Brain-Injured Man Speaks After 6 Years
Brain-Injured Man Speaks After 6 Years
Aug 1 01:01 PM US/Eastern
By MALCOLM RITTER
AP Science Writer
NEW YORK (AP) - A brain-damaged man who could communicate only with
slight eye or thumb movements for six years can speak again, after stimulating
electrodes were placed in his brain, researchers report.
The 38-year-old also regained the ability to chew and swallow,
which allows him to be spoon-fed, rather than relying on nourishment through a
tube in his belly.
The man's brain was injured during an assault, he spent six years
with only occasional signs of consciousness and no useful movement of his
limbs. In an experiment, researchers implanted electrodes in his brain for a
procedure called deep brain stimulation, which is routinely done for
Parkinson's disease and some other illnesses.
They turned the electrodes on and off over six months to test their
effect, and reported the results in Thursday's issue of the journal Nature. The
man, who was not identified at the family's request, now has them on throughout
the day.
Experts called the report exciting but cautioned that the approach
must be tested in more people before its value can be known. The researchers
have already begun a study of additional patients.
Before the electrodes were implanted the man was in what doctors
call a "minimally conscious state." That means he showed only occasional
awareness of himself and the environment. In a coma or vegetative state, by
contrast, patients show no outward signs of awareness.
There are no firm statistics on how many Americans are in a
minimally conscious state, but one estimate suggests 112,000 to 280,000.
Doctors may try medications to improve their condition but no drugs have been
firmly established as helpful.
The man described in the Nature study speaks in a breathy but
audible voice, said Dr. Joseph Giacino, a co-lead author. He does not initiate
conversations but can reply to others, typically with one to three words, said
Giacino, of the JFK Johnson Rehabilitation Institute in Edison, N.J.
Several weeks ago he recited the first half of the Pledge of
Allegiance without assistance, Giacino said.
The man also recovered some movement. He can demonstrate motions
such as brushing his teeth, said study lead author Dr. Nicholas Schiff of Weill
Cornell Medical College in New York. He can't actually carry out that task
because the tendons in his arms contracted after years of immobility.
"He is still totally dependent and severely disabled," Schiff said.
But the treatment has helped him, the man's mother said in a
statement. "Now, my son can eat, express himself and let us know if he is in
pain. He enjoys a qualify of life we never thought possible," she said.
Dr. James Bernat, a professor of neurology at Darmouth Medical
School who didn't participate in the new work, called the Nature report
exciting and important. Further study is needed to shed light on how many
patients would respond and how to identify the minimally conscious patients
with the best chance of being helped, he said.
He noted that a similar treatment did not help Terri Schiavo, the
Florida woman in a vegetative state whose care triggered national controversy
before her death in 2005. That's the typical outcome for electrical brain
stimulation in vegetative states, he said.
Dr. Ross Zafonte of the University of Pittsburgh, who also was
familiar with the study results, agreed that "we need to know more" and said
the approach is "very interesting and holds great promise."
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On the Net:
http://www.nature.com/nature
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