Scientists have reported that they have found some success in using low-intensity, focused ultrasound to ‘jumpstart’ parts of human brains in coma-like conditions, reawakening some functions in patients who previously was in a “less sensitive condition” (MCS).
The method uses ultrasound stimulation to stimulate the neurons in the thalamus, a processing center for the entire brain, and an area known to be weaker after coma. Three MCS patients were given two 10-minute treatment sessions, with one week between each session.
Although one patient showed no response, researchers saw significant improvements in the other two patients. The research builds on similar findings from 2016, including one patient undergoing surgery and a medically induced coma. In the new study, coma-like states lasted much longer.
A person in a state of less consciousness may have a clear or subtle or inconsistent sense of consciousness. These signals, such as command press or wake-up call, are generally well maintained and are not perceived as reversible behavior, and help to differentiate MCS from capacity or vegetation states.
“I think this new result is much more important because these kidney patients were significantly more likely to recover on their own than the hungry patient we treated in 2016 – and usually next Any resuscitation occurs slowly over several months and usually years, not over days and weeks, as we show, ”says neuroscientist Martin Monti, of the University of California, Los Angeles (UCLA).
“It’s very likely that our decisions are just the result of an unbridled recovery.”
One of the patients who responded to the treatment was a 56-year-old man, who had been in such a low-sensitivity state for more than 14 months, unable to communicate at all. After treatment, he was not only able to look at pictures of relatives when their names were mentioned, he was also able to drop a member or get a hold of a request. When asked simple questions about his identity, he was able to shake his head ‘yes’ or ‘no’.
The other patient who showed signs of improvement, a 50-year-old woman, had been in an even deeper MCS for more than two and a half years. After the ultrasound sessions, she was able to understand speech and recognize basics, including pencil and comb.
Researchers say the device is safe because it uses only a small amount of energy, and patients had no changes in blood pressure, heart rates, or blood oxygen levels.
A small device targets ultrasound at the thalamus. (Martin Monti / UCLA)
“This is what we were hoping for, but it’s amazing to see it with your own eyes,” Monti said. “Seeing two of our three patients who had been in a persistent condition improve dramatically within days of treatment is a promising result.”
It is important to emphasize that the research is still at an early and experimental stage. Although the 50-year-old woman showed more sensory symptoms months later, the differences from the starting point of MCS were less significant. And after a few months without treatment, the 56-year-old man had returned to something close to his original state resembling a coma.
Enter the same patient who did not respond at all to the treatment, and the researchers remain cautious about the potential success of ultrasound, and how quickly it can be dispensed. Nevertheless, these results are very encouraging – there are definite signs that this type of treatment may help some patients some of the time.
The treatment can be applied to a device about the size of a saw, and the researchers hope that it can eventually be used at home on patients who are in long-term states of consciousness or vegetation.
“Importantly, these behaviors are diagnostic markers that have emerged from a sensory disorder,” Monti says. “For those patients, the smallest step can be very meaningful – for them and their families. For them it means the world.”
The research was published in Brain stimulation.