Clinical and electrophysiological investigation of spastic muscle overactivity in patients with disorders of consciousness following severe brain injury

Martens, Géraldine; Deltombe, Thierry; Foidart-Dessalle, Marguerite; Laureys, Steven; Thibaut, Aurore

doi:10.1016/j.clinph.2018.10.021

Article (Scientific journals)

Clinical and electrophysiological investigation of spastic muscle overactivity in patients with disorders of consciousness following severe brain injury

Martens, Géraldine; Deltombe, Thierry; Foidart-Dessalle, Marguerite et al.

2019 • In Clinical Neurophysiology, 130 (2)

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/232475

DOI
10.1016/j.clinph.2018.10.021

PubMed
30580243

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Keywords :

spasticity; Modified Ashworth Scale; H/M ratio; coma; minimally conscious state; unresponsive wakefulness syndrome

Abstract :

[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.

Disciplines :

Neurology

Author, co-author :

Martens, Géraldine ; Université de Liège - ULiège > GIGA : Coma Group

Deltombe, Thierry

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

Publication date :

February 2019

Journal title :

Clinical Neurophysiology

ISSN :

1388-2457

eISSN :

1872-8952

Publisher :

Elsevier, Netherlands

Volume :

130

Issue :

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://www.sciencedirect.com/science/article/pii/S1388245718313816

European Projects :

H2020 - 686764 - LUMINOUS - Studying, Measuring and Altering Consciousness through information theory in the electrical brain

Funders :

CE - Commission Européenne

Available on ORBi :

since 03 February 2019

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