Right Median Nerve Electrical Stimulation for Acute Traumatic Coma Patients

医学 麻醉 彗差(光学) 创伤性脑损伤 格拉斯哥昏迷指数 队列 刺激 外科 最小意识状态 内科学 心理学 意识 物理 神经科学 精神科 光学
作者
Jin Lei,Lei Wang,Guoyi Gao,Edwin Cooper,Jiyao Jiang
出处
期刊:Journal of Neurotrauma [Mary Ann Liebert]
卷期号:32 (20): 1584-1589 被引量:45
标识
DOI:10.1089/neu.2014.3768
摘要

The right median nerve as a peripheral portal to the central nervous system can be electrically stimulated to help coma arousal after traumatic brain injury (TBI). The present study set out to examine the efficacy and safety of right median nerve electrical stimulation (RMNS) in a cohort of 437 comatose patients after severe TBI from August 2005 to December 2011. The patients were enrolled 2 weeks after their injury and assigned to the RMNS group (n=221) receiving electrical stimulation for 2 weeks or the control group (n=216) treated by standard management according to the date of birth in the month. The baseline data were similar. After the 2-week treatment, the RMNS-treated patients demonstrated a more rapid increase of the mean Glasgow Coma Score, although statistical significance was not reached (8.43±4.98 vs. 7.47±5.37, p=0.0532). The follow-up data at 6-month post-injury showed a significantly higher proportion of patients who regained consciousness (59.8% vs. 46.2%, p=0.0073). There was a lower proportion of vegetative persons in the RMNS group than in the control group (17.6% vs. 22.0%, p=0.0012). For persons regaining consciousness, the functional independence measurement (FIM) score was higher among the RMNS group patients (91.45±8.65 vs. 76.23±11.02, p<0.001). There were no unique complications associated with the RMNS treatment. The current study, although with some limitations, showed that RMNS may serve as an easy, effective, and noninvasive technique to promote the recovery of traumatic coma in the early phase.
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