文章基本信息

标题：The clinical effect of vagus nerve stimulation in the treatment of patients with a minimally conscious state
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作者：Xun-Jie Xiang
期刊名称：Journal of Neurorestoratology
电子版ISSN：2324-2426
出版年度：2020
卷号：8
期号：3
页码：160-171
DOI：10.26599/JNR.2020.9040016
出版社：Dove Medical Press Ltd
摘要：Objective: Vagus nerve stimulation (VNS) has recently been used in neurorehabilitation and the recovery of consciousness based on its effects on cortical plasticity. The aim of this study was to examine the therapeutic effects of VNS on patients with a minimally conscious state (MCS). Methods: All patients included in the study were assessed more than 5 months after injury and were receiving regular rehabilitation at our hospital from August 2018 to October 2019. Ten patients diagnosed with MCS by Coma Recovery Scale-Revised (CRS-R) test who underwent VNS surgery were enrolled. The scores on CRS-R evaluation at baseline (before VNS implantation) and 1, 3, and 6 months after VNS treatment were recorded. The stimulation parameters were chosen according to a previous study. All clinical rehabilitation protocols remained unchanged during the study. Furthermore, safety was assessed by analyzing treatment-emergent adverse events (TEAEs). Results: No significant improvement in the total CRS-R scores at the end of the 1-month follow-up was observed ( p > 0.05). After 3 months of stimulation, a significant difference ( p = 0.0078) was observed in the total CRS-R scores compared with the baseline. After 6 months of VNS treatment, CRS-R assessments showed a continuous significant improvement ( p = 0.0039); one patient emerged from the MCS and recovered functional communication and object use. Interestingly, one item of CRS-R scores on visual domain was sensitive to VNS treatment ( p = 0.0039). Furthermore, no serious adverse event occurred throughout the study. Conclusion: This exploratory study provides preliminary evidence suggesting that VNS is a safe and effective tool for consciousness recovery in patients with MCS.
关键词：disorders of consciousness;vegetative state;minimally conscious state;vagus nerve stimulation