Magnetic field awakens patient from three-year coma

October 16th, 2008 - 11:33 am ICT by IANS  

Washington, Oct 16 (IANS) Josh Villa, 26, driving back home after a drink with a friend three years ago, sustained massive head injuries and fell into a coma, after his car mounted the kerb and flipped over, flinging him through the windscreen. Almost a year later, there was little sign of improvement. “He would open his eyes, but he was not responsive to any external stimuli in his environment,” said Theresa Pape of US Department of Veterans Affairs in Chicago, who helped treat him.

Usually there is little more that can be done for people in this condition. Villa was to be sent home to Rockford, Illinois, where his mother, Laurie McAndrews, had volunteered to care for him, according to a Veterans Department press release.

But Pape had a different suggestion. She enrolled him in a six-week study in which an electromagnetic coil was held over the front of his head to stimulate the underlying brain tissue.

Such transcranial magnetic stimulation (TMS) has been investigated as a way of treating migraine, stroke, Parkinson’s disease and depression, with some promising results, but this is the first time it has been used as a potential therapy for someone in a coma-like state.

The rapidly changing magnetic fields that the coil creates can be used either to excite or inhibit brain cells - making it easier or harder for them to communicate with one another.

In Villa’s case, the coil was used to excite brain cells in the right prefrontal brain. This area has strong connections to the brainstem, which sends out pulses to the rest of the brain that tell it to pay attention. “It’s like an ‘OK, I’m awake’ pulse,” said Pape.

At first, there was little change in Villa’s condition, but after around 15 sessions something happened. “You started talking to him and he would turn his head and look at you,” says McAndrews. “That was huge.”

Villa started obeying one-step commands, such as following the movement of a thumb and speaking single words. “They were very slurred but they were there,” said Pape, who presented her findings this month at an international meeting on brain stimulation at the University of Göttingen, Germany. “He’d say like “erm”, “help”, “help me”.

After the 30 planned sessions the TMS was stopped. Without it, Villa became very tired and his condition declined a little, but he was still much better than before. Six weeks later he was given another 10 sessions, but there were no further improvements and he was sent home, where he remains today.

Villa is by no means cured. But he is easier to care for and can interact with visitors such as his girlfriend, who has stuck by him following the accident. “When you talk to him he will move his mouth to show he is listening,” McAndrews says. “If I ask him, “Do you love me?” he’ll do two slow eye blinks, yes. Some people would say it’s not much, but he’s improving and that’s the main thing.”

John Whyte of the Moss Rehabilitation Research Institute in Philadelphia, Pennsylvania, cautions that as intriguing as Villa’s case is, it alone does not show that TMS is a useful treatment.

Pape hopes to begin treating a second patient in a coma-like state later this year. This time she plans to adjust the number of pulses of TMS in each train, and to alter the gap between pulses to see if there is an optimum interval.

McAndrews is also in no doubt that her son’s quality of life has improved as a result of TMS. “Before I felt like he was not responsive, that he was depressed almost. Now you move him around and he complains - he can show emotions on that level.”

These findings were reported in the New Scientist.

Tags: , , , , , , , , ,

Posted in World |