Can Ultrasound in the ICU Help Wake Up Coma Patients?
Ultrasonic Deep Brain Neuromodulation in Acute Disorders of Consciousness: A Proof-of-Concept
Cain, J. A., Spivak, N. M., Coetzee, J. P., Crone, J. S., Johnson, M. A., Lutkenhoff, E. S., Real, C., Buitrago-Blanco, M., Vespa, P. M., Schnakers, C., Monti, M. M.
What's the Point?
This early report describes the acute ICU arm of the first clinical trial to use focused ultrasound neuromodulation in patients with disorders of consciousness. It established that the procedure is feasible and safe in critically ill patients and produced initial signs of behavioral improvement.
Patients admitted to the ICU with severe brain injury can fall into a coma or minimally conscious state. Once acute care is stable, there is little a doctor can do to actively promote recovery of awareness.
This paper reports the acute arm of the first-in-human trial (NCT02522429) applying MR-guided thalamic focused ultrasound in ICU patients with disorders of consciousness, tracked with the CRS-R and neuroimaging.
A subset of patients showed significant CRS-R improvement within a week of stimulation. Changes in thalamic connectivity and cortical perfusion tracked behavioral recovery.
A proof-of-concept that non-invasive thalamic ultrasound is feasible and safe in the ICU, and may complement standard neurocritical care for acute disorders of consciousness.
From the manuscript
This paper reports the acute arm of the first-in-human clinical trial (NCT02522429) of MR-guided low-intensity focused ultrasound of the thalamus in ICU patients with disorders of consciousness. A subset of patients showed significant improvement on the Coma Recovery Scale-Revised within a week of stimulation, accompanied by changes in thalamic connectivity and cortical perfusion linked to behavioral recovery.
- Disorders of Consciousness
- Clinical Trial
- Focused Ultrasound
Infographic summarizing objectives, methods, and findings.
Full citation
Cain, J. A., Spivak, N. M., Coetzee, J. P., Crone, J. S., Johnson, M. A., Lutkenhoff, E. S., Real, C., Buitrago-Blanco, M., Vespa, P. M., Schnakers, C., & Monti, M. M. (2022). Ultrasonic Deep Brain Neuromodulation in Acute Disorders of Consciousness: A Proof-of-Concept. Brain Sciences, 12(4), 428.