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Non-Invasive Ultrasonic Thalamic Stimulation in Disorders of Consciousness after Severe Brain Injury: A First-in-Man Report

  • Martin M. Monti
    Correspondence
    Corresponding author. Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA.Fax: +13102065895
    Affiliations
    Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
    Brain Injury Research Center (BIRC), Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA 90095, USA
    Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
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  • Caroline Schnakers
    Affiliations
    Brain Injury Research Center (BIRC), Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA 90095, USA
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  • Alexander S. Korb
    Affiliations
    Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
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  • Alexander Bystritsky
    Affiliations
    Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90095, USA
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  • Paul M. Vespa
    Affiliations
    Brain Injury Research Center (BIRC), Department of Neurosurgery, University of California Los Angeles, Los Angeles, CA 90095, USA
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      Modern intensive care medicine has greatly increased the rates of survival after severe brain injury (BI). Nonetheless, a number of patients fail to fully recover from coma, and awaken to a disorder of consciousness (DOC) such as the vegetative state (VS) or the minimally conscious state (MCS) [
      • Monti M.M.
      • Laureys S.
      • Owen A.M.
      The vegetative state.
      ]. In these conditions, which can be transient or last indefinitely, patients can lose virtually all autonomy and have almost no treatment options [
      • Monti M.M.
      • Laureys S.
      • Owen A.M.
      The vegetative state.
      ,
      • Giacino J.T.
      • Whyte J.
      • Bagiella E.
      • Kalmar K.
      • Childs N.
      • Khademi A.
      • et al.
      Placebo-controlled trial of amantadine for severe traumatic brain injury.
      ]. In addition, these conditions place great emotional and financial strain on families, lead to increased burn-out rates among care-takers, impose financial stress on medical structures and public finances due to the costs of prolonged intensive care, and raise difficult legal and ethical questions [
      • Monti M.M.
      • Sannita W.G.
      Brain function and responsiveness in disorders of consciousness.
      ].
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      References

        • Monti M.M.
        • Laureys S.
        • Owen A.M.
        The vegetative state.
        Br Med J. 2000; 341: c3765
        • Giacino J.T.
        • Whyte J.
        • Bagiella E.
        • Kalmar K.
        • Childs N.
        • Khademi A.
        • et al.
        Placebo-controlled trial of amantadine for severe traumatic brain injury.
        N Engl J Med. 2012; 366: 819-826
        • Monti M.M.
        • Sannita W.G.
        Brain function and responsiveness in disorders of consciousness.
        Springer International Publishing, Switzerland2016
        • Schiff N.D.
        Recovery of consciousness after brain injury: a mesocircuit hypothesis.
        Trends Neurosci. 2010; 33: 1-9
        • Schiff N.D.
        • Giacino J.T.
        • Kalmar K.
        • Victor J.D.
        • Baker K.
        • Gerber M.
        • et al.
        Behavioural improvements with thalamic stimulation after severe traumatic brain injury.
        Nature. 2007; 448: 600-603
        • Thibaut A.
        • Bruno M.A.
        • Ledoux D.
        • Demertzi A.
        • Laureys S.
        tDCS in patients with disorders of consciousness Sham-controlled randomized double-blind study.
        Neurology. 2014; 82: 1112-1118
        • Yoo S.S.
        • Kim H.
        • Min B.K.
        • Franck S.P.
        Transcranial focused ultrasound to the thalamus alters anesthesia time in rats.
        Neuroreport. 2011; 22: 783
        • Bystritsky A.
        • Korb A.S.
        • Douglas P.K.
        • Cohen M.S.
        • Melega W.P.
        • Mulgaonkar A.P.
        • et al.
        A review of low-intensity focused ultrasound pulsation.
        Brain Stimul. 2011; 4: 125-136
        • Legon W.
        • Sato T.F.
        • Opitz A.
        • Mueller J.
        • Barbour A.
        • Williams A.
        • et al.
        Transcranial focused ultrasound modulates the activity of primary somatosensory cortex in humans.
        Nat Neurosci. 2014; 17: 322-329
        • Giacino J.T.
        • Kalmar K.
        • Whyte J.
        The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility.
        Arch Phys Med Rehabil. 2004; 85: 2020-2029