cognitive motor dissociation; cortically mediated state; covert awareness; covert brain complexity; functional locked-in syndrome; non-behavioral minimally conscious state
Abstract :
[en] Over the past decade, it has become apparent that up to 25% of behaviorally unresponsive patients with acute or chronic disorders of consciousness either reveal high spatio-temporal complexity following a direct electrical or magnetic pulse to the brain, or highly differentiated electroencephalographic responses, or can, voluntarily modulate their brain activity on command, each of which has been interpreted, to varying degrees, as evidence of consciousness. Practitioners designate this phenomenon using a dizzying variety of terms. The realization that unresponsiveness does not equate to unconsciousness changes the way patients should be assessed and how the medical team communicates with the patient, their families and the world at large. We here propose that the term covert consciousness be used in all such communications to designate this subcategory of behavioral unresponsive patients, with context-appropriate qualifiers and counseling accompanying its use.
Disciplines :
Neurology
Author, co-author :
Aubinet, Charlène ; Université de Liège - ULiège > GIGA > GIGA Neurosciences - Coma Science Group
Claassen, Jan; Disorders of Consciousness Laboratory, Columbia University Irving Medical Center, 10032 New York, USA ; New York-Presbyterian Hospital, 10032 New York, USA
Edlow, Brian L ; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 02114 Boston, MA, USA
Fischer, David ; Recovery of Consciousness via Evidence-Based Medicine and Research (RECOVER) Program, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, 19104 Philadelphia, USA
Gosseries, Olivia ; Université de Liège - ULiège > GIGA > GIGA Neurosciences - Coma Science Group
Koch, Christof ; Allen Institute, 98109 Seattle, USA ; Tiny Blue Dot Foundation, 90069, West Hollywood, USA
Kondziella, Daniel ; Department of Neurology, Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark ; Department of Clinical Medicine, University of Copenhagen, 2100 Copenhagen, Denmark
Massimini, Marcello; Department of Biomedical & Clinical Sciences, University of Milan, 20157 Milan ; 12IRCCS Fondazione Don Carlo Gnocchi IRCCS, 20162 Milan, Italy
Young, Michael J ; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 02114 Boston, MA, USA
