Researchers at the University of California, Los Angeles continue to find success using ultrasound to jump-start the brains of people trapped in a minimally conscious state. In a report This month they describe two patients with chronic and severe brain damage who have experienced improvements in their awareness of the outside world after undergoing treatment. Scientists now have more hope about the future of ultrasound for these difficult cases.
In 2016, California-based Bradley Crehan was hit by a car, causing serious brain damage. After surgery, Crehan was put into a medically induced coma to help him recover. But Crehan showed little sign of consciousness after he was awakened and was largely unable to communicate with others. He was then given an experimental treatment called lowintensity-directed ultrasound (LIFU) by scientists at UCLA.
The treatment that went with it pulses of ultrasound targeting the brain’s thalamus – an area that helps us coordinate our motor and sensory functions and is thought to play a key role in consciousness – for five minutes, in the hope of awakening activity that tends to remain inactive during a coma. One day after the treatmentCrehan began to show signs of recovery and was acan recognize and reach objects. Days later, he was able to respond to questions by blinking his eyes. And within four months, earlier than the doctors predicted, he was fully conscious and was able to leave the hospital, although he still needed physical therapy and rehabilitation.
As amazing as Crehan’s recovery was, it is of course possible that the ultrasound therapy was not the case cause. People recovering spontaneously from a coma-like state is not unheard of, especially in the first days and weeks after it starts. It was possible that the technique was just a red herring and Crehan would have woken up no matter what doctors did.
In the new report, published this month in the journal Brain Stimulation, today’s authors say have more evidence that ultrasounds can really help people who are teetering on the brink of consciousness.
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They used the technique on three patients who had been living with chronic brain damage that had left them conscious for more than half a year a year. In one patient, the ultrasound did not seem to improve their function at all. But in the other two, doctors saw an improvement within days of the first of two treatments. One patient – a 56-year-old male who has a stroke – was able to respond to certain commands, answer yes-no questions and recognize family members in a photo. The other – a 50-year-old woman in cardiac arrest – was now able to recognize objects and communicate with others.
“What’s remarkable is that both showed meaningful responses within days of the intervention,” said study author and UCLA psychologist Martin Monti in a statement. released by the university. “We had hoped for this, but it is wonderful to see it with your own eyes. It is an extremely promising result to see that two of our three patients who were in a chronic state improved significantly within days of treatment. “
Because chronic coma-like patients spontaneously recover much less quickly than acutely comatose patients, the researchers are more confident that echo made the difference here. Importantly, no safety concerns were noted either, with the patient’s vital signs maintained during treatment.
Unfortunately, the treatment of these patients is did not lead to the same astonishing fix that Crehan experienced. The 50-year-old woman kept having it consciousness improved months later, but she was still considered minimally conscious, as the 56-year-old man’s condition dropped to its baseline by the time of a follow-up visit three months later. It is likely that in many cases restoring people’s consciousness will remain a difficult and impossible task, even if this technique proves to work.
Yet for the families of these patients, even some level of regained consciousness will be worthwhile, and there may still be ways to improve the effectiveness of these and similar brain stimulation techniques being studied. For now, the UCLA scientists continue their research with ultrasound and hope to continue clinical trials with a larger group of patients soon. They also plan to study exactly how this technique changes the brain.