A research team in Lyons, France, has released data that shows a positive result in a single patient who has been in a permanent vegetative state (PVS) for greater than 15 years through a nerve implant in the patient's chest.
The stimulated nerve activates and reorganizes the thalamo-cortical network, according to the study. Through this network, the researchers were able to "report beneficial effects on [the] consciousness level of a single patient in a vegetative state, including improved behavioral responsiveness and enhanced brain connectivity patterns," the study stated. It is continuously stimulated until results are produced.
Their study stemmed from the hypothesis that vagus nerve stimulation functionally reorganizes the thalamo-cortical network that has had positive results with epilepsy and depression, areas in the cortex that would assist in communication and muscle control.
The subject of the study had been in a PVS for 15 years following a traumatic brain injury incurred in a car accident. The procedure itself only took 20 minutes to complete, but it resulted in positive change over the following month, reports Futurism. During that time, researchers noted significant improvement in the patient's brain stimuli, attention, and movements.
The treatment targets the vagus nerve by sending electrical signals to it which, in turn, sends signals to the brain. This is the longest nerve, connecting all the way to the gut, and it plays a major role in remaining alert and even walking.
According to a press release published to Cell Press, the 35-year-old man began responding to simple orders that had been impossible before. He could now follow an object with his eyes and turn his head upon request, and the patient's mother reported an improvement in the patient's ability to stay awake when listening to his therapist read a book aloud.
Niels Birbaumer of the University of Tubingen, a pioneer of brain-computer interfaces created to help patients with neurological disorders communicate, said the findings also brought ethical issues to light.
“Many of these patients may and will have been neglected, and passive euthanasia may happen often in a vegetative state,” he said. “This paper is a warning to all those believing that this state is hopeless after a year,” Birbaumer said to The Guardian.
The research challenges a widely-accepted view that if a patient has been in a vegetative state for longer than 12 months, the chances of recovering consciousness are slim to none.
Angela Sirigu, who led the work at the institute in Lyon, France, said to The Guardian regarding the patient's condition that “he is still paralyzed, he cannot talk, but he can respond. Now he is more aware.”
The study gives families of PVS patients hope that they may be able to communicate one day. However the question of whether the patient would want to be aware of being in a severely injured state is still present.
“I cannot answer ... this question,” Sirigu said. “Personally I think it’s better to be aware, even if it’s a bad state, to be conscious of what’s happening. Then you can have a decision if you want to go on or if you want [euthanasia].”
Sirigu and her team are looking to apply the same technique to patients with less serious brain injuries, according to The Guardian. There may even be patients, she said, in which the cortex is intact but who have brain stem injuries that have led to limited awareness or consciousness.