Article (Scientific journals)
Minimally conscious state “plus”: diagnostic criteria and relation to functional recovery
Thibaut, Aurore; Bodien, Y. G.; Laureys, Steven et al.
2020In Journal of Neurology, 267 (5), p. 1245-1254
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Keywords :
Brain-injuries; Coma recovery scale-revised; Command-following; Disability rating scale; Disorders of consciousness; Intelligible verbalization; Intentional communication; Minimally conscious state
Abstract :
[en] Background: We investigated the relationship between three language-dependent behaviors (i.e., command-following, intelligible verbalization, and intentional communication) and the functional status of patients with disorders of consciousness (DoC). We hypothesized that patients in minimally conscious state (MCS) who retain behavioral evidence of preserved language function would have similar levels of functional disability, while patients who lack these behaviors would demonstrate significantly greater disability. We reasoned that these results could then be used to establish empirically-based diagnostic criteria for MCS+. Methods: In this retrospective cohort study we included rehabilitation inpatients diagnosed with DoC following severe-acquired brain injury (MCS = 57; vegetative state/unresponsive wakefulness syndrome [VS/UWS] = 63); women: 46; mean age: 47 ± 19 years; traumatic etiology: 68; time post-injury: 40 ± 23 days). We compared the scores of the Disability Rating Scale score (DRS) at time of transition from VS/UWS to MCS or from MCS– to MCS+, and at discharge between groups. Results: Level of disability on the DRS was similar in patients with any combination of the three language-related behaviors. MCS patients with no behavioral evidence of language function (i.e., MCS–) were more functionally impaired than patients with MCS+ at time of transition and at discharge. Conclusions: Command-following, intelligible verbalization, and intentional communication are not associated with different levels of functional disability. Thus, the MCS+ syndrome can be diagnosed based on the presence of any one of these language-related behaviors. Patients in MCS+ may evidence less functional disability compared to those in MCS who fail to demonstrate language function (i.e., MCS–). © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
Research Center/Unit :
CHU de Liège-Centre du Cerveau² - ULiège
Disciplines :
Neurosciences & behavior
Author, co-author :
Thibaut, Aurore ;  Université de Liège - ULiège > GIGA Consciousness-Coma Science Group
Bodien, Y. G.;  Department of Neurology, Massachusetts General Hospital, Center for Neurotechnology and Neurorecovery, Harvard Medical School, Boston, MA, United States, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
Laureys, Steven  ;  Université de Liège - ULiège > GIGA Consciousness-Coma Science Group
Giacino, J. T.;  Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States, Department of Psychiatry, Massachusetts General Hospital, Boston, United States
Language :
English
Title :
Minimally conscious state “plus”: diagnostic criteria and relation to functional recovery
Publication date :
2020
Journal title :
Journal of Neurology
ISSN :
0340-5354
eISSN :
1432-1459
Publisher :
Springer
Volume :
267
Issue :
5
Pages :
1245-1254
Peer reviewed :
Peer Reviewed verified by ORBi
Funders :
NIDILRR - National Institute on Disability, Independent Living, and Rehabilitation Research [US-WA]
WBI - Wallonie-Bruxelles International [BE]
JSMF - James S McDonnell Foundation [US-MO]
BAEF - Belgian American Educational Foundation [BE]
Fonds Léon Fredericq [BE]
F.R.S.-FNRS - Fonds de la Recherche Scientifique [BE]
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