Promising results of a clinical study on apomorphine conducted to improve recovery after coma
The results of the study led by the Belgian researchers were published this week in eClinicalMedicine, an international journal part of The Lancet series.
The study examined the effects of apomorphine administered subcutaneously for 30 days in patients suffering from severe brain injury with impaired consciousness, for example following head trauma or cardiac arrest. Treated patients showed an improvement compared to the pre-treatment phase, which persisted even after apomorphine withdrawal, as well as significantly better recovery than a control group admitted to the same neurorehabilitation center (CHN William Lennox in Ottignies) but not receiving the treatment, which seems to confirm the therapeutic potential of apomorphine in these rare neurological diseases. The authors describe an increase in conscious behaviors observed at the patients' bedside (e.g., visual pursuit, response to command or communication), measured using standardized scales (Coma Recovery Scale - Revised), but also an improvement in electrophysiological (electroencephalogram) and neuroimaging (PET-scan) measures between pre- and post-treatment conditions.
“This preliminary study will need to be confirmed by larger double-blind randomized clinical trials, but it provides promising results on both the safety and the efficacy of apomorphine for post-coma recovery” reports Dr. Leandro Sanz, first author of the paper, neurology resident at CHUV (Lausanne, Switzerland) and researcher at the Coma Science Group.
The Coma Science Group is a leading international research center for the study of disorders of consciousness. It aims to improve the clinical management of patients in coma, unresponsive wakefulness syndrome or minimally conscious state, and to investigate the neural correlates of consciousness. The William Lennox Neurological Center is a renowned center of expertise for the neurological revalidation of patients with disorders of consciousness. This work was made possible by the financial support of the King Baudouin Foundation through the Generet Award 2019, awarded to Prof. Steven Laureys, which allowed the funding of several research projects on altered consciousness.
“We have very few tools to improve the prognosis of patients after severe brain injury, and our understanding of the mechanisms underlying consciousness remains incomplete. This study provides hope for accelerating the functional recovery of these patients, but also helps us to understand and target the neural processes involved in consciousness disorders,” says Dr. Olivia Gosseries, principal investigator of the study, co-director of the Coma Science Group and FRS-FNRS research fellow.
Reference
Sanz et al, “Apomorphine for prolonged disorders of consciousness: a multimodal open-label study”, eClinicalMedicine, 2024
https://www.sciencedirect.com/science/article/pii/S2589537024005042
Contacts
At GIGA
Olivia Gosseries
Dr Leandro Sanz, MD, PhD, leandro.sanz@chuv.ch
Coma Science Group, GIGA-Consciousness
University of Liège et CHU Liège, Belgium
