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

Heliyon, 2024 · DOI: https://doi.org/10.1016/j.heliyon.2024.e34913 · Published: July 19, 2024

Simple Explanation

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. Conventional treatment combined with spinal cord electrical stimulation can improve the degree of disturbance of consciousness and promote recovery from the condition.

Study Duration

2 months

Participants

1 male patient, 78 years old

Evidence Level

Level 4; Case Report

Key Findings

1
Conventional treatment and spinal cord electrical stimulation displayed a positive effect on increasing brain functional strength connection.
2
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.
3
The strength of brain functional connectivity was 0.576, which was significantly higher than that at the time of admission.

Research Summary

This case report discusses the use of spinal cord electrical stimulation (SCES) in a 78-year-old male with severe disturbance of consciousness following a traumatic brain injury (TBI). The study used functional near-infrared spectroscopy (fNIRS) to monitor and evaluate the efficacy of SCES combined with conventional treatment. The results suggest that SCES, particularly at parameters of 4.5 V amplitude, 210 μs pulse width, and 70 Hz frequency, can improve brain functional connectivity and promote recovery of consciousness in patients with severe TBI.

Practical Implications

Clinical Treatment Reference

The findings provide a reference for clinicians treating severe consciousness disturbances, especially in optimizing spinal cord electrical stimulation parameters.

Assessment Tool

Functional near-infrared spectroscopy (fNIRS) can be used as an objective tool to assess the effectiveness of treatments for consciousness disorders.

Personalized Treatment

The study highlights the importance of adjusting spinal cord electrical stimulation parameters based on individual patient responses to maximize treatment benefits.

Study Limitations

1
Individual differences of patients
2
More case studies should be included in the future
3
Treatment methods such as acupuncture and rehabilitation training intervention time, transcranial magnetic stimulation, and median nerve electrical stimulation should be combined to draw more precise conclusions

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