Electromagnetics 'roused' patient

Last Modified: 15 Oct 2008
Source: PA News

An electromagnetic "wand" has been used for the first time to rouse a patient from a coma-like state, doctors believe.

The patient in the US had not improved for a year when an attempt was made to stimulate his brain with a magnetic field.

After around 15 sessions he started speaking slurred single words and following the movement of a thumb with his eyes. He also responded to his mother asking if he loved her by making two slow eye blinks - a signal meaning "yes".

Doctors at the US Department of Veteran Affairs in Chicago believe it is the first time such results have been seen from transcranial magnetic stimulation (TMS). The technique has already been used to treat migraine, stroke, Parkinson's disease and depression. But it had never before been tried as a potential therapy for brain-damaged patients in a vegetative state.

Josh Villa was 26 years old when his car mounted the kerb and flipped over, throwing him through the windscreen. Almost a year later he was still not responding to any external stimuli, despite being able to open his eyes.

After he was sent home to be cared for by his mother in Rockford, Illinois, he was enrolled in the six-week TMS study. Doctors held an electromagnetic coil in front of his head to stimulate the underlying brain tissue.

Dr Theresa Pape, who led the medical team, recalled the breakthrough when Josh began to utter words. "They were very slurred, but they were there," she told New Scientist magazine. "He'd say, like, 'erm, help, help me'"

Six weeks after the treatment Josh was given 10 more sessions but did not progress further and was sent home. His mother, Laurie McAndrews, said her son's condition remained improved. "If I ask him, 'do you love me?' he'll do two slow eye blinks; yes," she said. "Some people would say it's not much, but he's improving and that's the main thing."

Dr John Whyte, of the Moss Rehabilitation Research Institute in Philadelphia, Pennsylvania, cautioned that on its own the case did not prove TMS was a useful treatment for patients like Josh. "Even after eight months, it's not uncommon for patients to transition from the vegetative to the minimally conscious state without any particular intervention," he said.

However, he thought TMS merited further investigation, along with experimental drug treatments and deep brain stimulation, which involves inserting wires into the brain. Dr Pape hopes to begin treating a second patient in a coma-like state with TMS later this year.

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