Survival and consciousness recovery are better in the minimally conscious state than in the vegetative state

Faugeras, Frédéric; Rohaut, Benjamin; Valente, Mélanie; Sitt, Jacobo; Demeret, Sophie; Bolgert, Françis; Grinea, Alexandra; Marois, Clémence; Quirins, M.; Demertzi, Athena; Raimondo, Federico; Galanaud, Damien; Habert, Marie‐Odile; Engemann, Denis A.; Puybasset, Louis; Naccache, Lionel

doi:10.1080/02699052.2017.1364421

Cited by 74 publications

(70 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, presence of residual cognition at an early stage was related to subsequent consciousness recovery, in agreement with previous findings with the first version of the MBT . Our data, prospectively obtained in an ICU setting, support the notion that a wide range of cognitive capacities might be detected early after brain injury, and, more important, that their assessment is critical for determining an accurate prognosis . The integration, as early as possible in the ICU setting, of MBT‐r–based clinical observation might improve/contribute to outcome prediction based on electrophysiological and functional neuroimaging …”

Section: Discussionsupporting

confidence: 90%

“…The MBT‐r–based outcome prediction, in terms of consciousness recovery, may indeed highlight the involvement of blocked motor efference/output, rather than a true consciousness disorder, in a subset of patients with DOC who show minimal responsiveness at the bedside. Given the prognostic implications, establishing whether a patient has residual cognition is of great significance, and we believe that the MBT‐r may serve as a simple and economic tool for distinguishing CMD from other DOC. However, without valid references to confirm the presence of CMD, this should be regarded as a working hypothesis and further confirmed by experiments comparing/integrating the MBT‐r with functional neuroimaging and/or neurophysiological measurements …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Motor behavior unmasks residual cognition in disorders of consciousness

Pincherle

Jöhr

Chatelle³

et al. 2019

Annals of Neurology

View full text Add to dashboard Cite

Disorders of consciousness (DOC) are a common consequence of severe brain injuries, and clinical evaluation is critical to provide a correct diagnosis and prognosis. The revised Motor Behavior Tool (MBT-r) is a clinical complementary tool aiming to identify subtle motor behaviors that might reflect residual cognition in DOC. In this prospective study including 30 DOC patients in the early stage after brain injury, we show that the revised MBT-r has an excellent inter-rater agreement and has the ability to identify a subgroup of patients, underestimated by the Coma Recovery Scale-Revised, showing residual cognition and a subsequent recovery of consciousness.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Motor behavior unmasks residual cognition in disorders of consciousness

Pincherle

Jöhr

Chatelle³

et al. 2019

Annals of Neurology

View full text Add to dashboard Cite

show abstract

“…A lot of work has been accomplished to correctly diagnose patients with disorders of consciousness (DOC) 1,2 to establish prognostic indicators 3 and to understand the neural correlates of consciousness, 4 which is crucial since misdiagnosis can lead to important medical decisions such as premature withdrawal of life-sustaining care. 5,6 DOC includes the unresponsive wakefulness syndrome/vegetative state (UWS/VS; reflex behaviors only) and the minimally conscious state (MCS; clinical demonstration of signs of consciousness).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic interventions in patients with prolonged disorders of consciousness

Thibaut

Schiff

Giacino

et al. 2019

The Lancet Neurology

290

229

View full text Add to dashboard Cite

The management of patients with severe brain injuries and prolonged disorders of consciousness (DOC) raises important issues particularly with respect to their therapeutic options. The lack of treatment is challenged by new clinical and neuroimaging data indicating that some patients with prolonged DOC may benefit from therapeutic interventions, even years after the injury. The majority of the studies aiming at improving patients' level of consciousness and functional recovery includes behavioural and brain imaging open-label trials and case-reports, but several randomized clinical trials (RCT) have been conducted, especially using non-invasive brain stimulation. Only a couple of RCTs focused on the effects of drugs or sensory stimulation approaches, and only two Class II studies, on amantadine and transcranial direct current stimulation, have been published. While new therapeutic approaches seem to be valuable for patients with prolonged DOC, optimized stimulation parameters, alternative drugs or rehabilitation strategies still need to be tested and validated.

show abstract

“…Anoxic injuries have a far less optimistic prognosis than traumatic injuries [12,13]. A more favorable prognosis is associated with MCS (as opposed to UWS) regarding recovery of consciousness [14,15]. The potential for recovery of functional independence in ambulation and activities of daily living in MCS appears crucial in the first three months [16].…”

Section: Introductionmentioning

confidence: 99%

Recovery in cognitive motor dissociation after severe brain injury: A cohort study

Jöhr¹,

Halimi²,

Pasquier

et al. 2020

PLoS ONE

View full text Add to dashboard Cite

Objective To investigate the functional and cognitive outcomes during early intensive neurorehabilitation and to compare the recovery patterns of patients presenting with cognitive motor dissociation (CMD), disorders of consciousness (DOC) and non-DOC. Methods We conducted a single center observational cohort study of 141 patients with severe acquired brain injury, consecutively admitted to an acute neurorehabilitation unit. We divided patients into three groups according to initial neurobehavioral diagnosis at admission using the Coma Recovery Scale-Revised (CRS-R) and the Motor Behavior Tool (MBT): potential clinical CMD, [N = 105]; DOC [N = 19]; non-DOC [N = 17]). Functional and cognitive outcomes were assessed at admission and discharge using the Glasgow Outcome Scale, the Early Rehabilitation Barthel Index, the Disability Rating Scale, the Rancho Los Amigos Levels of Cognitive Functioning, the Functional Ambulation Classification Scale and the modified Rankin Scale. Confirmed recovery of conscious awareness was based on CRS-R criteria. Results CMD patients were significantly associated with better functional outcomes and potential for improvement than DOC. Furthermore, outcomes of CMD patients did not differ significantly from those of non-DOC. Using the CRS-R scale only; approximatively 30% of CMD patients did not recover consciousness at discharge. Interpretation Our findings support the fact that patients presenting with CMD condition constitute a separate category, with different potential for improvement and functional outcomes than patients suffering from DOC. This reinforces the need for CMD to be urgently recognized, as it may directly affect patient care, influencing life-or-death decisions.

show abstract

Survival and consciousness recovery are better in the minimally conscious state than in the vegetative state

Abstract: Early accurate clinical diagnosis of VS/UWS or MCS conveys a strong prognostic value of survival and of consciousness recovery.

Cited by 74 publications

References 22 publications

Motor behavior unmasks residual cognition in disorders of consciousness

Motor behavior unmasks residual cognition in disorders of consciousness

Therapeutic interventions in patients with prolonged disorders of consciousness

Recovery in cognitive motor dissociation after severe brain injury: A cohort study

Contact Info

Product

Resources

About