Neruomodulation treatment for patients under persistent vegetative state
10.3760/cma.j.issn.1671-8925.2013.12.003
- VernacularTitle:持续性植物状态的神经调控治疗
- Author:
Jiang-Hong HE
1
;
Yi YANG
;
Hui JIAO
;
Yuan-Yuan DANG
;
Yi-Wu DAI
;
Qiang ZHANG
;
Ru-Xiang XU
Author Information
1. 北京军区总医院附属八一脑科医院
- Keywords:
Persistent vegetative state;
Neuromodulation;
Deep brain stimulation;
Spinal cord stimulation
- From:
Chinese Journal of Neuromedicine
2013;12(12):1197-1200
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of neruomodulation treatment,including deep brain stimulation (DBS) and spinal cord stimulation (SCS),on patients under persistent vegetative state (PVS).Methods Fifty-three patients diagnosed as having PVS,admitted to our hospital from July 2011 to December 2012,were chosen in our study; after selection,42 patients were enrolled (27 males and 15 females,mean 42.9±5.47 years old) and prospectively divided into control group (n=20) and surgical group (n=22).Patients from surgical group received DBS (n=5) and SCS (n=17) treatments,while patients from control group underwent routine rehabilitation activities.Behavioral assessments were repeatedly performed using Revised Coma-Recovery Scale (CRS-R).Some patients underwent functional magnetic resonance imaging (fMRI) to further assess the outcomes.Clinical baseline values were collected and compared to follow-up data.Results No statistical significant differences of age,duration of coma and CRS-R scores were noted between the two groups before treatment.Thirty-seven patients (17 in control group and 20 in surgical group) got follow-up for 6-24 months (median 11.2 months); seven patients in the surgical group emerged from PVS to achieve consistent discemible behavioral evidence of consciousness with a recovery rate of 35 ％ (7/20),while only 1 from the control group with a recovery rate of 5.9％(1/17); significant difference was noted between the two groups (P＜0.05).Improvement in behavioral assessments (CRS-R scores) in the surgical group was significantly better than that in the control group (P＜0.05); however,no significant difference of CRS-R scores was noted between patients received DBS and SCS treatment (P＞0.05).The fMRI showed good consistency of activation of resting state default network key area and function connected degree with clinical assessment.Conclusion Neuromodulation therapy can effectively promote awareness of PVS patients based on rigorous selection criteria; DBS and SCS treatments show no difference in the clinical efficacy.
