(Reuters Health) - In a very small and preliminary study, comatose patients became more responsive after hearing recordings of a loved one telling a familiar story several times a day for weeks.

None of the eight patients who got this treatment emerged to full consciousness during the study, although they did appear to be more "aroused" and "aware" than a comparison group when assessed according to a standard coma scale.

"We see a very organized activation in regions of the brain we would expect a healthy person to use in order to understand a story being told to them," said lead author Theresa Louise-Bender Pape.

"It appears to be helping the brain filter out what's relevant and not relevant," said Pape of the Veterans Affairs (VA) department's Center for Innovation in Complex Chronic Healthcare and Research Service, Edward Hines Jr. VA Hospital in Hines, Illinois.

Past research suggests that sensory stimulation - especially when it's repeated at regular intervals - may enhance awareness in patients with "disordered consciousness" after traumatic brain injury, Pape and her colleagues write in the journal Neurorehabilitation and Neural Repair.

Disordered consciousness includes coma, a deep unconsciousness with no signs of wakefulness or awareness, as well as vegetative and minimally-conscious states, where there may be wakefulness but no awareness or only sporadic signs of awareness.

The researchers divided 15 patients in states of disordered consciousness into two groups around 70 days after each one's traumatic brain injury - which were often the result of an automobile, motorcycle or snowmobile crash.

None of the patients was in a coma at the start of the study. Some started in a vegetative state, and others were minimally conscious.

Eight of the patients were treated with Familiar Auditory Sensory Training (FAST), listening to recordings of stories from their past told by people they know well who shared those experiences. Researchers played the recordings for the patients for 10 minutes, four times per day, for six weeks.

The other seven patients lay in silence for the same periods. Visitors were allowed to interact with all of the patients as they usually would, speaking or playing music. And all patients continued to receive their usual-care medications.

After six weeks, both groups had shown similar improvement, on average, according to the Disorders of Consciousness Scale, a precise rating system scoring level of consciousness from "consistently responsive" to "extreme coma."

On a different scale, the FAST patients did appear to have more gains in arousal and awareness than the comparison group.

The change indicated by the second scale would be subtle, but noticeable, Pape said.

"You shouldn't expect them to wake up and start talking," she said. "This is a subtle change in one aspect of full consciousness, they'll be more aware of people in their environment."

Turning your head in response to a tap on the shoulder, which some of the FAST patients were able to do, is one of the "basic key ingredients" to full consciousness, she said.

"We don't know if they are more likely to regain full consciousness yet," she said.

But patients do need awareness to engage in therapies, so in that sense, FAST did seem to help, Pape said.

Therapists can help families develop the stories and try the FAST treatment, Pape said. Traumatic brain injury patients should still have access to good specialty services within six months of the injury, she said.

Pape theorizes that pulling content from long-term memories forces the patient's brain to "exercise" in an important way. It's still unclear whether the stories themselves, the familiar voice, or just hearing any story told in any voice drove the improvement in the FAST group, she said.

The trial was well designed, "however the patient group here is very small and is not sufficient to draw strong inferences," said Professor Luigi Trojano of the psychology department at the Second University of Naples in Italy, who was not part of the new research.

Familiar environments or interactions may activate brain plasticity, but Trojano is not strongly convinced that reading someone a story can really make the difference, he told Reuters Health by email.

Furthermore, 10 of the 15 patients were in a minimally conscious state and perhaps could have been involved in a variety of more advanced treatment programs, said Giulio Lancioni of the department of neuroscience and sense organs at the University of Bari in Italy, also not part of the study.

To date, the most promising therapy for accelerating recovery from prolonged disorders of consciousness has been amantadine, a drug which treats Parkinson's disease and is already commonly prescribed to patients after a traumatic brain injury.

"I would say that it is not important that family members read a story repetitively to their beloved ones, but that they do not stop interacting with their relatives (by speaking, touching, taking care), even when their relatives are not (overtly) capable of responding," Trojano said.

SOURCE: http://bit.ly/1uyoRbk Neurorehabilitation and Neural Repair, online January 22, 2015.