Device wakes man with severe brain injuries

CHICAGO Thu Aug 2, 2007 1:29am EDT

1 of 4. An undated lateral x-ray image of the patient showing the DBS leads implanted. A man with severe brain injuries who spent six years in a near-vegetative state can now chew his food, watch a movie and talk with family thanks to a brain pacemaker that may change the way such patients are treated, U.S. researchers said on Wednesday.

Credit: Reuters/Cleveland Clinic/Handout

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CHICAGO (Reuters) - A man with severe brain injuries who spent six years in a near-vegetative state can now chew his food, watch a movie and talk with family thanks to a brain pacemaker that may change the way such patients are treated, U.S. researchers said on Wednesday.

The 38-year-old man is the first person in a minimally conscious state to be treated with deep-brain stimulation, a treatment that uses a pacemaker and two electrodes to send impulses into a part of the brain regulating consciousness.

His awakening may change the way doctors think about people with severe brain injuries, who are largely unresponsive but still have some level of consciousness. These patients typically spend the rest of their lives in nursing homes, with little efforts at rehabilitation and slim chance of recovery.

"This is a group of patients that are really, in many ways, forgotten about," said Dr. Ali Rezai, director of the Cleveland Clinic's Center for Neurological Restoration.

"We have to do more research, obviously, but I think down the line it will change the way we are treating or even looking at people with severe brain injury."

Rezai and a team of specialists from the JFK Johnson Rehabilitation Institute-Center for Head Injuries in Edison, New Jersey, and the Weill Cornell Medical College in New York detailed the patient's progress in the journal Nature.

They used a device made by Medtronic Inc.. Like a heart pacemaker, the device is implanted in the chest under the skin, but electrodes deliver stimulation to precisely targeted areas deep in the brain.

Researchers think the electrical stimulation may be enhancing the brain circuits that are still capable of functioning.

LOVED TO DRAW

Before his injury, the man -- whose identity was not disclosed -- loved to draw, collected comic books and fancied movies about superheroes.

He was attacked and robbed in 1999.

"His skull was completely crushed and he was left for dead," his mother told reporters in a telephone briefing.

He spent the next five years in a nursing home with no hope of recovery. He would occasionally mouth the word yes or no, but could not communicate reliably or eat on his own.

His parents agreed to try the experimental treatment in August 2005, and doctors saw immediate results.

He was alert and could move his head to follow voices.

He can now drink from a cup, recall and speak 16 words, and watch a movie.

Rezai said he is engaged with his family, playing cards with his mother and taking short trips outside the facility.

Because of years of immobility, he may never walk.

"He still has got a long way to go, but given where he was, he is dramatically improved," Rezai said.

The man is the first of 12 patients who will undergo the treatment as part of a pilot study approved by the U.S. Food and Drug Administration.

Experts believe about 100,000 to 300,000 patients with traumatic brain injury may be in a minimally conscious state. Most do not receive active therapy, but Rezai and colleagues think this may need to change.

"Judging from the results, we are very encouraged about the potential of this technology to improve the function of these brain-injured patients," he said.

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