Article (Scientific journals)
Cognitive impairment, clinical symptoms and functional disability in patients emerging from the minimally conscious state
Bodien, Yelena G.; Martens, Géraldine; Ostrow, Joseph et al.
2020In NeuroRehabilitation, 46 (1), p. 65-74
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Keywords :
Brain injury
Abstract :
[en] BACKGROUND: Although emergence from the minimally conscious state (eMCS) is associated with symptoms including disorientation, memory and attention impairment, restlessness, and significant functional disability, the neurobehavioral profile of eMCS has not been empirically characterized. OBJECTIVE: Determine degree of cognitive impairment, presence of clinical symptoms and functional disability at time eMCS in patients with traumatic and non-traumatic brain injury (TBI, nTBI). METHODS: Retrospective observational study of 169 adults (median [interquartile range] age: 51 [29, 62] years; male: 116; TBI: 103) who emerged from MCS based on the Coma Recovery Scale-Revised while in an inpatient Disorders of Consciousness program. Outcome measures include the Confusion Assessment Protocol (CAP) and Disability Rating Scale (DRS). RESULTS: CAP administration was attempted in 54 subjects. Twenty-eight subjects had valid scores on all CAP items, with a median [interquartile range] of 4 [3-5] symptoms of confusion. Scores in 93% of this subsample were consistent with an acute confusional state. The most common symptoms were cognitive impairment (98% of subjects), disorientation (93%), and agitation (69%). The median DRS score upon emergence from MCS was 14.5 [13, 16], indicating severe disability (n = 140). CONCLUSIONS: eMCS is associated with an acute confusional state and severe disability. This finding may inform the lower boundary of confusion as well as approach to treatment and caregiver education.
Disciplines :
Neurology
Author, co-author :
Bodien, Yelena G.;  Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, MA, Boston, United States, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, MA, Boston, United States
Martens, Géraldine  ;  Université de Liège - ULiège > GIGA
Ostrow, Joseph;  Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, MA, Boston, United States
Sheau, Kristen;  Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, MA, Boston, United States
Giacino, Joseph T.;  Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, MA, Boston, United States
Language :
English
Title :
Cognitive impairment, clinical symptoms and functional disability in patients emerging from the minimally conscious state
Publication date :
2020
Journal title :
NeuroRehabilitation
ISSN :
1053-8135
eISSN :
1878-6448
Publisher :
NLM (Medline)
Volume :
46
Issue :
1
Pages :
65-74
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 01 May 2020

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