WEDNESDAY, Aug. 1 (HealthDay News) -- In a scene reminiscent of Oliver Sacks' book Awakenings, doctors have managed to partially rekindle the mind of a man who had been in a minimally conscious state for six years.
The 38-year-old patient, who was severely brain-damaged, received deep brain stimulation and can now feed himself and communicate, activities that were unthinkable before the therapy.
This is the first time that deep brain stimulation has been used on a person with a traumatic brain injury in a minimally conscious state, and it offers some hope for others in similar situations, the researchers said.
"Hopefully, this will now begin to open doors that were closed up to this point," said Joseph Giacino, study co-investigator and associate director of neuropsychology at JFK Johnson Rehabilitation Institute and at the New Jersey Neuroscience Institute in Edison, N.J. "There's a very nihilistic view that when a brain is badly damaged there's not much we can do to change that. We have a very tough time getting research funded because of the need to jump higher than most other research. By demonstrating that we did move the bar in this patient this late, we hope that it's going to force people to revisit this somewhat nihilistic view."
Lead study author Dr. Nicholas Schiff, an associate professor of neurology and neuroscience at Weill Cornell Medical College in New York City, said: "We set out with a goal to try to identify a set of patients who might, if this was successful, regain functional communication and we thought that was important because being able to communicate is important, even if you remain disabled, because you can reengage with people in your immediate environment, including family and the people taking care of you and give a better idea of your needs. We were able to do this for this patient. Whether this means we'll be able to do this again, we don't know until we do it again but we do think there will be other patients who can respond to this. It's a first step to building a science to do this."
The patient was the first of 12 patients to try deep brain stimulation in a U.S. Food and Drug Administration-approved trial.
Dr. Ali Rezai, senior author of the paper and director of the Cleveland Clinic's Center for Neurological Restoration, said, "There's a great period of scientific discovery coming with respect to traumatic brain injury. This had been a great big desert of unknowns. There are 1.5 million new cases of TBI [traumatic brain injury] in the U.S. each year and two-thirds of Iraq war veterans have TBI. This is an exciting time to come."
The finding is published in the Aug. 2 issue of Nature.
People in a minimally conscious state can show sporadic evidence that they are aware of themselves or their environment. The state is not the same as a persistent vegetative state or a coma.
An estimated 100,000 to 300,000 traumatic brain injury patients in the United States are currently diagnosed with minimally conscious state. Most do not receive active rehabilitation and are relegated to long-term facilities.
"These patients are devastated and their families are devastated. They are taken to nursing homes and chronic-care facilities and forgotten about," Rezai said.