Is Animal-Assisted Therapy for Minimally Conscious State Beneficial? A Case Study.

OBJECTIVE: The goal of this single case study was to qualitatively investigate the effects of animal-assisted therapy in a patient in a minimally conscious state. METHOD: We present a 28-year-old female patient in a minimally conscious state following polytrauma after a sports accident leading to cerebral fat embolism causing multiple CNS ischemic lesions. She received eight animal-assisted therapy sessions and eight paralleled control therapy sessions over 4 weeks. We investigated the reactions of the patient during these sessions via qualitative behavior analysis. RESULTS: The patient showed a broader variability and higher quality of behavior during animal-assisted therapy compared to control therapy sessions. CONCLUSION: The observed behavioral changes showed higher arousal and increased awareness in the presence of an animal. The presented case supports the assumption that animal-assisted therapy can be a beneficial treatment approach for patients in a minimally conscious state.

Sixteen years of deep brain stimulation in Tourette's Syndrome: a critical review.

INTRODUCTION: The aim of this paper was to perform a critical and systematic review of the published papers on deep brain stimulation (DBS) for Tourette's Syndrome (TS). EVIDENCE ACQUISITION: A PubMed search on DBS in TS was conducted selecting papers that reported on the clinical outcome of DBS. EVIDENCE SYNTHESIS: The majority of papers were case reports or small series. The thalamus and the globus pallidus internus appear to be the most promising targets. However, in light of the great methodological diversity a balanced comparison of clinical outcome and understanding of the role of DBS in TS remains difficult. CONCLUSIONS: Despite 16 years of experience with DBS in TS a consensus on many issues, foremost on target selection and the age of inclusion continue to be missing. Class I evidence and international collaborations, to increase the number of included patients, are urgently needed, in order to evaluate further the role of DBS in TS.

Clinical review of deep brain stimulation and its effects on limbic basal ganglia circuitry.

This paper aims to provide an overview of factors that may contribute to cognitive and mood alterations following DBS (and lesion therapy). A PubMed search based on studies in the English-language was undertaken, and included all publications on the topics of mood and surgery for movement disorders. Information was collected on pre-operative and post-operative characteristics of each study, and study methodology was examined. One-hundred and forty published articles were selected and reviewed for mood and behavior changes following neurosurgery for movement disorders. There were a variety of mood and cognitive changes associated with DBS (and lesion therapy). These alterations of behavior and cognition were seen in all targets but not frequently reported with thalamic DBS. However methodological limitations, small sample sizes, lack of control groups, and the heterogeneity of data reported underscore why interpretation and comparison of limbic effects of DBS remains challenging. The collection and reporting of more standardized minimal data sets will allow for future comparisons, and improve the power required to answer many of the questions raised in this review.