PVS

 

Widening the opening of the “window” to the brains of patients who are in a PVS or who are minimally conscious

By Dave Andrusko

Dr. Steven Laureys

I confess my predilection for research (which grows yearly) that proves there is a lot more going on with patients who’ve suffered severe brain injuries than many “experts” have led us to believe. This is separate from misdiagnoses, which are a constant bane.

We’re referring, rather, to the kind of excruciatingly careful experiments that reveal that the brains of people who’ve been diagnosed as being in either a persistent vegetative state or “minimally conscious” can be roused.
The latest example—“Brain zap rouses people from years of vegetative state”—is explored in “New Scientist” magazine. (The story is more sober than the headline.)
What you notice is that many of the same names crop up–Steven Laureys and Joseph Fins, in particular. These are scientists who’ve invested a large portion of their professional careers to finding “windows” and then widening the opening.
Here’s what they did, here’s what they found, according to New Scientist correspondent Helen Thomson.

“The team worked with 55 people who had experienced a traumatic brain injury or lack of oxygen to the brain and were in a minimally conscious or vegetative state. They placed electrodes over their left dorsolateral prefrontal cortex – an area involved in memory, decision-making and awareness. Then they delivered 20 minutes of stimulation to some of the people and a sham treatment to the others. The next day, the two groups received the opposite therapy. …

And the results?

“Soon after it was applied to their brains, 15 people with severe brain damage showed signs of consciousness, including moving their hands or following instructions using their eyes. Two people were even able to answer questions for 2 hours before drifting back into their previous uncommunicative state.”

[Thirteen of the 15 had been diagnosed to be minimal conscious and two people were in a persistent vegetative state.]
Laureys, who led the research, was simultaneously very cautious and optimistic in reporting the results to Thomson.

“I don’t want to give people false hope – these people weren’t getting up and walking around – but it shows there is potential for the brain to recover functionality, even several years after damage.”

Dr. Joseph Fins

And that is one of the most encouraging results. Mild electrical stimulation led to improvements not just in those who’ve recently suffered traumas.
Why is that important? According to Laureys, “There’s this dogma that if you don’t see a change in 12 months you will never see it. This research challenges that.”
True, the results did not last; by and large two hours was the outer limit. The objective, obviously, is to realize “more lasting arousal” of the brain.
There are lots of ways of tinkering with the treatment, Thomson reports: stimulating the brain for longer periods of time and stimulating other areas of the brain, for example, which is what Laureys is already doing.
But, having said that, it is also true, as noted above, “Two patients emerged from a minimally conscious state altogether,” Laureys said. Thomson writes

“When asked questions such as ‘Am I touching my nose?,’ they were able to answer by nodding their head or making specific eye movements.

“Others were able to respond to simple commands to nod, or squeeze their hand.”

We will continue to keep you updated on the latest results.
The more we know about severely brain-injured people, the less likely many doctors will reflexively conclude that the prognosis is hopelessly bleak and suggest to the family to “pull the plug.”
For more NRL News Today stories about Laureys’ and Fins’ research, go to nrlc.cc/1gaKJRU; nrlc.cc/1gaKR3O; nrlc.cc/1orB65M; and nrlc.cc/1orBdhy.
You can read another great story about a different technique here.

Source: NRLC News