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Central thalamic deep brain stimulation for support of forebrain arousal regulation in the minimally conscious state.

TitleCentral thalamic deep brain stimulation for support of forebrain arousal regulation in the minimally conscious state.
Publication TypeJournal Article
Year of Publication2013
AuthorsSchiff, Nicholas D.
JournalHandb Clin Neurol
Volume116
Pagination295-306
Date Published2013
ISSN0072-9752
Abstract

This chapter considers the use of central thalamic deep brain stimulation (CT/DBS) to support arousal regulation mechanisms in the minimally conscious state (MCS). CT/DBS for selected patients in a MCS is first placed in the historical context of prior efforts to use thalamic electrical brain stimulation to treat the unconscious clinical conditions of coma and vegetative state. These previous studies and a proof of concept result from a single-subject study of a patient in a MCS are reviewed against the background of new population data providing benchmarks of the natural history of vegetative and MCSs. The conceptual foundations for CT/DBS in selected patients in a MCS are then presented with consideration of both circuit and cellular mechanisms underlying recovery of consciousness identified from empirical studies. Directions for developing future generalizable criteria for CT/DBS that focus on the integrity of necessary brain systems and behavioral profiles in patients in a MCS that may optimally response to support of arousal regulation mechanisms are proposed.

DOI10.1016/B978-0-444-53497-2.00024-3
Alternate JournalHandb Clin Neurol
PubMed ID24112903

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