Treatment for Disorders of Consciousness: What’s New?

Presenters:

  • John Whyte
  • Aurore Thibaut
  • Erin Wegener
  • Nathan Zasler

Objectives:

  • Current standards and definitions regarding states of disordered consciousness
  • Current treatment options that have either been validated or are under study to enhance function and/or expedite recovery in persons with DOC
  • The role and theoretical basis of neuro modulation for treatment of disorders of consciousness

Description:

Very few options exist for patients who survive severe traumatic brain injury but fail to fully recover and develop a disorder of consciousness (e.g. vegetative state, minimally conscious state). The growing understanding of the biology of disorders of consciousness has led to a renaissance in the development of therapeutic interventions for these patients. High-quality evidence is emerging for pharmacological and neurostimulatory interventions. Among pharmacological approaches, Amantadine has shown the ability to accelerate functional recovery. Although with very low frequency, Zolpidem has shown the ability to improve the level of consciousness transiently and, possibly, also in a sustained fashion. Among neuromodulatory approaches, transcranial direct current stimulation has been shown to transiently improve behavioral responsiveness, but mostly in patients in minimally conscious states. New evidence for thalamic deep brain stimulation calls into question its cost/benefit trade-off. Other exciting new approaches still await systematic assessment. Finally, music therapy has recently been introduced as a potential additional options to treat impaired consciousness after severe brain injury. This workshop will introduce the theoretical principles underlying these therapeutic treatment approaches, the studies assessing their clinical efficacy and benefit as well as the level of acceptance of these methodologies by the neuroscience community. We will also discuss the limitations of said treatments and consider future directions for clinical research.

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