A
25-year-old man recovering from a coma has made remarkable progress
following a treatment at UCLA to jump-start his brain using ultrasound.
The technique uses sonic stimulation to excite the neurons in the
thalamus, an egg-shaped structure that serves as the brain's central hub
for processing information.
"It's almost as if we
were jump-starting the neurons back into function," said Martin Monti,
the study's lead author and a UCLA associate professor of psychology and
neurosurgery. "Until now, the only way to achieve this was a risky
surgical procedure known as deep brain stimulation, in which electrodes
are implanted directly inside the thalamus," he said. "Our approach
directly targets the thalamus but is noninvasive."
Monti said the
researchers expected the positive result, but he cautioned that the
procedure requires further study on additional patients before they
determine whether it could be used consistently to help other people
recovering from comas.
"It is possible that we were just very
lucky and happened to have stimulated the patient just as he was
spontaneously recovering," Monti said.
A report on the treatment is published in the journal Brain Stimulation. This is the first time the approach has been used to treat severe brain injury.
The
technique, called low-intensity focused ultrasound pulsation, was
pioneered by Alexander Bystritsky, a UCLA professor of psychiatry and
biobehavioral sciences in the Semel Institute for Neuroscience and Human
Behavior and a co-author of the study. Bystritsky is also a founder of
Brainsonix, a Sherman Oaks, California-based company that provided the
device the researchers used in the study.
That device, about the
size of a coffee cup saucer, creates a small sphere of acoustic energy
that can be aimed at different regions of the brain to excite brain
tissue. For the new study, researchers placed it by the side of the
man's head and activated it 10 times for 30 seconds each, in a 10-minute
period.
Monti said the device is safe because it emits only a small amount of energy -- less than a conventional Doppler ultrasound.
Before
the procedure began, the man showed only minimal signs of being
conscious and of understanding speech -- for example, he could perform
small, limited movements when asked. By the day after the treatment, his
responses had improved measurably. Three days later, the patient had
regained full consciousness and full language comprehension, and he
could reliably communicate by nodding his head "yes" or shaking his head
"no." He even made a fist-bump gesture to say goodbye to one of his
doctors.
"The changes were remarkable," Monti said.
The
technique targets the thalamus because, in people whose mental function
is deeply impaired after a coma, thalamus performance is typically
diminished. And medications that are commonly prescribed to people who
are coming out of a coma target the thalamus only indirectly.
Under
the direction of Paul Vespa, a UCLA professor of neurology and
neurosurgery at the David Geffen School of Medicine at UCLA, the
researchers plan to test the procedure on several more people beginning
this fall at the Ronald Reagan UCLA Medical Center. Those tests will be
conducted in partnership with the UCLA Brain Injury Research Center and
funded in part by the Dana Foundation and the Tiny Blue Dot Foundation.
If
the technology helps other people recovering from coma, Monti said, it
could eventually be used to build a portable device -- perhaps
incorporated into a helmet -- as a low-cost way to help "wake up"
patients, perhaps even those who are in a vegetative or minimally
conscious state. Currently, there is almost no effective treatment for
such patients, he said.
The study's other co-authors are Vespa,
who holds UCLA's Gary L. Brinderson Family Chair in Neurocritical Care
and is director of neurocritical care at the Ronald Reagan UCLA Medical
Center; Caroline Schnakers, a UCLA neurosurgery researcher; and
Alexander Korb, a Semel Institute researcher.
Story Source:
The above post is reprinted from
materials provided by
University of California - Los Angeles. The original item was written by Stuart Wolpert.
Note: Content may be edited for style and length.
No comments:
Post a Comment