Assisted by tiny electrodes implanted in his brain, a man who had been in a comalike state for six years regained the ability to drink from a cup, comb his hair and speak in short sentences, researchers said Wednesday.
Within hours of receiving what researchers described as an electrical pacemaker for the brain, the man opened his eyes and tracked the movement of people in his hospital room.
More than a year later the man’s progress continued, and recently he recited the first 16 words of the Pledge of Allegiance from memory, researchers said.
The report in the journal Nature challenges the belief that patients trapped in minimally conscious states for prolonged periods are untreatable, researchers said.
“This is a real landmark,” said Dr. Adrian Owen, a neuroscientist at the Medical Research Council’s Cognition and Brain Sciences Unit in Cambridge, England, who was not involved in the research. “This suggests a possible treatment for some patients.”
Researchers said it was clear that the technology would not benefit every minimally conscious patient. The cause and severity of brain injury varies widely, they said, and specific brain connections must remain intact for the treatment to work.
Still, “the report provides hope,” said Dr. Paul Matthews, a professor of clinical neuroscience at Imperial College London, who was not connected to the study. “It emphasizes that improvements can be made by patients even long after an injury.”
In a minimally conscious state, a patient shows intermittent signs of awareness but is generally unable to communicate with the outside world. It is a less severe condition than persistent vegetative state, in which a patient is awake but lacks awareness of self or surroundings.
The late Terri Schiavo had been in a persistent vegetative state for 15 years when her husband won a bitter court battle to have her feeding tube removed in 2005.
There are 100,000 to 300,000 minimally conscious patients in the U.S., researchers said, and most of them are cared for in long-term nursing homes.
The man in the study suffered severe brain injury after he was robbed, beaten and left for dead. Researchers said he was 38 and now lived in an East Coast facility but did not identify him.
Before treatment, the man occasionally nodded his head and mouthed “yes” or “no” but seldom opened his eyes. Because he could not swallow, he received nourishment through a feeding tube.
Using computer-generated maps and image-guided navigation equipment, researchers implanted tiny electrodes in the man’s thalamus, a brain area involved in attention, movement and other control functions. The electrodes were attached by wires to programmable pacemaker batteries implanted in the man’s chest.
The device, called a deep brain stimulator, delivers electrical pulses to the brain and is approved to treat such neurological disorders as Parkinson’s disease.
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