The impact of spinal cord stimulation treatment on patients with prolonged disorders of consciousness and their caregivers: A follow-up study

Abstract

Objective

Prolonged disorders of consciousness (pDoC) are conditions characterized by a long-term reduction in consciousness level due to severe brain injury, including vegetative state and minimally conscious state. The rehabilitation for these patients is prolonged, significantly impacting the psychological stress, physical burden, and family life of their caregivers. This study aims to evaluate the effects of spinal cord stimulation (SCS) on the treatment of patients with pDoC and its impact on the burden and mental health of primary caregivers.

Methods

The study reviewed 32 patients with pDoC and their caregivers who underwent SCS at the Affiliated Brain Hospital of Nanjing Medical University between August 2020 and December 2023. Patients were assessed using Coma Recovery Scale-Revised scale (CRS-R), and caregivers were evaluated using the Zarit Burden Interview (Zarit), Zung Self-Rating Depression Scale (SDS), and Self-Rating Anxiety Scale (SAS) at pre-surgery and 1, 6, and 12 months post-surgery follow-ups.

Results

After receiving SCS treatment, 23 patients showed significant improvement in consciousness. Caregivers’ Zarit, SDS, and SAS scores significantly decreased post-surgery, indicating alleviation of family burden, depression, and anxiety. The improvement in CRS-R scores was significantly correlated with the reduction in caregiver burden.

Conclusion

Spinal cord stimulation positively impacts consciousness recovery in patients with pDoC, while indirectly reducing caregiving burden and psychological stress for their caregivers, thus improving their mental state.