Pilot study of electrical stimulation on median nerve in comatose severe brain injured patients: 3-month outcome

Peri, Cristian V.; Shaffrey, Mark E.; Farace, Elana; Cooper, Ellis; Alves, Wayne M.; Cooper, JD; Young, Jeff S.; Jane, John A.

doi:10.1080/02699050110065709

Cited by 37 publications

(41 citation statements)

References 6 publications

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“…The right median nerve not only stimulate the brain stem and cerebrum to increase awareness but also better pattern of speech and abilities to calculate have been observed after right median nerve electrical stimulation 26,27 . As Broca's speech area is in the left frontotemporal region, this area has been shown to become more active in positron emission tomography when a subject moves his or her hand 28 . In this study it has found that after median nerve stimulation there is increase in scores of Glasgow coma scale, improvement in speech, which helped in faster recovery of the subjects.…”

Section: Discussionmentioning

confidence: 99%

Effect of Right Median Nerve Stimulation on Level of Consciousness in Traumatic Brain Injury Subjects

Nekkanti

Shaik

Mondem

et al. 2016

AJPRHC

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Background: The median nerve serves a peripheral gateway to the central nervous system. Median nerve stimulation is positively associated with regaining the level of consciousness in patients with traumatic brain injury, but the level of evidence is still a research question. So the purpose of the study is to find out the effectiveness of right median nerve stimulation on the level of consciousness and the relation between them in subjects with traumatic brain injury. Methodology: Twenty subjects with traumatic brain injury of axonal type were selected for study and randomized into two groups. Experimental group received right median nerve stimulation along with medications where as control group received medications only one month, 30minutes a day. Glasgow coma scale is used to assess the changes in conscious levels. Result: The results have revealed that there is a significant improvement noted in experimental group when compared to control group. Comparison of Glasgow coma scale scores between experimental and control groups after one month showed significant difference with a P value of 0.0261. Conclusion: Right median nerve stimulation is strongly associated with improvement of consciousness in patients with traumatic brain injury.

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Section: Discussionmentioning

confidence: 99%

Effect of Right Median Nerve Stimulation on Level of Consciousness in Traumatic Brain Injury Subjects

Nekkanti

Shaik

Mondem

et al. 2016

AJPRHC

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“…Multiple MNS studies have been done in the USA at the University of Virginia (Cooper et al, 1999;Peri et al, 2001) and East Carolina University . Similar studies have been initiated by neurosurgeons in Japan (Yokoyama, Kamei, & Kanno, 1996) and Taiwan (Liu et al, 2003).…”

Section: Methodsmentioning

confidence: 99%

“…In the earlier study the electrical treatment group had a shorter time in the intensive care unit (Cooper et al, 1999). In the second study the electrically treated comatose patients had a shorter time of endotracheal intubation (Peri et al, 2001).…”

Section: Acute Stage Of Tbi Comamentioning

confidence: 99%

“…In the 1990s, 38 comatose patients with severe closed head injury received right median nerve electrical (or sham) stimulation in a series of pilot studies at the University of Virginia in Charlottesville, Virginia (Cooper et al, 1999;Peri et al, 2001) and the East Carolina University in Greenville, North Carolina (Cooper et al, 1999). Similar RMNS protocols were used at both university medical centres.…”

Section: Acute Stage Of Tbi Comamentioning

confidence: 99%

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Electrical treatment of reduced consciousness: Experience with coma and Alzheimer's disease

Cooper

Scherder

Cooper

2005

Neuropsychological Rehabilitation

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The right median nerve can be stimulated electrically to help arouse the central nervous system for persons with reduced levels of consciousness. The mechanisms of central action include increased cerebral blood flow and raised levels of dopamine. There is 11 years of experience in the USA of using nerve stimulation for acute coma after traumatic brain injury. There is a much longer period of experience by neurosurgeons in Japan with implanted electrodes on the cervical spinal cord for persons in the persistent vegetative state (PVS). But the use of right median nerve electrical stimulation (RMNS) for patients in the subacute and chronic phases of coma is relatively new. Surface electrical stimulation to treat anoxic brain injury as well as traumatic brain injury is evolving.Novel applications of electrical stimulation in Amsterdam have produced cognitive behavioural effects in persons with early and mid-stage Alzheimer's disease employing transcutaneous electrical nerve stimulation (TENS). Improvements in short-term memory and speech fluency have also been noted.Regardless of the aetiology of the coma or reduced level of awareness, electrical stimulation may serve as a catalyst to enhance central nervous system functions. It remains for the standard treatments and modalities to retrain the injured brain emerging from reduced levels of consciousness.

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“…This electrode placement requires hardly any undressing and enables the nursing staff to control for muscular contractions at a distance because there is no need to cover the electrodes by clothing. In clinical studies, RMNS has only been applied to coma patients and appeared to accelerate awakening from deep coma (Cooper, Jane, Alves, & Cooper, 1999;Peri et al, 2001;Liu et al, 2003). Similar to the TENS studies in AD, the rationale underlying the coma studies is that RMNS stimulates the ARAS (Cooper et al, 1999;Cooper, Scherder, & Cooper, 2005).…”

mentioning

confidence: 99%

Estimating the Effects of Right Median Nerve Stimulation on Memory in Alzheimer's Disease: A Randomized Controlled Pilot Study

Scherder

Vuijk

Swaab

et al. 2007

Experimental Aging Research

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Pilot study of electrical stimulation on median nerve in comatose severe brain injured patients: 3-month outcome

Abstract: These data show an interesting trend, although statistical power was limited in this small pilot study, suggesting the need for a larger trial.

Cited by 37 publications

References 6 publications

Effect of Right Median Nerve Stimulation on Level of Consciousness in Traumatic Brain Injury Subjects

Effect of Right Median Nerve Stimulation on Level of Consciousness in Traumatic Brain Injury Subjects

Electrical treatment of reduced consciousness: Experience with coma and Alzheimer's disease

Estimating the Effects of Right Median Nerve Stimulation on Memory in Alzheimer's Disease: A Randomized Controlled Pilot Study

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