Prolonged disorders of consciousness (pDoC) are pathologies in which there is a loss of consciousness for more than 28 days. The number of patients with pDoC is increasing as the level of critical care treatment and monitoring improves. However, clinical trials for patients with pDoC are limited by small sample sizes, lack of placebo groups, and use of heterogeneous outcome measures. As a result, few therapies have strong evidence to support their use. In recent years, ketamine has been used with remarkable success in the treatment of neuropsychiatric disorders by inducing neuroplasticity, increasing neurophysiologic complexity, and expanding functional brain connectivity states. Considering increased brain plasticity as well as brain complexity, it may be beneficial for consciousness recovery. In this study, the investigators aimed to explore the effects of esketamine on brain networks and level of consciousness in patients with pDoC, and to discuss its possible use as a wakefulness-promoting treatment for patients with pDoC.
Age 18 - 65 years old, native Chinese speaker, dextromanual;
Chronic disorder of consciousness;
Spinal cord electrical stimulator implantation under general anesthesia;
Signed informed consent.
Continuous sedation was administered within 72 hours prior to the study;
Open head injury, parenchymal resection and other damage of brain structural integrity;
The intracranial compliance decreased due to hydrocephalus and swelling;
Known hearing impairment;