Nerve stimulation restores consciousness to Frenchman who had been in a “persistent vegetative state” for 15 years

By Dave Andrusko

On the right, the warmer colours indicate an increase in connectivity following vagus nerve stimulation among brain regions responsible for planned movements, spatial reasoning and attention. Illustration: Corazzol et al.

On the right, the warmer colours indicate an increase in connectivity following vagus nerve stimulation among brain regions responsible for planned movements, spatial reasoning and attention.
Illustration: Corazzol et al.

If there is anything we’ve learned in the last decade about the adaptability and recuperative powers of the human brain it is that the “givens” about how the brain responds to massive injury continue to fall, one by one.

Near the top of the list is that if a patient has been in a so-called “persistent vegetative state” for longer than 12 months, there is no chance–no chance–of recovery.

A new study, published Monday in the journal Current Biology, took on that assumption head-on and the results are extremely encouraging.

Mindful that the shorter the period the patient has been in a “PVS,” the less likely skeptics would be to concede that improvements are a result of therapy, Dr. Angela Sirigu and associates worked with a Frenchman who had been in a PVS for 15 years following a car accident.

Once the 35-year-old man received a pioneering therapy involving nerve stimulation, he “appeared to flicker back into a state of consciousness,” according to Hannah Devin, a health correspondent for The Guardian.

He started to track objects with his eyes, began to stay awake while being read a story and his eyes opened wide in surprise when the examiner suddenly moved her face close to the patient’s. He could even respond to some simple requests, such as turning his head when asked – although this took about a minute.

For a response, Devlin interviewed Niels Birbaumer, of the University of Tübingen and a pioneer of brain-computer interfaces to help patients with neurological disorders communicate.

“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.”

In a surgery that lasted only 20 minutes, “a small implant was placed around the vagus nerve in the man’s neck,” Devlin explained. (Nerve activity in the vagus, which travels into the brain stem, is “important for arousal, alertness and the fight-or-flight response,” Dr. Sirigu told CNN in an email.)

“After one month of vagal nerve stimulation, the patient’s attention, movements and brain activity significantly improved and he had shifted into a state of minimal consciousness,” Devlin wrote.

Scans also revealed major changes in brain activity, “with signs of increased electrical communication between brain regions and significantly more activity in areas linked to movement, sensation and awareness,” she noted.

What excites researchers who were not involved in the study seemed to be two-fold: that the results reinforced what other researchers had found and its possible extension to patients with different conditions.

For example, there is Dr. Nicholas Schiff, a neuroscientist at Weill Cornell Medicine and New York-Presbyterian, whose work on human consciousness we have written about often.

He told CNN’s Susan Scutti the new study is “another demonstration of what is possible to do, and it’s a new technique, and it might have some real advantages for some patients.”

“The general point here is that taken together with all the other information that we have now, it’s very clear that the severely injured human brain has greater potential than it’s given credit for,” Schiff said. “So you can lay around for years and, in principle, still be responsive to medications, devices and other things.”

Even with that much brain injury, you can still “move the dial,” said Schiff.

Scutti added, “Plausibly, this work would also contribute to explaining neurodegenerative diseases, like Alzheimer’s disease, as well as cognitive impairment resulting from traumatic brain injury.”