Navigation Links
Patient roused from coma by a magnetic field
Date:10/15/2008

JOSH VILLA was 26 and driving home after a drink with a friend on 28 August 2005 when his car mounted the kerb and flipped over. Villa was thrown through the windscreen, suffered massive head injuries and fell into a coma.

Almost a year later, there was little sign of improvement. "He would open his eyes, but he was not responsive to any external stimuli in his environment," says Theresa Pape of the US Department of Veterans Affairs in Chicago, who helped treat him.

Usually there is little more that can be done for people in this condition. Villa was to be sent home to Rockford, Illinois, where his mother, Laurie McAndrews, had volunteered to care for him.

But Pape had a different suggestion. She enrolled him in a six-week study in which an electromagnetic coil was held over the front of his head to stimulate the underlying brain tissue. Such transcranial magnetic stimulation (TMS) has been investigated as a way of treating migraine, stroke, Parkinson's disease and depression, with some promising results, but this is the first time it has been used as a potential therapy for someone in a coma-like state.

The rapidly changing magnetic fields that the coil creates can be used either to excite or inhibit brain cells - making it easier or harder for them to communicate with one another. In Villa's case, the coil was used to excite brain cells in the right prefrontal dorsolateral cortex. This area has strong connections to the brainstem, which sends out pulses to the rest of the brain that tell it to pay attention. "It's like an "OK, I'm awake" pulse," says Pape.

At first, there was little change in Villa's condition, but after around 15 sessions something happened. "You started talking to him and he would turn his head and look at you," says McAndrews. "That was huge."

Villa started obeying one-step commands, such as following the movement of a thumb and speaking single words. "They were very slurred but they were there," says Pape, who presented her findings this month at an international meeting on brain stimulation at the University of Gttingen, Germany. "He'd say like "erm", "help", "help me".

After the 30 planned sessions the TMS was stopped. Without it, Villa became very tired and his condition declined a little, but he was still much better than before. Six weeks later he was given another 10 sessions, but there were no further improvements and he was sent home, where he remains today.

Villa is by no means cured. But he is easier to care for and can interact with visitors such as his girlfriend, who has stuck by him following the accident. "When you talk to him he will move his mouth to show he is listening," McAndrews says. "If I ask him, "Do you love me?" he'll do two slow eye blinks, yes. Some people would say it's not much, but he's improving and that's the main thing."

John Whyte of the Moss Rehabilitation Research Institute in Philadelphia, Pennsylvania, cautions that as intriguing as Villa's case is, it alone does not show that TMS is a useful treatment. "Even after eight months, it is not uncommon for patients to transition from the vegetative to the minimally conscious state without any particular intervention," he points out. He says TMS merits further investigation, along with other experimental treatments such as drugs which have temporarily roused three men from a coma, and deep brain stimulation, an invasive technique that roused a man out of a minimally conscious state.

"This is the first and very interesting use of repetitive TMS in coma," says Steven Laureys of the Coma Research Group at the University of Lige in Belgium. Our understanding of disorders of consciousness is so limited that even a single study can provide new insights, he says.

Pape acknowledges that further studies are needed to demonstrate that TMS really is beneficial, though she is convinced that it helped Villa.

He had only been given a 20 to 40 per cent chance of long-term recovery, and until he was given TMS his functioning had not improved since about four months after the accident. What's more, after the 15th TMS session, he improved incrementally with each session - further evidence that TMS was the cause.

Pape hopes to begin treating a second patient in a coma-like state later this year. This time she plans to adjust the number of pulses of TMS in each train, and to alter the gap between pulses to see if there is an optimum interval.

McAndrews is also in no doubt that her son's quality of life has improved as a result of TMS. "Before I felt like he was not responsive, that he was depressed almost. Now you move him around and he complains - he can show emotions on that level."


'/>"/>

Contact: Claire Bowles
claire.bowles@newscientist.com
44-207-611-1210
New Scientist
Source:Eurekalert

Related medicine news :

1. Fluctuating eye pressure associated with visual field deterioration in glaucoma patients
2. Comparison of obstetric outcomes between on-call and patients own obstetricians
3. Vision restoration therapy shown to improve brain activity in brain injured patients
4. Diabetes appears to increase risk of death for patients with acute coronary syndromes
5. Ambulatory oxygen rarely a benefit in COPD patients without resting hypoxemia
6. Restricting Blood Flow May Help Heart Bypass Patients
7. Patients with Medicaid and those lacking insurance have higher risk of advanced laryngeal cancer
8. Study provides hope that some transplant patients could live free of antirejection drugs
9. Study provides hope that some transplant patients could live free of anti-rejection drugs
10. Longer ambulance journeys boost death risk for seriously ill patients
11. Expenses Overshadow Optimism for Kidney Failure Patients
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/28/2016)... , ... April 28, 2016 , ... Head Over Heels ... 9 Western Championships. The competition will be held at the University of Montana on ... gymnasts west of the Mississippi River. , In order to qualify, Varize needed to ...
(Date:4/28/2016)... ... April 28, 2016 , ... ... open availability of a new CDISC standard, Clinical Trial Registry (CTR) XML. ... This innovative standard will make it possible to build applications that generate ...
(Date:4/28/2016)... ... April 28, 2016 , ... Cosmetic Town, an online ... cosmetictown.com . The forum section was recently revamped and upgraded to allow even more ... in use across the country. , According to the senior editor of Cosmetic Town, ...
(Date:4/28/2016)... ... 2016 , ... Greener Hydroponics is now offering a large selection of Smart ... organic farmers and nurseries according to Sales Manager Joe Steele who says, “Now is ... is to offer wholesale level pricing and ultra-fast shipping for growers of any size.” ...
(Date:4/28/2016)... ... April 28, 2016 , ... In 2011, TIME magazine ... the emerging field of biomechatronics, technology that marries human physiology with electromechanics. He continues ... He is also the Founder of BionX , a leader in the field ...
Breaking Medicine News(10 mins):
(Date:4/27/2016)... 27, 2016 ... in Zürich gab Strekin AG den Start ... zur Erhaltung des Resthörvermögens von Patienten, denen ... die umfassende Phase-II-Doppelblindstudie mit Placebo-Kontrollgruppe werden momentan ... wird während der Operation direkt ins Mittelohr ...
(Date:4/27/2016)... PARIS , April 27, 2016 ... Year-Over-Year Including 42% Growth in Recurring Consumable Sales  ... Mauna Kea Technologies (Euronext: MKEA, OTCQX: MKEAY) ... today announced its sales for the first quarter ended ... business and the execution of its commercial strategy. ...
(Date:4/27/2016)... 2016 Transparency Market Research has ... - Global Industry Analysis, Size, Share, Growth, Trends, and ... global skincare devices market was valued at US$ 7,255.8 ... a CAGR of 10.1% from 2015 to 2023 to ... the full Skincare Devices Market (Treatment Device - LED Therapy ...
Breaking Medicine Technology: