engleski

Deep brain stimulation for the early treatment of the minimal consciousness state and vegetative state.

Introduction: To present results of DBS for the early treatment of minimal consciousness state (MCS) and vegetative state (VS) caused by hypoxic encephalopathy or traumatic brain injury in eleven patients. Methods: Eleven patients were evaluated neurologically and electrophysiologically for possible treatment with deep brain stimulation. Among these patients, seven patients were in vegetative state and four patients were in minimal consciousness state. The stimulation sites in all patients were centromedian-parafascicular nucleus complex. Somatosensory, motor and brain stem auditory evoked potentials, and 24 hour recordings of EEG were performed before surgery. PET CT was performed before and after DBS implantation. Patients were stimulated during the day for 30 min every three hours with different intensity and frequency parameters. Results: Two patients in MCS regained consciousness, independent walking without help, become able to speak, showing impressive speech comprehension, but needed some assistance with their everyday life. Other nine patients remained bedridden and their status remained unchanged but showed improvement in Rappaport Coma/Near coma scale. Conclusion: The DBS is not yet “evidence-based treatment” of the vegetative and MCS. This report shows that if the patient fulfills neurophysiologic, PET and clinical criteria he should be treated with DBS at the very early stage of MCS.

Deep brain stimulation; minimal consciousness state

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