Efficacy of high-cervical spinal cord stimulation in vegetative patients and its effect on blood flow

Abstract

To investigate the efficacy of high-cervical spinal cord stimulation in vegetative patients and its effect on blood flow. Sixty patients with persistent vegetative state were assigned in a control group (n=30) for routine coma arousal program and a treatment group (n=30) for high-cervical spinal cord stimulation besides routine coma arousal program using a random number table method. The number of patients out from vegetative state, consciousness (Coma Recovery Scale-revised), electroencephalogram, brainstem auditory evoked potential, somatosensory evoked potential and cerebral blood flow were observed before and post treatment. One patient in the control group while seven patients in the treatment group were out from vegetative state 6 months after treatment (P<0.05). Post-treatment Coma Recovery Scale-Revised scores increased in both groups of patients (9.23±2.78 vs 4.43±1.06 and 7.12±2.91 vs 4.51±1.16, P<0.001), with a more evident increase in the treatment group than in the control group (9.23±2.78 vs 7.12±2.91, P<0.01). Electroencephalogram, brainstem auditory evoked potential and somatosensory evoked potential enhanced post treatment (all P<0.01), with greater improvements in the treatment group (all P<0.01). Cerebral blood flow rose in both groups post treatment (56.32±5.88 vs 44.22±5.21 and 51.12±5.56 vs 44.99±5.32, P<0.001), with a more distinct increase in the treatment group than in the control group (56.32±5.88 vs 51.12±5.56, P<0.001). High-cervical spinal cord stimulation for patients with persistent vegetative state can promote the recovery of consciousness, enhance neuroelectrophysiological activity and improve cerebral blood flow. However, more clinical studies are needed to confirm its efficacy.