Does ultrasound wake you up from a coma?

With the help of ultrasound, scientists brought two more patients out of a coma

Svetlana Maslova, Hi-tech+

The first successful case of withdrawal from coma by focused ultrasound occurred in 2016 with a 25-year-old patient (Monti et al., Non-Invasive Ultrasonic Thalamic Stimulation in Disorders of Consciousness after Severe Brain Injury: A First-in-Man Report // Brain Stimulation).

However, until now, the authors of the method themselves partially considered this event as luck and could not say for sure that it was ultrasound exposure that helped. Two new cases of elderly people in more serious condition prove that the treatment works. This opens up new opportunities for thousands of people who have been living for many months and even years only thanks to connecting to medical devices.

Scientists call the new results much more significant, since elderly patients in a chronic vegetative state had much less chance of spontaneous recovery than a young man in the acute phase five years ago. This time, the first signs of consciousness were achieved in a 56-year-old man with a severe traumatic brain injury and a 50-year-old woman who fell into a coma after cardiac arrest.

The findings of the study are published in the journal Brain Stimulation (Cain et al., Ultrasonic Thalamic Stimulation in Chronic Disorders of Consciousness), a press release is available on the website of the University of California at Davis (Scientists jump-start two people's brains after coma) – WM.

In such patients, recovery is slow – for several months or even years. Focused ultrasound therapy showed the first result within a few days. "It is unlikely that the results are spontaneous," commented study leader Martin Monti.

Two clinical cases

The man was in a vegetative state for more than 14 months after the TBI, but after the first of the two procedures he demonstrated the ability to throw and catch a ball, and also probably recognized some of his relatives in photographs. When asked his own name, he could affirmatively say "yes" or "no" in response to the options.

After the second procedure, the patient could already write with a pen on paper, drink from a bottle on his own, as well as communicate and answer questions.

"It is important to note that this behavior is a diagnostic marker of coming out of a coma," Monti stressed.

The second case was even more severe. The woman had a cardiac arrest more than 2.5 years ago and she was in a difficult situation. A few days after the first treatment session, she was able to recognize some household items for the first time. Then she also demonstrated the ability to understand speech.

In both cases, scientists observed a significant reaction within just a few days after the intervention. We were hoping for this, but watching the result was exciting, they said.

In total, three people took part in the experiment, but for a man who was in a coma for 5.5 years after a serious accident, treatment did not bring results.

Focused ultrasound

The effect of low-intensity focused ultrasound is aimed at stimulating the neurons of the thalamus, whose function decreases as a result of the onset of coma. While scientists do not know how ultrasound changes brain function, however, they plan to find out the mechanism in further research.

The entire treatment process took 10 minutes each in the first and second weeks of the course.

No side effects were also observed. Scientists have not recorded changes in blood pressure, heart rate, blood oxygen levels and other signs of complications. "This is a safe method that emits less energy than Doppler ultrasound (which is used to diagnose the condition of the fetus in pregnant women)," the authors concluded.

Currently, scientists are planning to adapt the technology so that treatment can be carried out both in a hospital and at home. However, in the next few years, the method will not yet be available in clinical practice. First of all, scientists need to confirm the results obtained and assess the long-term prospects for the first improvements.

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