Martin Monti, a Professor of Psychology and Neurosurgery at UCLA, and colleagues have recently published a paper in the journal Brain Stimulation, describing their success in jump-starting the brains of two patients in a long-term “minimally conscious state”.
While Monti had already performed a similar procedure on a 25-year-old man recovering from a coma back in 2016, he claims that results of that particular intervention had more to do with luck than the effectiveness of the treatment.
Image credit: pixy.org, CC0 Public Domain
“I consider this new result much more significant because these chronic patients were much less likely to recover spontaneously than the acute patient we treated in 2016 — and any recovery typically occurs slowly over several months and more typically years, not over days and weeks, as we show,” Monti said. “It’s very unlikely that our findings are simply due to spontaneous recovery.”
This time, ultrasound was used on three patients: a 58-year-old man who was put into a “minimally conscious state” by a car accident more than five years ago, a 56-year-old man in the same condition following a stroke, and a 50-year-old woman in even less of a conscious state after a cardiac event that happened two-and-a-half years ago.
Applying small does of ultrasound to the thalamus (pictured above) seems to “wake up” some patients from low-consciousness states induced by traumatic brain injury. Image: Wikipedia.org, CC BY-SA 3.0
All three patients were exposed to low-intensity ultrasound in two sessions, one week apart. During each session, acoustic energy was delivered by a small device placed near the patients' heads and activated 10 times for 30 seconds.
Ultrasound was directed at the thalamus – the brain’s processing hub involved in relaying sensory signals and the regulation of sleep, alertness, and consciousness. Thalamus function is often impaired following a coma.
Although the first patient did not show any improvement, the other two recovered a small, but highly significant degree of function. Within mere days of the intervention, the responsive patients were able to identify and grasp different objects, as well as use pen and paper to communicate and answer questions.
Referring to the wife of the 56-year-old patient, Monti had this to say: “She said to us, ‘This is the first conversation I had with him since the accident’. For these patients, the smallest step can be very meaningful – for them and their families. To them it means the world”.
The intervention was well-tolerated and Monti hopes to eventually make it available in the form of a small device that could be safely used at home to rouse patients from a “minimally conscious” or vegetative state.
Once assured of being safe from COVID-19, Monti and his team plan to commence further clinical trials to learn more about the way in which ultrasound modulates thalamic function in comatose patients.
Source: newsroom.ucla.edu