Towards modern post-coma care based on neuroscientific evidence.

CRS-R, Coma Recovery Scale - Revised; Coma; Disorders of Consciousness; DoC, Disorders of Consciousness; EEG, Electroencephalography; MCS, Minimally Conscious State; Minimally Conscious State; Neuroimaging; PET, Positron Emission Tomography; SECONDs, Short Evaluation of Consciousness Disorders; UWS, Unresponsive Wakefulness Syndrome; Unresponsive Wakefulness Syndrome; VS, Vegetative State; fMRI, Functional Magnetic Resonance Imaging; Clinical Psychology

Abstract :

[en] [en] BACKGROUND: Understanding the mechanisms underlying human consciousness is pivotal to improve the prognostication and treatment of severely brain-injured patients. Consciousness remains an elusive concept and the identification of its neural correlates is an active subject of research, however recent neuroscientific advances have allowed scientists to better characterize disorders of consciousness. These breakthroughs question the historical nomenclature and our current management of post-comatose patients. METHOD: This review examines the contribution of consciousness neurosciences to the current clinical management of severe brain injury. It investigates the major impact of consciousness disorders on healthcare systems, the scientific frameworks employed to identify their neural correlates and how evidence-based data from neuroimaging research have reshaped the landscape of post-coma care in recent years. RESULTS: Our increased ability to detect behavioral and neurophysiological signatures of consciousness has led to significant changes in taxonomy and clinical practice. We advocate for a multimodal framework for the management of severely brain-injured patients based on precision medicine and evidence-based decisions, integrating epidemiology, health economics and neuroethics. CONCLUSIONS: Major progress in brain imaging and clinical assessment have opened the door to a new era of post-coma care based on standardized neuroscientific evidence. We highlight its implications in clinical applications and call for improved collaborations between researchers and clinicians to better translate findings to the bedside.

Disciplines :

Neurosciences & behavior

Author, co-author :

Sanz, Leandro ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group

Laureys, Steven ; Centre Hospitalier Universitaire de Liège - CHU > > Centre du Cerveau² ; Joint International Research Unit on Consciousness, CERVO Brain Research Centre, CIUSS, Laval University, Québec, Canada

Gosseries, Olivia ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group

Language :

English

Title :

Towards modern post-coma care based on neuroscientific evidence.

Publication date :

2023

Journal title :

International Journal of Clinical and Health Psychology

ISSN :

1697-2600

eISSN :

2174-0852

Publisher :

Elsevier BV, Spain

Volume :

Issue :

Pages :

100370

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://api.elsevier.com/content/article/PII:S1697260023000066?httpAccept=text/xml

Available on ORBi :

since 17 March 2023

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