title: Right Median Nerve Electrical Stimulation for Acute Traumatic Coma Patients.
abstract: The right median nerve as a peripheral portal to the central nervous system can be electrically stimulated to help coma arousal after traumatic brain injury (TBI). The present study set out to examine the efficacy and safety of right median nerve electrical stimulation (RMNS) in a cohort of 437 comatose patients after severe TBI from August 2005 to December 2011. The patients were enrolled 2 weeks after their injury and assigned to the RMNS group (n=221) receiving electrical stimulation for 2 weeks or the control group (n = 216) treated by standard management according to the date of birth in the month. The baseline data were similar. After the 2-week treatment, the RMNS-treated patients demonstrated a more rapid increase of the mean Glasgow Coma Score, although statistical significance was not reached (8.43 ± 4.98 vs. 7.47 ± 5.37, p = 0.0532). The follow-up data at 6-month post-injury showed a significantly higher proportion of patients who regained consciousness (59.8% vs. 46.2%, p = 0.0073). There was a lower proportion of vegetative persons in the RMNS group than in the control group (17.6% vs. 22.0%, p = 0.0012). For persons regaining consciousness, the functional independence measurement (FIM) score was higher among the RMNS group patients (91.45 ± 8.65 vs. 76.23 ± 11.02, p < 0.001). There were no unique complications associated with the RMNS treatment. The current study, although with some limitations, showed that RMNS may serve as an easy, effective, and noninvasive technique to promote the recovery of traumatic coma in the early phase.
authors: 1 Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .|2 Shanghai Institute of Head Trauma , Shanghai, China .
authors: Jin
authors: J
authors: Lei
authors: 1 Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .|2 Shanghai Institute of Head Trauma , Shanghai, China .
authors: Lei
authors: L
authors: Wang
authors: 1 Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .|2 Shanghai Institute of Head Trauma , Shanghai, China .
authors: Guoyi
authors: G
authors: Gao
authors: 3 Department of Neurological Surgery, University of Virginia Health System , Charlottesville, Virginia.
authors: Edwin
authors: E
authors: Cooper
authors: 1 Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .|2 Shanghai Institute of Head Trauma , Shanghai, China .
authors: Jiyao
authors: J
authors: Jiang
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D020207:Coma, Post-Head Injury / Q000209:etiology / Q000628:therapy*; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008475:Median Nerve; D008875:Middle Aged; D016896:Treatment Outcome
keywords: coma; efficacy; right median nerve stimulation; severe traumatic brain injury