Recent advances in neurocritical care have greatly increased the number of individuals who survive severe brain injury. Many patients go on to make significant cognitive and physical recovery, some even to a fully independent lifestyle. A number of these patients may fail to fully recover a state of consciousness – defined by the presence of arousal (i.e., cycles of eye-opening and closing) and awareness (e.g. voluntary responsiveness) – and enter, transiently or permanently, into a disorder of consciousness (DoC) such as coma, the VS/UWS, or the minimally conscious state (MCS). In addition to the devastating effects on quality of life, these conditions are known to pose great emotional and financial strain on families, increase burnout rates in caregivers, and give rise to difficult ethical discussions, making the development of effective therapeutic interventions even more important and pressing. The growing understanding of the biology of disorders of consciousness has led to a renaissance in the development of therapeutic interventions for patients with DoC. High-quality evidence is emerging for pharmacological (i.e. Amantadine) and neurostimulatory (i.e. transcranial direct current stimulation) interventions, although further studies are needed to delineate preconditions, optimal dosages, and timing of administration. Other exciting new approaches (e.g., low intensity focused ultrasound) are under development and investigation. In this symposium, we will provide an overview of the current and emerging pharmacological as well as neuromodulation therapies for persons with DoC.
Pharmacological Treatment In Disorders of Consciousness
Olivia Gosseries, Belgium
Emerging Neuromodulation Therapies In Disorders of Consciousness
Martin Monti, USA
Aurore Thibaut, Belgium