Nociception Coma Scale Revised allows to identify patients with preserved neural basis for pain experience

[en] The Nociception Coma Scale-Revised (NCS-R) was developed to help assess pain in patients with disorders of consciousness (DOC). Several studies have shown its sensitivity in assessing response 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 a NCS-R cut-off score supporting preserved neural basis for pain experience, based on brain metabolism preservation as measured by fluorodeoxyglucose positron emission tomography (FDG-PET). We included patients in unresponsive wakefulness syndrome (UWS) confirmed by the FDG-PET and examined the NCS-R total scores. As the highest score was 4, we defined the cut-off to be 5 and compared the brain metabolism of these patients to matched patients with DOC and a NCS-R cut-off score ≥ 5 (i.e., potential pain), as well as healthy subjects. We found a higher global cerebral metabolism in healthy subjects compared to both patient 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 compared with FDG-PET confirmed UWS.

Research Center/Unit :

Coma Science Group
GIGA Consciousness (Coma Science Group, Centre du Cerveau)

Disciplines :

Neurosciences & behavior

Author, co-author :

Bonin, Estelle ; Université de Liège - ULiège > GIGA-Consciousness-Coma Science Group ; CHU de Liège - Centre du Cerveau²

Lejeune, Nicolas ; Université de Liège - ULiège > Form. doct. sc. méd. (paysage)

Thibaut, Aurore ; Université de Liège - ULiège > Consciousness-Coma Science Group

Cassol, Helena ; Université de Liège - ULiège > Consciousness-Coma Science Group

Antonopoulos, Georgios ; Université de Liège - ULiège > GIGA : Coma Group

Wannez, Sarah ; Université de Liège - ULiège > GIGA Consciousness > Coma Science Group

Martial, Charlotte ; Université de Liège - ULiège > Consciousness-Coma Science Group

Schnakers, Caroline; Research institute Casa Colina hospital and centers for healthcare

LAUREYS, Steven ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Centre intégré pluridisc. étude cerveau-cognition-conscience

Chatelle, Camille ; Université de Liège - ULiège > Consciousness-Coma Science Group

Language :

English

Title :

Nociception Coma Scale Revised allows to identify patients with preserved neural basis for pain experience

Publication date :

2020

Journal title :

Journal of Pain

ISSN :

1526-5900

eISSN :

1528-8447

Publisher :

Elsevier, United States

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 06 January 2020

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