Reference : Residual cognitive function in comatose, vegetative and minimally conscious states
Scientific journals : Article
Human health sciences : Neurology
Residual cognitive function in comatose, vegetative and minimally conscious states
Laureys, Steven mailto [Université de Liège - ULiège > Centre de recherches du cyclotron - Comagroup > > >]
Perrin, F. [> > > >]
Schnakers, Caroline mailto [Université de Liège - ULiège > > Centre de recherches du cyclotron >]
Boly, Mélanie mailto [Université de Liège - ULiège > Centre de Recherches du Cyclotron - Comagroup > Neurologie > > >]
Majerus, Steve [Université de Liège - ULiège > Département des sciences cognitives > Psychopathologie cognitive >]
Current Opinion In Neurology
Lippincott Williams and Wilkins
Yes (verified by ORBi)
[en] brain injury ; coma ; functional imaging ; minimally conscious state ; vegetative state
[fr] cérébro-lésé ; coma ; imagerie cérébrale fonctionnelle ; neuropsychopathologie ; traumatisme crânien
[en] Purpose of review The clinical evaluation of cognition in non-communicative severely brain-damaged patients is inherently difficult. In addition to novel behavioural 'consciousness-scales', the role of para-clinical markers of consciousness, such as event related potentials and functional neuroimaging is reviewed. Recent findings New behavioural scales for vegetative and minimally conscious patients have been shown to reduce diagnostic error but regrettably remain underused in clinical routine. Electrophysiological studies have confirmed their role in estimating outcome and possibly cognition. Several recent functional neuroimaging studies have shown residual cortical function in undeniably vegetative patients. This cortical activation, however, seems limited to primary 'low-level' areas and does not imply 'higher-order' integration, considered necessary for conscious perception. Minimally conscious patients show large-scale high-order cerebral activation, apparently dependent upon the emotional relevance of the stimulation. Summary Careful clinical assessment of putative 'conscious behaviour' in vegetative and minimally conscious patients is the first requirement for their proper diagnosis and management. Complementary functional neuroimaging and electrophysiological studies will have a major impact on future clinical decision making and may guide selective therapeutic options. At present, more experimental evidence and the elucidation of methodological and ethical controversies are awaited prior to their routine clinical use.
Fonds de la Recherche Scientifique (Communauté française de Belgique) - F.R.S.-FNRS

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