Electrical stimulation restores some speech in brain-damaged man

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(NaturalNews) A team of researchers from New York-Presbyterian/Weill Cornell, the JFK Johnson Rehabilitation Institute in Edison, N.J., and the Cleveland Clinic Foundation reported Sunday that a severely brain-damaged man had shown some improvement in movement and speech after his brain was stimulated with pulses of electric current.

The researchers received permission from the 38-year-old man's family to perform the experiment, before which he was only able to respond to questions and commands occasionally by moving his thumb or nodding, but was otherwise unable to move or speak. According to the report the researchers made at the annual meeting of the Society for Neuroscience, the man -- not named for privacy reasons -- was chosen because he was partly conscious after a head injury, his condition had been stable for years, and imaging tests showed that the thinking, purposeful regions of the brain were intact.

The scientists stimulated the man's brain through deep brain stimulation, an operation that involves threading two wires through the man's skull into the subcortical area known as the thalamus, where functions such as arousal, attention, emotion and others are controlled. The two wires are then attached to a pacemaker-like device placed under the man's collarbone, and current is passed through the wires.

Afterward, the man began to grow more attentive, speak a few words, and was able to identify pictures during testing. The team tracked the patient's abilities over four weeks while the current was active, and for four weeks while it was off, without being informed of whether the device was active. According to lead researcher Dr. Nicholas D. Schiff, a Cornell neurologist, the scientists observed a "consistent trend of improved verbal and behavioral responsiveness during the on condition."

The case stands to revive interest in the use of electrical stimulation on the roughly 100,000 to 200,000 patients in states of partial consciousness in the United States, experts said, but added that there was no way to tell how many people would be helped, and many ethics questions were raised about performing the surgery on patients unable to give or refuse consent.

"Given the legacy of psychosurgery, and that states of unconsciousness, like the vegetative state, can be so contentious, we have to be very concerned about ethical issues" like informed consent, said Dr. Joseph J. Fins, chief of medical ethics at Cornell and study coauthor. Any ethical guidelines should both reinforce the right of patients to health care and "preserve their right to refuse it," he said, adding that a patient who regained decision-making abilities from the procedure could end up deciding to forego further treatment.

The surgery itself is not new. It has been used on many brain damaged patients, including Terri Schiavo, the brain damaged Florida woman who died after her feeding tube was removed, the debate over which made national headlines. In most of the prior cases, the treatment was administered too early following the injury and made no difference at all, including with Terri Schiavo, the scientists said. They added that this new case, however, provides the first convincing evidence that the surgery can be beneficial.

"I think this case suggests that this surgery probably will be one of the choices of treatment we can give to certain patients who have some chance of recovery," said Dr. James L. Bernat, a professor of neurology at Dartmouth Medical School, who was not involved in the case. He noted that patients who had been completely unresponsive for more than a year were unlikely to benefit from the procedure, but said doctors should "be aggressive and do whatever it takes" to help improve those who are occasionally or partly responsive after an injury.

Despite his improvements, the patient in the latest case is still unable to give an opinion of the surgery or give insight into his current state of consciousness, said doctors who were familiar with the case, though uninvolved. However, experts say the case is an important reinforcement of all that has been learned about recovering brain function after head trauma.

"Even though this is a first step, it is of utmost importance, because is shows that this therapeutic approach is worth studying," said Dr. Steven Laureys, a neurologist at the University of Liege in Belgium. "I can only hope that further cases will confirm this result, because if that would fail, we would see this whole idea go back into the fridge for a long time."

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