Brain Implants Jump-Start Comatose Man
A man who spent six years unable to talk, eat, or walk as a result of severe brain damage has made a remarkable recovery thanks to a revolutionary implant of electrodes deep in his brain.
The 38-year-old had been written off by one doctor as a vegetable, but he is now able to talk, eat normally, laugh, drink, and carry out simple tasks such as brushing his teeth.
The man had been in left a "minimally conscious state" after being beaten up when robbed. He was unable to speak audibly and could only communicate by nods or tiny eye or finger movements.
He was also unable to chew or swallow and had to be fed through a tube. His eyes mostly remained shut. But after two electrodes delivered pulses of electricity to arouse his brain, he can now use words and gestures, respond reliably to requests, and carry out simple tasks.
His muscles have wasted and contracted to such a degree, however, that it is uncertain whether he will walk again. The patient's family has requested that he not be identified but, speaking yesterday, his mother said: "I prayed for a miracle. The most important part is that he can say, ‘Mummy and Pop, I love you.'"
She described him, the oldest of her three sons, as "an all around good kid" who loved to draw, collected comic books, and worked with his father. Then one night in 1999, while walking home, "he was assaulted, he was robbed, he was beaten, he was kicked about in his head. His skull was completely crushed in, and he was left for dead." After emergency surgery, a doctor told her: "If your son pulls out of this, he will be a vegetable for the rest of his life."
Eventually, she gave a "do not resuscitate order" to doctors because the prospect of change seemed hopeless.
Then, in 2005, he had the chance to take part in the pioneering brain stimulation trial, the culmination of a decade's work by a team at the JFK Johnson Rehabilitation Institute Center for Head Injuries, New Jersey; the Cleveland Clinic, and Weill Cornell Medical College, New York City. Today, he enjoys a quality of life his mother never thought possible.
The breakthrough in artificial arousal will raise hopes that up to 300,000 such patients worldwide — including about 2,500 in Britain — who have been written off as untreatable could, in theory, be coaxed back to awareness.
The research, published today in the journal Nature, will also raise false hopes that all brain-damaged patients could now be revived, when the possibilities depend on the extent of damage.
The minimally conscious state is distinct from a persistent vegetative state, or coma, in that patients do show intermittent signs of awareness and may fleetingly attempt simple words or signals.
The new approach was developed when Dr. Nicholas Schiff, the lead author of the report, saw scanner studies that suggested language brain centers of such patients were sometimes intact. His team wanted to arouse the central thalamus, the gateway between the brain stem that controls involuntary functions such as breathing and the cortex, where consciousness is thought to reside.
They used deep brain stimulation that, to date, has been used on around 40,000 patients worldwide in treating Parkinson's, epilepsy, depression and other problems where 1-millimeter electrodes "jump-start" brain areas.
The electrodes, which are powered by a battery pack implanted in the chest, were inserted into the American patient during a 10-hour operation. The results of activation were striking, as the patient's eyes opened and focused on those around him. The implant was carried out in February 2005 and the brain continues to be stimulated by the electrodes.
