Clinical effect of short-term spinal cord stimulation in the treatment of patients with primary brainstem hemorrhage-induced disorders of consciousness

Weilong Huang; Qiang Chen; Lin Liu; Jianhong Tang; Hua Zhou; Zhiji Tang; Qing Jiang; Tao Li; Jianwu Liu; Dong Wang

doi:10.3389/fneur.2023.1124871

Clinical effect of short-term spinal cord stimulation in the treatment of patients with primary brainstem hemorrhage-induced disorders of consciousness

Front Neurol. 2023 Mar 17:14:1124871. doi: 10.3389/fneur.2023.1124871. eCollection 2023.

Authors

Weilong Huang¹, Qiang Chen¹, Lin Liu², Jianhong Tang³, Hua Zhou¹, Zhiji Tang¹, Qing Jiang¹, Tao Li¹, Jianwu Liu¹, Dong Wang¹

Affiliations

¹ Department of Neurosurgery, Ganzhou People's Hospital, Ganzhou, China.
² Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education, Gannan Medical University, Ganzhou, China.
³ Laboratory Animal Engineering Research Center of Ganzhou, Gannan Medical University, Ganzhou, China.

Abstract

Objective: Recently, short-term spinal cord stimulation (st-SCS) has been used in neurorehabilitation and consciousness recovery. However, little is known about its effects on primary brainstem hemorrhage (PBSH)-induced disorders of consciousness (DOC). In this study, we examined the therapeutic effects of st-SCS in patients with PBSH-induced DOC.

Methods: Fourteen patients received a 2-week st-SCS therapy. Each patient's state of consciousness was evaluated using the Coma Recovery Scale-Revised (CRS-R). CRS-R evaluation scores were recorded at the baseline (before SCS implantation) and 14 days later.

Results: Over 70% (10/14) of the patients (CRS-R score increased to ≥2 points) responded to the SCS stimulation after 14 days of st-SCS treatment. All items included in the CRS-R exhibited a significant increase post-treatment compared with pretreatment. After 2 weeks of st-SCS treatment, seven patients showed diagnostic improvement, resulting in a 50% (7/14) overall effective rate. Approximately 75% (3/4) of patients with minimally conscious state plus (MCS+) improved to emergence from MCS (eMCS), and 50% (1/2) of patients with vegetative state or unresponsive wakefulness syndrome (VS/UWS) improved to MCS+.

Conclusion: In PBSH-induced DOC, st-SCS is a safe and effective treatment. The clinical behavior of the patients improved significantly following the st-SCS intervention, and their CRS-R scores markedly increased. This was most effective for MCS+.

Keywords: disorder of consciousness; minimally conscious state; neuromodulation; primary brainstem hemorrhage; short-term spinal cord stimulation.

Grants and funding

This study was supported by the Jiangxi Provincial Health Technology Project (202311895) and the Natural Science Foundation of Jiangxi Province (20224BAB206041).