Researchers at the University of California, Los Angeles, continue to be successful in using ultrasound to “start” the brain of people paralyzed in a minimally conscious state. On a report as of this month, they detail two patients with chronic and severe brain injuries who have experienced improvements in their awareness of the outside world after undergoing treatment. Scientists are now more hopeful about the future of ultrasound for these difficult cases.
In 2016, California resident Bradley Crehan was hit by a car, causing severe brain damage. After the surgery, Crehan was put into an induced coma to help him recover. But Crehan showed few signs of conscience after being woken up and was unable to communicate with other people. He was then given away an experimental treatment called lowIntensity-focused ultrasound (LIFU) by UCLA scientists.
The treatment involved ultrasound pulses directed at the brain’s thalamus – a region that helps us coordinate our motor and sensory functions and that plays a key role in consciousness – for five minutes, hoping to awaken the activity that tends to go dormant during the coma. One day after treatment, Crehan started showing signs of recovery and was anable to recognize and reach objects. Days later, he was able to answer the blinking questions. And within four months, earlier than the doctors had predicted, he was fully conscious and able to leave the hospital, although he still needed physical therapy and ongoing rehabilitation.
As incredible as Crehan’s recovery was, it is clear that it is possible that ultrasound therapy was not the cause. People who recover spontaneously from a coma are not uncommon, especially in the first few days and weeks after onset. It was possible that the technique was simply a false clue and that Crehan had woken up regardless of what the doctors did.
At the new report, Published this month in the journal Brain Stimulation, the authors say that now we have more evidence that ultrasound can really help people who are on the edge of consciousness.
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They used the technique on three patients who lived with chronic brain injuries that left them in a minimally conscious state for more than one year. In one patient, ultrasound did not seem to improve his function at all. But in the other two, doctors noticed an improvement a few days after the first of two treatments. One patient – a 56-year-old man who had suffered a Stroke – was able to answer certain commands, answer yes or no questions and recognize family members in a photo. The other – a 50-year-old woman who suffered cardiac arrest – was now able to recognize objects and communicate with other people.
“What is remarkable is that they both exhibited significant responses a few days after the intervention,” said study author and UCLA psychologist Martin Monti in a statement released by the University. “This is what we expected, but it is impressive to see it with your own eyes. Seeing two of our three patients who were in a chronic condition improve very significantly within a few days of treatment is an extremely promising result. “
Because patients in chronic coma are much less likely to recover spontaneously than patients in acute coma, researchers are more confident that ultrasound made the difference here. It is important to note that there were also no safety problems noted, with the patients’ vital signs remaining level throughout the treatment.
Unfortunately, the treatment of these patients did not lead to the same amazing get it back Crehan experimented. The 50-year-old woman continued to have improved awareness months later, but she he was still considered minimally conscious, while the 56-year-old man’s condition regressed to baseline at the time of a follow-up visit three months later. It is likely that restoring people’s consciousness will remain a difficult and impossible task in many cases, even if this technique will work.
Still, for the families of these patients, even some level of recovered consciousness will be worthwhile, and there may still be ways to improve the effectiveness of this and similar brain stimulation techniques being studied. For now, UCLA scientists are continuing their research with ultrasound and hope soon conduct clinical trials with a larger group of patients. They also plan to study exactly how this technique is altering the brain.