Sensory stimulation to improve arousal in comatose patients after traumatic brain injury: a systematic review of the literature

Neurol Sci. 2020 Sep;41(9):2367-2376. doi: 10.1007/s10072-020-04410-9. Epub 2020 Apr 22.

Abstract

Background: No standard rehabilitative treatment for coma arousal after traumatic brain injury (TBI) exists. Based on our clinical experience, we hypothesized that sensory stimulation (SS) is a promising protocol to improve outcomes in these patients.

Methods: We performed a literature review on the progress of sensory stimulation to enhance coma arousal after traumatic brain injury. We searched the databases on Medline, Embase, and Cochrane to gain access to relevant publications using the key words "traumatic brain injury," "disorders of consciousness," "sensory stimulation," and "coma scale."

Results: We included all original studies published in English with patients presenting severe disorders of consciousness due to traumatic brain injury who had received SS and whose behavioral/neural responses had been measured. We compared data on ten selected studies and analyzed the SS effects in comatose patient outcomes after TBI. Our review outlines the role of SS in patients with TBI and provides guidance for its implementation in the clinical practice.

Conclusions: The literature suggests the SS program improves coma arousal after TBI. However, high-quality clinical trials are needed to establish standard SS protocols.

Keywords: Coma arousal; Neurorehabilitation; Post-traumatic coma; Sensory stimulation; Traumatic brain injury.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Arousal
  • Brain Injuries, Traumatic* / complications
  • Brain Injuries, Traumatic* / therapy
  • Coma* / etiology
  • Coma* / therapy
  • Consciousness
  • Glasgow Coma Scale
  • Humans