Neuromodulation on cervical spinal cord combined with hyperbaric oxygen in comatose patients--a preliminary report.

Abstract

BACKGROUND:

Because both SCS and HBO therapy have shown some promise in treating patients with states of reduced consciousness, we evaluated the combination of therapies in a prospective trial in comatose patients.

METHODS:

Twelve patients who had received median nerve stimulation for 3 months without improvement in consciousness received cSCS for 1 year combined with simultaneous HBO therapy for the first 3 months. Another group enrolled 12 patients who received median nerve stimulation only were served as control.

RESULTS:

Six patients emerged from coma at 1 year (after conclusion of treatment). Glasgow Coma Scale score, SPECT imaging, and PVS scores (state and reaction subscores) of the 12 patients were all significantly increased at 1 year compared with enrollment (P < .05). Neither respirator nor tracheostomy was needed to assist respiration in any patient. Only 1 of 12 patients still needed nasogastric tube feeding at 1 year. By contrast, control patients (without cSCS and HBO therapy) showed no apparent improvement.

CONCLUSION:

Increase of GCS score, cerebral blood perfusion, and PVS scores were observed in comatose patients treated with combined cSCS and HBO therapy.

• Authors: Jung-Tung Liu, Jong-Kang Lee, Yeu-Sheng Tyan, Che-Yu Liu, Yung-Hsiang Chen, Tzer-Bin Lin
• Journal: Surgical neurology (Surg Neurol) Vol. 72 Suppl 2 Pg. S28-34; discussion S34-5 (Dec 2009) ISSN: 1879-3339 [Electronic] United States
• PMID: 19665182 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers

Topics

• Adult
• Biomarkers
• Brain Hemorrhage, Traumatic (complications, physiopathology)
• Cerebrovascular Circulation (physiology)
• Cervical Vertebrae (surgery)
• Coma (diagnostic imaging, physiopathology, therapy)
• Combined Modality Therapy (instrumentation, methods)
• Electric Stimulation Therapy (methods, statistics & numerical data)
• Electrodes, Implanted
• Enteral Nutrition (statistics & numerical data)
• Female
• Glasgow Coma Scale
• Humans
• Hyperbaric Oxygenation (methods, statistics & numerical data)
• Male
• Median Nerve (physiology)
• Outcome Assessment, Health Care
• Prospective Studies
• Respiration, Artificial (statistics & numerical data)
• Spinal Cord (physiology, surgery)
• Tomography, Emission-Computed, Single-Photon
• Treatment Outcome
• Young Adult