Personalized objects can optimize the diagnosis of EMCS in the assessment of functional object use in the CRS-R: A double blind, randomized clinical trial
Coma recovery scale-revised; Functional object use; Non-personalized objects; Personalized objects
Abstract :
[en] Background: Behavioral assessment has been acted as the gold standard for the diagnosis of disorders of consciousness (DOC) patients. The item "Functional Object Use" in the motor function sub-scale in the Coma Recovery Scale-Revised (CRS-R) is a key item in differentiating between minimally conscious state (MCS) and emergence from MCS (EMCS). However, previous studies suggested that certain specific stimuli, especially something self-relevant can affect DOC patients' scores of behavioral assessment scale. So, we attempted to find out if personalized objects can improve the diagnosis of EMCS in the assessment of Functional Object Use by comparing the use of patients' favorite objects and other common objects in MCS patients. Methods: Twenty-one post-comatose patients diagnosed as MCS were prospectively included. The item "Functional Object Use" was assessed by using personalized objects (e.g., cigarette, paper) and non-personalized objects, which were presented in a random order. The rest assessments were performed following the standard protocol of the CRS-R. The differences between functional uses of the two types of objects were analyzed by the McNemar test. Results: The incidence of Functional Object Use was significantly higher using personalized objects than non-personalized objects in the CRS-R. Five out of the 21 MCS studied patients, who were assessed with non-personalized objects, were re-diagnosed as EMCS with personalized objects (χ2 = 5, df=1, p<0.05). Conclusions: Personalized objects employed here seem to be more effective to elicit patients' responses as compared to non-personalized objects during the assessment of Functional Object Use in DOC patients.
Research center :
Coma Science Group
Disciplines :
Neurology
Author, co-author :
Sun, Yuxiao; Hangzhou Normal University, International Vegetative State and Consciousness Science Institute, Hangzhou, China
Wang, Jianan; Hangzhou Normal University, International Vegetative State and Consciousness Science Institute, Hangzhou, China
Heine, Lizette ; University and Neurology Department, Hospital of Liege, GIGA, GIGA-Consciousness, Coma Science Group, Liege, Belgium, Audition Cognition and Psychoacoustics Team, Lyon Neuroscience Research Center, Lyon, France
Huang, Wanggshan; Hangzhou Normal University, International Vegetative State and Consciousness Science Institute, Hangzhou, China
Wang, Jing; Hangzhou Normal University, International Vegetative State and Consciousness Science Institute, Hangzhou, China
Hu, Nantu; Hangzhou Normal University, International Vegetative State and Consciousness Science Institute, Hangzhou, China
Hu, Xiaohua; Rehabilitation Center for Brain Damage, Wujing Hospital of Hangzhou City, Hangzhou, China
Fang, Xiaohui; Hangzhou Normal University, International Vegetative State and Consciousness Science Institute, Hangzhou, China
Huang, Supeng; Hangzhou Normal University, International Vegetative State and Consciousness Science Institute, Hangzhou, China
Laureys, Steven ; Université de Liège - ULiège > GIGA : Coma Group
Di, Haibo; Hangzhou Normal University, International Vegetative State and Consciousness Science Institute, Hangzhou, China
Language :
English
Title :
Personalized objects can optimize the diagnosis of EMCS in the assessment of functional object use in the CRS-R: A double blind, randomized clinical trial
Publication date :
2018
Journal title :
BMC Neurology
eISSN :
1471-2377
Publisher :
BioMed Central Ltd.
Volume :
18
Issue :
1
Peer reviewed :
Peer Reviewed verified by ORBi
Name of the research project :
National High Technology Research and Development Program of China
Funders :
NSCF - National Natural Science Foundation of China [CN] Hangzhou Normal University F.R.S.-FNRS - Fonds de la Recherche Scientifique [BE] Fonds Léon Fredericq [BE] ULiège - Université de Liège [BE]
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