Reference : Nociception Coma Scale Revised allows to identify patients with preserved neural basi...
Scientific congresses and symposiums : Poster
Social & behavioral sciences, psychology : Neurosciences & behavior
http://hdl.handle.net/2268/233818
Nociception Coma Scale Revised allows to identify patients with preserved neural basis for pain experience.
English
Bonin, Estelle mailto [Université de Liège - ULiège > > Consciousness-Coma Science Group >]
Lejeune, Nicolas mailto [Université Catholique de Louvain - UCL > > Neuroscience > >]
Thibaut, Aurore mailto [Université de Liège - ULiège > > Consciousness-Coma Science Group >]
Cassol, Helena mailto [Université de Liège - ULiège > > Consciousness-Coma Science Group >]
Antonopoulos, Georgios mailto [Université de Liège - ULiège > > GIGA : Coma Group >]
Wannez, Sarah mailto [Université de Liège - ULiège > Consciousness-Coma Science Group > > >]
Martial, Charlotte mailto [Université de Liège - ULiège > > Consciousness-Coma Science Group >]
Schnakers, Caroline mailto [University of California, Los Angeles - UCLA > Neurochirurgie et psychiatrie > > >]
LAUREYS, Steven mailto [Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Coma Science Group >]
Chatelle, Camille mailto [Université de Liège - ULiège > > Consciousness-Coma Science Group >]
14-Mar-2019
Yes
International
13th World congress on brain injury
from 13/03/2019 to 16/03/2019
IBIA (International Brain Injury Association)
Toronto
Canada
[en] nociception ; scale ; threshold
[en] The Nociception Coma Scale-Revised (NCS-R) was developed to help assessing pain in non-communicative patients with disorders of consciousness (DOC). Several studies have shown its sensitivity in assessing responses to acute noxious stimuli. However, they failed to determine a reliable cut-off score that could be used to infer pain processing in these patients.
This retrospective cross-sectional study aimed to determine an NCS-R cut-off score supporting preserved neural basis for pain experience, based on brain metabolism as measured by fluorodeoxyglucose positron emission tomography (FDG-PET).
We included FDG-PET confirmed patient with unresponsive wakefulness syndrome (UWS) (n=13) and looked at their highest NCS-R total scores. As the highest score was 4, we determined the cut-off of 5 and compared the brain metabolism of these patients with matched DOC patients with a cut-off score ≥ 5 (i.e., potential pain) and healthy controls.
We found a higher global cerebral metabolism in healthy subjects compared with both patients’ groups and also in patients with potential pain compared with FDG-PET confirmed UWS. We observed a preserved metabolism in the left insula in patients with potential pain when compared with FDG-PET confirmed UWS. We also found a preservation of the connectivity between the left insula and the medial frontal gyrus in patients with potential pain compared with FDG-PET confirmed UWS. Our data suggest that using the cut-off score of 5 can be helpful to improve pain management in DOC patients. Future studies should focus on patients showing scores below this cut-off to better characterize their profile and improve cares.
Consciousness-Coma Science Group
Researchers
http://hdl.handle.net/2268/233818

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