Researchers targeted the thalamus with low-intensity focused ultrasound pulsation. Source: Martin Monti/UCLA Researchers describe the patient’s recovery as “remarkable,” and believe the new, non-invasive ultrasound technique could lead to a low-cost therapy for patients with severe brain injury.
The device creates a small sphere of acoustic energy that can be aimed at different regions of the brain to excite brain tissue. For this study, researchers placed it by the side of the man’s head and activated it 10 times for 30 seconds each, in a 10-minute period. The device safely emits only a small amount of energy, less than a conventional Doppler ultrasound, researchers said.
The technique, called low-intensity focused ultrasound pulsation, was pioneered by Alexander Bystritsky, a UCLA professor of psychiatry and bio-behavioral sciences, and a founder of Brainsonix, the California company that supplied the device.
The treatment targets the thalamus, an egg-shaped structure that serves as the brain’s central hub for processing information. This area is targeted because thalamus performance is typically diminished in patients whose mental function is deeply impaired after a coma, researchers said.
Results of the procedure on this patient were “remarkable,” said lead researcher Martin Monti, a UCLA associate professor of psychology and neurosurgery. “It’s almost as if we were jump-starting the neurons back into function.”
Until now, the only way to achieve this was a risky surgical procedure known as deep brain stimulation, in which electrodes are implanted directly inside the thalamus, he said. “Our approach directly targets the thalamus but is noninvasive.”
Before the procedure began, the man showed only minimal signs of being conscious and understanding speech, and he could only perform small, limited movements when asked. By the day after the treatment, his responses had improved measurably. Three days later, the patient had regained full consciousness and full language comprehension, and could reliably communicate by nodding his head “yes” or shaking his head “no.” He even made a fist-bump gesture to say goodbye to one of his doctors.
Researchers plan to test the procedure on more patients at the Ronald Reagan UCLA Medical Center beginning this fall. If the technology helps others recovering from a coma, Monti said, it could eventually be used to build a portable device—perhaps incorporated into a helmet—as a low-cost way to help “wake up” patients, perhaps even those who are in a vegetative or minimally conscious state.
Currently there is almost no effective treatment for such patients, he said.
