The Glasgow Coma Scale: time for critical reappraisal?

Laureys, Steven; Bodart, Olivier; Gosseries, Olivia

doi:10.1016/s1474-4422(14)70152-8

Cited by 39 publications

(15 citation statements)

References 14 publications

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“…For instance, a patient may be clinically unwell yet score 15 (E4, V5, M6) on the GCS, such as in meningitis 6. Research for the use of the GCS within other medical specialties is lacking.…”

Section: Limitations Of the Gcsmentioning

confidence: 99%

Glasgow coma scale explained

Mehta¹,

trainee²,

Chinthapalli³

et al. 2019

BMJ

117

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Section: Limitations Of the Gcsmentioning

confidence: 99%

Glasgow coma scale explained

Mehta¹,

trainee²,

Chinthapalli³

et al. 2019

BMJ

117

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“…While several studies have, to date, focused on characterizing the levels of consciousness and prognostic factors in patients with disorders of consciousness (Demertzi et al, ; Di Perri et al, ; Laureys, Bodart, & Gosseries, ; Stender et al, ), their residual cognitive functions still remain poorly investigated. It has been shown that patient's own name stimulation activated associative areas in unresponsive patients who subsequently evolved to MCS (Di et al, ).…”

Section: Introductionmentioning

confidence: 99%

Clinical subcategorization of minimally conscious state according to resting functional connectivity

Aubinet¹,

Larroque²,

Heine

et al. 2018

Human Brain Mapping

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Patients in minimally conscious state (MCS) have been subcategorized in MCS plus and MCS minus, based on command-following, intelligible verbalization or intentional communication. We here aimed to better characterize the functional neuroanatomy of MCS based on this clinical subcategorization by means of resting state functional magnetic resonance imaging (fMRI). Resting state fMRI was acquired in 292 MCS patients and a seed-based analysis was conducted on a convenience sample of 10 MCS plus patients, 9 MCS minus patients and 35 healthy subjects. We investigated the left and right frontoparietal networks (FPN), auditory network, default mode network (DMN), thalamocortical connectivity and DMN between-network anticorrelations. We also employed an analysis based on regions of interest (ROI) to examine interhemispheric connectivity and investigated intergroup differences in gray/white matter volume by means of voxel-based morphometry. We found a higher connectivity in MCS plus as compared to MCS minus in the left FPN, specifically between the left dorso-lateral prefrontal cortex and left temporo-occipital fusiform cortex. No differences between patient groups were observed in the auditory network, right FPN, DMN, thalamocortical and interhemispheric connectivity, between-network anticorrelations and gray/white matter volume. Our preliminary group-level results suggest that the clinical subcategorization of MCS may involve functional connectivity differences in a language-related executive control network. MCS plus and minus patients are seemingly not differentiated by networks associated to auditory processing, perception of surroundings and internal awareness/self-mentation, nor by interhemispheric integration and structural brain damage.

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“…Si celle-ci est particulièrement utile pour évaluer un patient en phase aiguë, elle n'est toutefois pas la mieux adaptée pour différencier les patients post-coma qui s'éveillent et entrent progressivement en EV/ENR ou en ECM [15].…”

Section: éChelles Comportementalesunclassified

Diagnostic, pronostic et traitements des troubles de la conscience

Cassol

Aubinet

Thibaut

et al. 2018

NPG Neurologie - Psychiatrie - Gériatrie

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ARTICLE IN PRESSSummary Advances in medicine and intensive care have led to an increase in the number of patients surviving a severe brain injury. Although some patients recover quickly, others remain in a state of altered consciousness. These patients can progress from a coma to a vegetative state or unresponsive wakefulness syndrome (VS/UWS) and later to a minimally conscious state (MCS). In this review, we first describe the different behavioral and neuroimaging methods used in the diagnosis of patients in an altered state of consciousness. We then describe the factors that can influence the prognosis and recovery of these patients, as well as the treatment and therapeutic management that can be proposed in order to improve their state of consciousness. Finally, we conclude this review by highlighting ethical considerations and end-of-life issues.

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The Glasgow Coma Scale: time for critical reappraisal?

Cited by 39 publications

References 14 publications

Glasgow coma scale explained

Glasgow coma scale explained

Clinical subcategorization of minimally conscious state according to resting functional connectivity

Diagnostic, pronostic et traitements des troubles de la conscience

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