Sleeping Pill Beauty: Patient Awakens From Eight-Year Unresponsive State After Taking Sleeping Pill

The unusual case of a patient, unable to move or talk for eight years, who suddenly regained the ability to do both after being administered a sleeping pill has been reported by researchers from Radboud University Medical Center and Amsterdam UMC. The spectacular but temporary effect was visualized with brain scans, giving researchers a better understanding of this disorder's underlying neurophysiological processes. The article has been published in Cortex.

Eight years ago, Richard, at the time a man in his late 20s, was hospitalized after a serious lack of oxygen. He survived but suffered a severe brain injury. Richard was no longer able to talk, eat independently, or move spontaneously. He was admitted to a specialized nursing home. Willemijn van Erp, an elderly care physician and researcher at Radboud university medical center, was still in training when she met Richard. "It was clear that Richard saw and heard us," she says, "but because of his brain injury, he was barely able to respond to us." This rare condition is known as akinetic mutism. Akinetic means that the patient is no longer able to move consciously. Mutism refers to the absence of speech.

There is a small chance that patients with this condition will temporarily recover after administering the Zolpidem sleeping medication. Van Erp: "Because Richard's situation seemed hopeless, the family and I decided to administer this medication to Richard. Against all expectations, Zolpidem had remarkable effects. After taking the sleep pill, Richard started talking, wanted to call his father, and started recognizing his brothers again. With some help, he could even get up from his wheelchair and walk short distances."

Researchers at Amsterdam UMC, including neurosurgeon resident Hisse Arnts, have used brain scans to demonstrate the differences between the two situations. This provided them with information that could be important for Richard and other patients with severe non-congenital brain injuries. Arnts: "Richard's brain scans show overactivity in certain parts of the brain. This overactivity causes noise and somehow shuts down the 'good brain activity'. We have discovered that administering this sleeping medication can suppress this unwanted brain overactivity, creating space for speech and movement."

The researchers presented their findings and a video of Richard in the magazine Cortex. The research has since continued. Zolpidem's positive effects have a limited duration, which is why the researchers are now looking for a more permanent solution for Richard and other patients with this specific form of severe brain injury.

Reference:

Arnts H, van Erp WS, Boon LI, et al. Awakening after a sleeping pill: Restoring functional brain networks after severe brain injury. Cortex. 2020;132:135-146. doi:10.1016/j.cortex.2020.08.011

This article has been republished from materials provided by Radboud University Medical Center. Note: material may have been edited for length and content. For further information, please contact the cited source.