Objective To investigate the effect of deep brain stimulation (DBS) and spinal cord electrical stimulation (SCS) neuromodulation therapy on patients in persistent vegetative state to promote wakefulness.
Methods From July 2011 to December 2012, a total of 53 patients with persistent vegetative state were admitted to Beijing Military General Hospital, and 42 cases were enrolled after screening. Among them, 27 were male and 15 were female; the average age was (42.9±5.47). The patients were divided into a control group of 20 cases and a surgical group of 22 cases according to their conditions and family wishes. The surgical group was treated with DBS in 5 cases and SCS in 17 cases; the control group received conventional rehabilitation treatment outside of surgery. The modified Coma Recovery Scale (CRS-R) was used as an assessment tool, and some patients received functional magnetic resonance imaging (fMRI) for further evaluation.
Results There were no statistically significant differences in gender, age, duration of illness and consciousness assessment between the 2 groups at the time of enrollment (P > 0.05). Follow-up was obtained in 37 patients (17 in the control group and 20 in the surgical group), with a mean follow-up of 11.2 months. Seven patients in the surgical group recovered consciousness, with a rate of 35%; one patient in the control group recovered consciousness, with a rate of 5.9%, and the difference was statistically significant (P < 0.05). The difference was statistically significant (P < 0.05). fMRI results suggested that the degree of activation and functional connectivity of key brain regions in the resting-state default network was in good agreement with the clinical assessment. Conclusion Neuromodulation therapy can effectively promote the recovery of consciousness in patients with PVS; no efficacy difference was found between DBS and SCS.