Background:Managing prolonged disorders of consciousness(pDoC)presents a significant clinical challenge despite numerous available therapies.While short-term spinal cord stimulation(st-SCS)for over 3 months has been r...Background:Managing prolonged disorders of consciousness(pDoC)presents a significant clinical challenge despite numerous available therapies.While short-term spinal cord stimulation(st-SCS)for over 3 months has been recognized as an effective treatment for pDoC,its efficacy within the first 3 months remains unclear.This study explores st-SCS's impact on patients with pDoC for less than 3 months.Material and methods:We enrolled 141 pDoC patients within 3 months of onset;104 received st-SCS,and 37 underwent conservative treatment.Consciousness levels were assessed using the Coma Recovery Scale-Revised(CRS-R)before treatment,2 weeks after,and at 3-month follow-up.Results:Comparing the data from the 3-month follow-up,we found that,the st-SCS group showed significantly greater improvement in CRS-R scores compared to the control group(p<0.01),with more patients showing symptom amelioration(51/104(49%)).Further analysis of the st-SCS treatment group showed significant improvement in CRS-R scores after 2 weeks(T1)and at the 3-month follow-up(T2)compared to baseline(T0).Both consciousness levels and specific CRS-R items improved notably posttreatment.Younger patients(<40 years)with traumatic brain injury and higher initial CRS-R scores were more likely to experience positive outcomes.Additionally,multivariate logistic regression identified etiology,time since injury,and initial CRS-R score as significant predictors of the 3-month outcome(p<0.05).Conclusions:st-SCS is an effective treatment for pDoC within 3 months of onset,particularly for younger patients and those with trauma-induced conditions,significantly improving consciousness and outcomes.展开更多
基金the Jiangxi Provincial Health Technology Project,grant numbers[202311895]and[SKJP220228867]the Natural Science Foundation of Jiangxi Province,grant number[20224BAB206041].
文摘Background:Managing prolonged disorders of consciousness(pDoC)presents a significant clinical challenge despite numerous available therapies.While short-term spinal cord stimulation(st-SCS)for over 3 months has been recognized as an effective treatment for pDoC,its efficacy within the first 3 months remains unclear.This study explores st-SCS's impact on patients with pDoC for less than 3 months.Material and methods:We enrolled 141 pDoC patients within 3 months of onset;104 received st-SCS,and 37 underwent conservative treatment.Consciousness levels were assessed using the Coma Recovery Scale-Revised(CRS-R)before treatment,2 weeks after,and at 3-month follow-up.Results:Comparing the data from the 3-month follow-up,we found that,the st-SCS group showed significantly greater improvement in CRS-R scores compared to the control group(p<0.01),with more patients showing symptom amelioration(51/104(49%)).Further analysis of the st-SCS treatment group showed significant improvement in CRS-R scores after 2 weeks(T1)and at the 3-month follow-up(T2)compared to baseline(T0).Both consciousness levels and specific CRS-R items improved notably posttreatment.Younger patients(<40 years)with traumatic brain injury and higher initial CRS-R scores were more likely to experience positive outcomes.Additionally,multivariate logistic regression identified etiology,time since injury,and initial CRS-R score as significant predictors of the 3-month outcome(p<0.05).Conclusions:st-SCS is an effective treatment for pDoC within 3 months of onset,particularly for younger patients and those with trauma-induced conditions,significantly improving consciousness and outcomes.
