Bifocal extradural cortical stimulation-induced recovery of consciousness in the permanent post-traumatic vegetative state
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To the Editor:
The chance of recovery from vegetative state (VS) 1 year after traumatic brain injury (TBI) is close to zero, i.e., it is permanent, PVS [5, 14]. Deep brain stimulation (DBS) of the midbrain or thalamus failed to improve awareness in PVS patients . Yet, imaging studies suggest the potential for cognitive processing in a subset of patients and potentially recruitable cortical regions [6, 7, 8, 9, 11]. Isolated thalamocortical “island” circuits may be working in PVS [6, 7, 8, 9, 11]. We now find that bifocal, extradural cortical stimulation (b-ECS), a very safe minimally invasive surgical method [2, 3, 4], can restore conscious contents in the PVS. The present result differs from recent reports of an improvement of the minimally conscious state by DBS : it is known that PVS and the MCS are different physiological entities, with large-scale “higher order” cortical activation on functional neuroimaging in MCS, normally not observed in PVS patients, a much better...
KeywordsDeep Brain Stimulation Encephalomalacia Visual Pursuit Decompressive Hemicraniectomy Simple Order
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