Noncanonical Adult Human Neurogenesis and Axonal Growth as Possible Structural Basis of Recovery From Traumatic Vegetative State

Abstract

Patient recovering from traumatic vegetative state has suddenly died from cardiac arrest. In-life improvement of consciousness appeared after reduction of generalized spasticity due to botulinum toxin administration. Neuropathologic examination revealed Musashi1+, Nestin+, PCNA+, and Ki67+ cells in the hippocampus, frontal, parietal and occipital cortex, caudate, thalamus, mammillary bodies, brainstem, cerebellum, and near the posterior horn of the lateral ventricle. New neurons with neurite growth (TUC4+) appeared in corpus callosum. At the same time, axonal growth was detected in all areas of interest. New cells whose functional state was continuously improving, as revealed by in-life neurologic and positron emission tomography monitoring, have mainly been found in brain areas without neuropathologic signs of damage. We suggest that the possible role of neurogenesis consists in improvement of the microenvironment and interneuron interactions, whereas the activation of neurogenesis and the induction of neurite growth may be associated with reduction of spasticity.