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Effects of musicokinetic therapy and spinal cord stimulation on patients in a persistent vegetative state

  • R. Noda
  • Y. Maeda
  • Atsuo Yoshino
Conference paper
Part of the Acta Neurochirurgica Supplements book series (NEUROCHIRURGICA, volume 87)

Summary

We developed a method of musicokinetic therapy (MKT), employing a trampoline with live music performance (saxophone or electric piano), in an attempt to improve the clinical condition of patients in a persistent vegetative state (PVS). As an initial step for assessing the effect of MKT on PVS, we analyzed the changes in PVS score (range: 0–30) after MKT, which was continued for 3 months, in a consecutive series of 26 patients. These patients fulfilled the definition of PVS adopted by the Multi-Society Task Force on PVS. In this series, 7 patients were being treated by spinal cord stimulation at the same time. We, therefore, also had an opportunity to examine the effect of spinal cord stimulation on PVS. A greater or lesser improvement in PVS score (post-MKT score — pre-MKT score, mean ± SD: 8.27 ± 5.52) was observed in all patients except one. Among 12 patients who had been in PVS for 1 year or more before the initiation of MKT, 7 patients (56.3%) demonstrated improvement of their PVS score by 5 or more, and 4 patients (33.3%) reached a post-MKT score of greater than 20. The condition defined as PVS can never be scored better than 20. Since it is commonly felt that spontaneous improvement rarely occurs if PVS has continued for more than 6 months, the improvement after MKT appears to be better than that which could be observed spontaneously. The improvement in PVS score was often noted in patients with brain damage caused by trauma or SAH. There was no significant difference in improvement of the PVS score between patients who were treated by spinal cord stimulation and those who were not. Although the present study did not directly prove an effect of MKT on PVS, because no controls were involved, the results were consistent with the hypothesis that MKT is useful for improving the clinical condition of patients in PVS, especially those with severe brain damage caused by trauma or SAH.

Keyword

Musicokinetic therapy persistent vegetative state brain damage spinal cord stimulation 

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References

  1. 1.
    Council on Scientific Affairs and Council on Ethical and Judicial Affairs (1990) Persistent vegetative state and decision to withdraw or withhold life support. JAMA 263: 426–430CrossRefGoogle Scholar
  2. 2.
    Groswasser Z, Sazbon L (1990) Outcome in 134 patients with prolonged post-traumatic unawareness: I. Parameters determining late recovery of consciousness. J Neurosurg 72: 75–80PubMedCrossRefGoogle Scholar
  3. 3.
    Jennett B, Plum F (1972) Persistent vegetative state after brain damage. Lancet 1: 734–737PubMedCrossRefGoogle Scholar
  4. 4.
    Katayama Y, Tsubokawa T, Yamamoto T, Hirayama T, Miyazaki S, Koyama S (1991) Characterization and modification of brain activity with deep brain stimulation in a persistent vegetative state. Pacing Clin Electrophysiol 14: 116–121PubMedCrossRefGoogle Scholar
  5. 5.
    Maeda Y, Koba K, Kajiki M, Noda R (2001) Effects of musical exercise therapy on 26 patients with prolonged disturbance of consciousness. Proceedings of the 10th Annual Meeting of the Society for Treatment of Coma, vol 10: pp 113–121Google Scholar
  6. 6.
    Noda R (2000) Stimulation of the five senses for patients with prolonged consciousness disturbance: effects of musical exercise therapy on prolonged consciousness disturbance. Proceedings of the 9th Annual Meeting of the Society for Treatment of Coma, vol 9: pp 9–21Google Scholar
  7. 7.
    The Multi-Society Task Force on PVS (1994) Medical aspects of the persistent vegetative state (First of two parts). N Engl J Med 330:1499–1508CrossRefGoogle Scholar
  8. 8.
    The Multi-Society Task Force on PVS (1994) Medical aspects of the persistent vegetative state (Second of two parts). N Engl J Med 330: 1572–1579CrossRefGoogle Scholar
  9. 9.
    The Society for Treatment of Coma, Japan (1997) Scoring system for PVS. Nikkenkagaku Co Ltd, TokyoGoogle Scholar
  10. 10.
    Tsubokawa T, Yamamoto T (1996) Deep brain stimulation in the persistent vegetative state. In: Gildenberger PL, Tasker RR (eds) Textbook of stereotactic and functional neurosurgery. McGraw-Hill New York, pp 1979–1986Google Scholar
  11. 11.
    Tsubokawa T, Yamamoto T, Katayama Y (1990) Prediction of the outcome of prolonged coma caused by brain damage. Brain Injury 4: 329–337PubMedCrossRefGoogle Scholar
  12. 12.
    Yamamoto T, Katayama Y, Oshima H, Fukaya C, Kawamata T, Tsubokawa T (2001) Deep brain stimulation therapy for a persistent vegetative state. Acta Neurochir (Wien) [Suppl] 79: 79–82Google Scholar

Copyright information

© Springer-Verlag Wien 2003

Authors and Affiliations

  1. 1.Arts Planning DepartmentOsaka University of ArtsOsakaJapan
  2. 2.Department of NeurosurgeryIshikiriseiki HospitalOsakaJapan
  3. 3.Department of Neurological SurgeryNihon University School of MedicineTokyoJapan

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