord Stimulation / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult