Clinical and electrophysiological investigation of spastic muscle overactivity in patients with disorders of consciousness following severe brain injury
[en] Objective
The clinical and electrophysiological profile of spastic muscle overactivity (SMO) is poorly documented in patients with disorders of consciousness (DOC) following severe cortical and subcortical injury. We aim at investigating the link between the clinical observations of SMO and the electrophysiological spastic over-reactivity in patients with prolonged DOC.
Methods
We prospectively enrolled adult patients with DOC at least 3 months post traumatic or non-traumatic brain injury. The spastic profile was investigated using the Modified Ashworth Scale and the Hmax/Mmax ratio. T1 MRI data and impact of medication were analyzed as well.
Results
21 patients were included (mean age: 41 ± 11 years; time since injury: 4 ± 5 years; 9 women; 10 traumatic etiologies). Eighteen patients presented signs of SMO and 11 had an increased ratio. Eight patients presented signs of SMO but no increased ratio. We did not find any significant correlation between the ratio and the MAS score for each limb (all ps > 0.05). The presence of medication was not significantly associated with a reduction in MAS scores or Hmax/Mmax ratios.
Conclusions
In this preliminary study, the Hmax/Mmax ratio does not seem to reflect the clinical MAS scores in patients with DOC. This supports the fact they do not only present spasticity but other forms of SMO and contracture.
Significance
Patients with DOC are still in need of optimized tools to evaluate their spastic profile and therapeutic approaches should be adapted accordingly.
Foidart-Dessalle, Marguerite ; Université de Liège - ULiège > Département des sciences de la motricité > Département des sciences de la motricité
Laureys, Steven ; Université de Liège - ULiège > Coma Science Group
Thibaut, Aurore ; Université de Liège - ULiège > Coma Science Group
Language :
English
Title :
Clinical and electrophysiological investigation of spastic muscle overactivity in patients with disorders of consciousness following severe brain injury
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