The Vegetative State and Stem Cells: Therapeutic Considerations

Abstract

The vegetative state (VS), also known as “unresponsive wakefulness syndrome,” is considered one of the most devastating outcomes of acquired brain injury. While diagnosis of this condition is generally well-defined clinically, patients often appear to be awake despite an absence of behavioral signs of awareness, which to the family can be confusing, leading them to believe the loved one is aware of their surroundings. This inequality of agreement can be very distressing. Currently, no cure for the VS is available; as a result, patients may remain in this condition for the rest of their lives, which in some cases amount to decades. Recent advances in stem cell approaches for the treatment of other neurological conditions may now provide an opportunity to intervene in this syndrome. This mini review will address the development of VS, its diagnosis, affected cerebral structures, and the underlying basis of how stem cells can offer therapeutic promise that would take advantage of the often long-term features associated with this maladie to effect a repair of the severely damaged circuitry. In addition, current limitations of this treatment strategy, including a lack of animal models, few long-term clinical studies that might identify benefits of stem cell treatment, and the potential for development of tumors are considered.

Therapies to Restore Consciousness in Patients with Severe Brain Injuries: A Gap Analysis and Future Directions

“…Stem Cell, Neurogenesis, Gliogenesis, and Axonal Regrowth Therapies: State of the Science Several therapeutic possibilities exist for using stem cells capable of neuronal differentiation in patients with DoC. These cells can be derived from adult neural stem cells, mesenchymal bone marrow stromal cells, umbilical cord blood, and induced pluripotent stem cells [209]. The application of this therapy to patients with DoC has been influenced by the development of platforms to test stem cell therapies in several other neurological diseases [210][211][212].…”

Transplantation of glutamatergic neuronal precursor cells in the paraventricular thalamus and claustrum facilitates awakening with recovery of consciousness

“…With the development of stem cell technology, stem cells have taken on an important therapeutic role as “seed cells 10 ” or “carrier cells 11 , 12 ” in clinical practice. In fact, stem cell therapy has the potential as a treatment for DOC 13 . At present, stem cell transplantation for the treatment of DOC is still in the exploratory stage and faces two main problems: the selection of transplanted cells and the identification of optimal transplantation targets.…”

The effect of Sedation Depth Regulation Monitored by Bispectral Index (BIS) during General Anesthesia on the Outcomes of Patients with ChronicConsciousness Disorders Undergoing Spinal Cord Stimulation Implantation: A real-world retrospective study

“…Currently, there is a lack of standardized treatment options with proven e cacy for patients with disorders of consciousness (DOC). Recommended treatments for DOC include hyperbaric oxygen therapy [19,20] , music therapy [21][22][23] , stem cell therapy [24,25] , and amantadine [26,27] . However, the effectiveness of these treatments remains controversial.…”