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

Title Central thalamic deep brain stimulation for support of forebrain arousal regulation in the minimally conscious state.
Publication Type Journal Article
Year of Publication 2013
Authors Schiff, Nicholas D.
Journal Handb Clin Neurol
Volume 116
Pagination 295-306
Date Published 2013
ISSN 0072-9752
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.

DOI
Alternate Journal Handb Clin Neurol
PubMed ID

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