A severely brain injured man, who has been in MCS (minimally conscious state) for the last six years, is again able to chew his own food and communicate with his family thanks to deep brain stimulation therapy. The surgical technique implants stimulators that send electrical impulses to the central thalamus.
“The changes in the man’s functional abilities were statistically linked to the use of DBS, and those changes have been remarkable and sustained,” says Dr. Rezai, the paper’s senior author, Director of the Cleveland Clinic’s Center for Neurological Restoration, and Professor of Neurosurgery. “We hope that the first use of DBS to treat patients in a MCS marks the beginning of a significant period of innovation in our approach to traumatic brain injury.”
“Prior to the use of DBS, the patient’s communication ability was inconsistent, including only slight eye or finger movements. Now, he regularly uses words and gestures and responds to questions quickly,” says Dr. Giacino, the study’s co-lead author and Associate Director of Neuropsychology at JFK Johnson Rehabilitation Institue and the New Jersey Neuroscience Institute. “In addition, he now chews and swallows his food and no longer requires a feeding tube. Before, he could not use his limbs for functional movement, but he can now perform some complex movements, including those required for drinking from a cup or brushing hair. Years of severe immobility and tendon contracture, however, do greatly limit him from carrying out these tasks.”
The DBS surgery targets deep-brain structures with millimeter-precision using computer-generated maps, image-guided navigation and physiological brain mapping. Tiny electrodes are implanted into these deep-brain structures and connected to programmable pacemaker batteries in the chest. The operation was complicated by the extensive damage to the patient’s brain from the traumatic injury. The procedure was performed in two stages and lasted 10 hours. DBS surgery is FDA-approved and routinely performed for patients with Parkinson’s disease. Various clinical trials using DBS for the treatment of epilepsy, obsessive-compulsive disorder and depression are also underway.
After an initial “titration” period – during which the team calibrated the best dose and timing – the patient began a 6-month, double-blinded on/off “crossover” trial, with periods of DBS alternating with periods where he did not receive the therapy.
Details in the NewYork/Presbytarian press release….