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Voice stimuli trigger neural responsivity in coma patients

Patients with severe traumatic brain injuries had increased neural responsivity to vocal stimuli in language regions when provided with familiar auditory sensory training, according to a recently published study.

“Our results suggest that improved arousal and awareness may be due to the [Familiar Auditory Sensory Training] protocol priming the brain to be more responsive to salient stimuli,” Theresa Louise-Bender Pape, DrPH, MA, of the Department of Veterans Affairs at Edward Hines Jr VA Hospital, and colleagues wrote.

Theresa Louise-Bender Pape

Pape and colleagues conducted a double-blind randomized placebo-controlled trial to examine neurobehavioral and neurophysiological effects of sensory stimulation on global behavioral functioning, arousal and awareness. They quantified neurobehavioral functioning using the Disorders of Consciousness Scale (DOCS) and arousal and awareness using the Coma-Near-Coma (CNC) scale.

They randomized patients (n=15) in states of disordered consciousness an average of 70 days after traumatic brain injury to receive either familiar auditory sensory training (FAST) in which the patient is played a recording of people’s voices they knew at least 1 year before their injury (n=8) or a placebo consisting of silence (n=7).

Results demonstrated that while the mean change in DOCS was not different between the two groups, the FAST group had greater change in CNC scores (FAST mean=1.0, SD=0.6; Placebo mean=0.25, SD=0.7; P=.049; 95% CI, –1.51 to –.005). Based on CNC, treatment effect was large (95% CI, 0.77), and 96% of the FAST group had CNC measures above the mean of the placebo group, according to researchers. Moreover, the FAST group had significant mean functional MRI activation changes (P<.05) in both language regions and the whole brain similar to heathy controls’ activations.

“Clinicians should consider providing the FAST [protocol] to support patient engagement in neurorehabilitation,” Pape and colleagues wrote.

Disclosure: The researchers report receiving a grant from the Department of Veterans Affairs. See the study for a full list of the researchers’ relevant financial disclosures.