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Return to Work after Limb Amputations

STUDY DESIGN Vegetative state or minimally conscious state patients at 6 months after a head trauma, cerebrovascular disease or anoxic brain damage will be submitted to a neurological evaluation in order to confi rm the diagnosis. A brain MRI and electrophysiological studied will be then performed to assess if they should be included in the study. The enrolled patients will be treated by a surgical intervention of bilateral electrodes implantation in centre-median thalamic nucleus and after that, in the next days, they will be stimulated by electrical currents with variable intensity and frequency, simultaneously recording from the centre-median thalamic nucleus. If almost one of electrophysiological parameters will improve, the patients will be submitted to a defi nitive stimulator device implantation under the skin of the thoracic region. The patients will be then followed up for one year by Coma Recovery Scale and Coma/Near Coma Scale and electrophysiological studied to test the effi cacy of thalamic stimulation. Primary end point: effi cacy assessment will require a clinical response based on a positive change in the score of Coma Recovery Scale and Coma/Near Coma Scale items, in comparison of pre-surgical time. Secondary end point: increasing of duration in desynchronization pattern on continuous spectral EEG frequency analysis in comparison of that at pre-surgical time. Patients: ten patients selected according to the inclusion criteria will be enrolled in the study. Study duration: 3 years