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We all know the movie trope where someone in a coma gets a wide-eyed reboot by a Frankenstein-type character supposedly buzzing something into their brains. Well, the reality is a little less dramatic, but no less fascinating.
No one was actually zapped out of a coma. However, many patients recovering from a coma and suffering from brain trauma in the aftermath still remain in a minimally conscious state (MCS), which is pretty much the least conscious you can be before you go unconscious. When UCLA scientists used ultrasound to “recharge” the brain of one such patient several years ago, how much luck was involved came into question. But now they have done it again with two more patients.
When a patient was on the edge of consciousness, the only previous treatment that could bring them back to some semblance of normalcy was thalamic deep brain stimulation (DBS). The thalamus is a multitasking part of the brain with different centers, whose main function is to send sensory and motor signals to the cerebral cortex –– all that gray matter you typically see in horror movies that's important when it comes to keeping someone conscious. The thalamus joins forces with the cerebral cortex to help regulate consciousness.
“The rapid (re)development of low intensity focused ultrasound (LIFU) as a means of reversible modulation of (subcortical) brain tissue offers a potential alternative to DBS for restorative intervention,” said Martin Monti, a UCLA professor of psychology and neurosurgery, who recently published a study in Brain Stimulation.
Electrodes have to be implanted in the brain for DBS to take effect. The electrical currents that run through these electrodes stimulate the brain, and in the case of thalamic DBS, the thalamus, in an attempt to help the patient return to a more conscious and alert state. There is still a downside to this method despite it showing promise. No one has really figured out the ideal part of the thalamus that electrodes should be placed on for it to be stimulated.
Monti and his team directed ultrasound pulses — low-intensity focused ultrasound or LIFU — to get the neurons in the thalamus, which are weakened by a coma, firing again. The patients this time ranged from 50-58 years old and, like the previous patient, were just barely able to respond to commands and exhibit other forms of nonfunctional communication. There was another man who had been in a car accident, a woman who had gone into cardiac arrest, and a man who had suffered a stroke.
The patients were put through one ultrasound session each week for two weeks. Ultimately, two of them showed signs of recovery, even though it was slow. Monti’s treatment was proven to be safe and tolerated well by all three patients, with no evident side effects. The two who regained consciousness were more aware of their surroundings and remembering things after a few days. The 58-year-old stroke victim made such remarkable progress that he was able to go home from the hospital and continue physical therapy and rehab on his own.
This is the first time anyone has ever done this, never mind done it on repeat. Skepticism still surrounds the ultrasound treatment, with other scientists questioning if any of the patients were more receptive to treatment or whether the sampling of patients Monti and his team treated was large enough to give an accurate idea of what results to expect. Even Monti has considered additional explanations to what seem like miraculous recoveries.
“These findings should compel double-blind and controlled procedures in future confirmatory work,” he said. “Nonetheless, these preliminary findings suggest that LIFU has potential as a novel, safe, and broadly applicable intervention for patients [who are minimally conscious].”
Movies are still the only realm in which someone will actually snap out of a coma or near-comatose state and start walking around right away, but this could be the start of something.