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Case Reports
. 2024 Jul 19;10(15):e34913.
doi: 10.1016/j.heliyon.2024.e34913. eCollection 2024 Aug 15.

Spinal cord electrical stimulation for severe disturbance of consciousness after traumatic brain injury: A case report

Zhiwen Zhu  1 , Xiaozhen Hu  1 , Yajun Mao  1
Affiliations
Case Reports

Spinal cord electrical stimulation for severe disturbance of consciousness after traumatic brain injury: A case report

Zhiwen Zhu et al. Heliyon. .

Abstract

Background: Currently, the use of spinal cord electrical stimulations for patients with severe disorders of consciousness after traumatic brain injury remains limited, and long-term follow-up studies are even scarcer. To date, there have been few reports using near-infrared spectroscopy to evaluate the clinical effects and optimal parameters of spinal cord electrical stimulation for severe consciousness disorders. This report describes a case of a patient with severe disturbance of consciousness after traumatic brain injury who underwent spinal cord electrical stimulation implantation. Advanced near-infrared spectroscopy was employed to monitor and evaluate postoperative efficacy. The findings of this case report will provide a reference for the clinical treatment of severe consciousness disturbances.

Methods: A patient diagnosed with a severe disturbance of consciousness following traumatic brain injury presented symptoms of coma and lack of voluntary activity. The treatment regimen included conventional approaches (medication combined with rehabilitation training) and adjustments to the spinal cord electrical stimulation parameters. Advanced functional near-infrared spectroscopy (fNIRS) was used to explore changes in brain functional connectivity strength and assess clinical efficacy.

Results: The integration of conventional treatment and continuous modification of spinal cord electrical stimulation parameters, combined with fNIRS monitoring, demonstrated that conventional treatment and spinal cord electrical stimulation displayed a positive effect on increasing brain functional strength connection. The Glasgow Coma Scale(GCS) score significantly improved from the baseline. Optimal results were observed with spinal cord stimulation settings at 4.5 V amplitude, 210 μs pulse width, and 70 Hz frequency, operating from 8:00-20:00 in a cycling mode of 15 min on and 15 min off, where improvements in consciousness were markedly evident.

Conclusions: Patients with severe disturbances of consciousness after traumatic brain injury recover slowly. Conventional treatment combined with spinal cord electrical stimulation can improve the degree of disturbance of consciousness and promote recovery from the condition.

Keywords: Brain trauma; Case report; Disturbance of consciousness; FNIRS; Spinal cord electrical stimulation.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
●Prefrontal network, PFN.
Fig. 2
Fig. 2
Near-infrared spectral imaging pictures at admission.Brain functional connectivity strength 0.131.
Fig. 3
Fig. 3
Near-infrared spectrum imaging picture after the first parameter adjustment. Brain functional connectivity strength 0.154.
Fig. 4
Fig. 4
The near-infrared spectrum image picture after that second parameter adjustment. Brain functional connectivity strength 0.19.
Fig. 5
Fig. 5
Near-infrared spectrum imaging picture after the third parameter adjustment. Brain functional connectivity strength 0.222.
Fig. 6
Fig. 6
Near-infrared spectroscopy imaging picture after the fourth parameter adjustment. Brain functional connectivity strength 0.181.
Fig. 7
Fig. 7
Near-infrared spectroscopy imaging picture after the fifth parameter adjustment. Brain functional connectivity strength 0.273.
Fig. 8
Fig. 8
Near-infrared spectral imaging images after 2 months of treatment. Brain functional connectivity strength 0.576.
Fig. 9
Fig. 9
One picture of MRI.
See this image and copyright information in PMC

References

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