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Journal of Neurorestoratology 2023, 11(1): 100041 https://doi.org/10.1016/j.jnrt.2023.100041
Case Report | Open Access | Issue | Published: 20 January 2023

Spinal cord stimulation improves motor function in disorders of consciousness: A case report

Show Author's Information Yutong Zhuanga,b,  Guangxiao Nic,  Long Xua,  Xueling Chena,  Xiaoli Genga,  Jianghong Hea( )
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Department of Neurosurgery, The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China
Department of Rehabilitation, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
Keywords:
Spinal cord stimulation, Disorders of consciousness, Frequency, Neuromodulation, Motor function
Cite this article:
Zhuang Y, Ni G, Xu L, et al. Spinal cord stimulation improves motor function in disorders of consciousness: A case report. Journal of Neurorestoratology, 2023, 11(1): 100041. https://doi.org/10.1016/j.jnrt.2023.100041
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Abstract Full text About this article

A 38-year-old male patient with disorders of consciousness (DOC) successfully recovered consciousness and get obvious motor function improvements through three stages of cervical spinal cord stimulation (SCS) treatment (6 Hz, 40 Hz, and combined frequency stimulation). We used the Coma Recovery Scale-Revised (CRS-R), Fugl–Meyer Assessment Scale, activities of daily living, and Berg Balance Scale to detect changes in consciousness and motor function during the 7-month postoperative follow-up. Electroencephalography-based individual alpha frequency (IAF) and relative power spectral density (RP) were used to assess changes in cognitive function and brain network function before and after the combined stimulation. The results revealed a gradually increased patient's CRS-R score after stimulation at 6 Hz, and the patient recovered consciousness 12 weeks postoperatively. The patient's motor function score gradually increased after adjusting the stimulation frequency to 40 Hz. However, the patient regressed in motor function when the stimulation frequency was decreased to 2 Hz. The patient's fine motor control of both hands significantly improved, accompanied by an increased RP in the beta band but the IAF decreased, after combined stimulation (40 Hz and 6 Hz). Then, motor function continued to improve with an increased IAF and RP in the alpha band after switching the stimulation order to 6 Hz and 40 Hz. Our results demonstrated that different frequency stimulations of cervical SCS may improve consciousness and motor function in patients with DOC.


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About this article

Spinal cord stimulation improves motor function in disorders of consciousness: A case report

Show Author's information Yutong Zhuanga,b, Guangxiao Nic, Long Xua, Xueling Chena, Xiaoli Genga, Jianghong Hea( )
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
Department of Neurosurgery, The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China
Department of Rehabilitation, Second Hospital of Hebei Medical University, Shijiazhuang 050000, China

Abstract

A 38-year-old male patient with disorders of consciousness (DOC) successfully recovered consciousness and get obvious motor function improvements through three stages of cervical spinal cord stimulation (SCS) treatment (6 Hz, 40 Hz, and combined frequency stimulation). We used the Coma Recovery Scale-Revised (CRS-R), Fugl–Meyer Assessment Scale, activities of daily living, and Berg Balance Scale to detect changes in consciousness and motor function during the 7-month postoperative follow-up. Electroencephalography-based individual alpha frequency (IAF) and relative power spectral density (RP) were used to assess changes in cognitive function and brain network function before and after the combined stimulation. The results revealed a gradually increased patient's CRS-R score after stimulation at 6 Hz, and the patient recovered consciousness 12 weeks postoperatively. The patient's motor function score gradually increased after adjusting the stimulation frequency to 40 Hz. However, the patient regressed in motor function when the stimulation frequency was decreased to 2 Hz. The patient's fine motor control of both hands significantly improved, accompanied by an increased RP in the beta band but the IAF decreased, after combined stimulation (40 Hz and 6 Hz). Then, motor function continued to improve with an increased IAF and RP in the alpha band after switching the stimulation order to 6 Hz and 40 Hz. Our results demonstrated that different frequency stimulations of cervical SCS may improve consciousness and motor function in patients with DOC.

Keywords: Spinal cord stimulation, Disorders of consciousness, Frequency, Neuromodulation, Motor function

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Publication history
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Publication history

Received: 14 November 2022
Revised: 15 December 2022
Accepted: 31 December 2022
Published: 20 January 2023
Issue date: March 2023

Copyright

© 2023 The Authors. Published by Elsevier Ltd on behalf of Tsinghua University Press.

Acknowledgements

All authors would like to thank Xin Miu for data collection, Qinghua Li for technical assistance, and the patient for participating in the study.

Rights and permissions

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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