Publications of Olivia Gosseries
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See detailDe la transe chamanique à la transe cognitive : revue de la littérature et approche biopsychosociale
Yannick, Lafon; Grégoire, Charlotte ULiege; VANHAUDENHUYSE, Audrey ULiege et al

in Josse, Evelyne; Struzik, Martine (Eds.) Les dimensions invisibles de la conscience, la mort et le deuil (in press)

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See detailNeuroimaging and neurophysiological diagnosis and prognosis in paediatric disorders of consciousness
Vitello, Marie ULiege; Szymkowicz, Emilie ULiege; Laureys, Steven ULiege et al

in Developmental Medicine and Child Neurology (in press)

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See detailDisruption in structural-functional network repertoire and time resolved subcortical-frontoparietal connectivity in disorders of consciousness
Panda, Rajanikant ULiege; THIBAUT, Aurore ULiege; Lopez-Gonzalez, Ane et al

E-print/Working paper (2021)

Understanding recovery of consciousness and elucidating its underlying mechanism is believed to be crucial in the field of basic neuroscience and medicine. Ideas such as the global neuronal workspace and ... [more ▼]

Understanding recovery of consciousness and elucidating its underlying mechanism is believed to be crucial in the field of basic neuroscience and medicine. Ideas such as the global neuronal workspace and the mesocircuit theory hypothesize that failure of recovery in conscious states coincide with loss of connectivity between subcortical and frontoparietal areas, a loss of the repertoire of functional networks states and metastable brain activation. We adopted a time-resolved functional connectivity framework to explore these ideas and assessed the repertoire of functional network states as a potential marker of consciousness and its potential ability to tell apart patients in the unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS). In addition, prediction of these functional network states by underlying hidden spatial patterns in the anatomical network, i.e. so-called eigenmodes, were supplemented as potential markers. By analysing time-resolved functional connectivity from fMRI data, we demonstrated a reduction of metastability and functional network repertoire in UWS compared to MCS patients. This was expressed in terms of diminished dwell times and loss of nonstationarity in the default mode network and fronto-parietal subcortical network in UWS compared to MCS patients. We further demonstrated that these findings co-occurred with a loss of dynamic interplay between structural eigenmodes and emerging time-resolved functional connectivity in UWS. These results are, amongst others, in support of the global neuronal workspace theory and the mesocircuit hypothesis, underpinning the role of time-resolved thalamo-cortical connections and metastability in the recovery of consciousness. [less ▲]

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See detailPosterior integration and thalamo-frontotemporal broadcasting are impaired in disorders of consciousness
Panda, Rajanikant ULiege; López-González, Ane; Gilson, Matthieu et al

E-print/Working paper (2021)

The study of the brain’s dynamical activity is opening a valuable source of assistance for the clinical diagnosis of patients with disorders of consciousness (DOC). For example, dysfunctional spread of ... [more ▼]

The study of the brain’s dynamical activity is opening a valuable source of assistance for the clinical diagnosis of patients with disorders of consciousness (DOC). For example, dysfunctional spread of naturalistic and synthetic stimuli has proven useful to characterize hampered consciousness. However, understanding of the mechanisms behind loss of consciousness following brain injury is still missing. Here, we study the propagation of endogenous and in-silico exogenous perturbations in patients with DOC, based upon directed and causal interactions estimated from resting-state fMRI. We found that patients with DOC suffer decreased capacity for neural propagation and responsiveness to events. Particularly, that loss of consciousness is related to the malfunctioning of two neural circuits: the posterior cortical regions failing to convey information, in conjunction with reduced broadcasting of information from subcortical, temporal, parietal and frontal regions. These results seed light on the mechanisms behind DOC, thus opening new possibilities for clinical applications. [less ▲]

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See detailUnifying turbulent dynamics framework distinguishes different brain states
Escrichs, Anira; Perl, Yonatan Sanz; Uribe, Carme et al

E-print/Working paper (2021)

Recently, significant advances have been made by identifying the levels of synchronicity of the underlying dynamics of a given brain state. This research has demonstrated that unconscious dynamics tend to ... [more ▼]

Recently, significant advances have been made by identifying the levels of synchronicity of the underlying dynamics of a given brain state. This research has demonstrated that unconscious dynamics tend to be more synchronous than those found in conscious states, which are more asynchronous. Here we go beyond this dichotomy to demonstrate that the different brain states are always underpinned by spatiotemporal chaos but with dissociable turbulent dynamics. We investigated human neuroimaging data from different brain states (resting state, meditation, deep sleep, and disorders of consciousness after coma) and were able to distinguish between them using complementary model-free and model-based measures of turbulent information transmission. Our model-free approach used recent advances describing a measure of information cascade across spatial scales using tools from turbulence theory. Complementarily, our model-based approach used exhaustive in silico perturbations of whole-brain models fitted to the empirical neuroimaging data, which allowed us to study the information encoding capabilities of the brain states. Overall, the current framework demonstrates that different levels of turbulent dynamics are fundamental for describing and differentiating between brain states. [less ▲]

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See detailSimplified Evaluation of CONsciousness Disorders (SECONDs) in individuals with severe brain injury: A validation study
Aubinet, Charlène ULiege; Cassol, Helena ULiege; BODART, Olivier ULiege et al

in Annals of Physical and Rehabilitation Medicine (2021), 64(5), 101432

Background The Coma Recovery Scale-Revised (CRS-R) is the gold standard to assess severely brain-injured patients with prolonged disorders of consciousness (DoC). However, the amount of time needed to ... [more ▼]

Background The Coma Recovery Scale-Revised (CRS-R) is the gold standard to assess severely brain-injured patients with prolonged disorders of consciousness (DoC). However, the amount of time needed to complete this examination may limit its use in clinical settings. Objective. We aimed to validate a new faster tool to assess consciousness in individuals with DoC. Methods This prospective validation study introduces the Simplified Evaluation of CONsciousness Disorders (SECONDs), a tool composed of 8 items: arousal, localization to pain, visual fixation, visual pursuit, oriented behaviors, command-following, and communication (both intentional and functional). A total of 57 individuals with DoC were assessed on 2 consecutive days by 3 blinded examiners: one CRS-R and one SECONDs were performed on 1 day, whereas 2 SECONDs were performed on the other day. A Mann-Whitney U test was used to compare the duration of administration of the SECONDs versus the CRS-R, and weighted Fleiss’ kappa coefficients were used to assess inter-/intra-rater reliability as well as concurrent validity. Results In the 57 participants, the SECONDs was about 2.5 times faster to administer than the CRS-R. The comparison of the CRS-R versus the SECONDs on the same day or the best of the 3 SECONDs led to “substantial” or “almost perfect” agreement (kappa coefficients ranging from 0.78 to 0.85). Intra-/inter-rater reliability also showed almost perfect agreement (kappa coefficients from 0.85 to 0.91 and 0.82 to 0.85, respectively). Conclusions The SECONDs appears to be a fast, reliable and easy-to-use scale to diagnose DoC and may be a good alternative to other scales in clinical settings where time constraints preclude a more thorough assessment. [less ▲]

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See detailUpdate on neuroimaging in disorders of consciousness
Sanz, Leandro ULiege; Thibaut, Aurore ULiege; Edlow, Brian et al

in Current Opinion in Neurology (2021), 34(4), 488-496

Purpose of review Neuroimaging has acquired a prominent place in the assessment of disorders of consciousness (DoC). Rapidly evolving technologies combined with state-of-the-art data analyses open new ... [more ▼]

Purpose of review Neuroimaging has acquired a prominent place in the assessment of disorders of consciousness (DoC). Rapidly evolving technologies combined with state-of-the-art data analyses open new horizons to probe brain activity, but selecting appropriate imaging modalities from the plethora of available techniques can be challenging for clinicians. This update reviews selected advances in neuroimaging that demonstrate clinical relevance and translational potential in the assessment of severely brain-injured patients with DoC. Recent findings Magnetic resonance imaging and high-density electroencephalography provide measurements of brain connectivity between functional networks, assessments of language function, detection of covert consciousness, and prognostic markers of recovery. Positron emission tomography can identify patients with preserved brain metabolism despite clinical unresponsiveness and can measure glucose consumption rates in targeted brain regions. Transcranial magnetic stimulation and near-infrared spectroscopy are noninvasive and practical tools with promising clinical applications. Summary Each neuroimaging technique conveys advantages and pitfalls to assess consciousness. We recommend a multimodal approach in which complementary techniques provide diagnostic and prognostic information about brain function. Patients demonstrating neuroimaging evidence of covert consciousness may benefit from early adapted rehabilitation. Translating methodological advances to clinical care will require the implementation of recently published international guidelines and the integration of neuroimaging techniques into patient-centered decision-making algorithms. [less ▲]

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See detailIncreased brain metabolism and EEG connectivity after apomorphine therapy in patients with chronic disorders of consciousness
Sanz, Leandro ULiege; Lejeune, Nicolas ULiege; Bonin, Estelle ULiege et al

Poster (2021, July 29)

Objectives: Few therapies to improve the prognosis of patients with disorders of consciousness (DoC) have reliable evidence to support their efficacy and outcome measures used in clinical trials rarely ... [more ▼]

Objectives: Few therapies to improve the prognosis of patients with disorders of consciousness (DoC) have reliable evidence to support their efficacy and outcome measures used in clinical trials rarely include neuroimaging biomarkers of recovery. Apomorphine is a dopaminergic agent which has demonstrated preliminary behavioral results in DoC. Its consciousness-promoting action is thought to rely on the restoration of dopaminergic striato-pallido-thalamo-cortical feedback loops in the mesocircuit. This open-label study uses clinical and neuroimaging outcome measures to investigate changes after apomorphine therapy, to confirm its efficacy and identify surrogate biomarkers of responsiveness. Methods: 6 patients with chronic DoC following severe brain injury (4 male; 4 traumatic; 1 unresponsive, 3 minimally conscious “minus”, 2 minimally conscious “plus”; 38-year-old average; 99 days post-onset average) received daily subcutaneous apomorphine for 30 days. Multimodal outcome measures were recorded 30 days before, during therapy and 30 days after treatment withdrawal. Weekly behavioral assessments included the Coma Recovery Scale–Revised (CRS-R) and rehabilitation scales. Surveys on subjective feeling about the patient’s clinical status were filled out by families and healthcare staff before and after therapy. High-density electroencephalography (hdEEG) and fluorodeoxyglucose positron emission tomography (FDG-PET) were acquired before and after treatment. Results: Compared to the 30-day baseline period, 3 patients improved their CRS-R behavioral diagnosis during therapy, 2 additional patients improved during the 12-month follow-up and the last patient spontaneously emerged before treatment but improved on all rehabilitation scales during therapy. All patients maintained their improvements at the latest available follow-up. Mean CRS-R scores were higher during therapy (+2.1 points) and 30-day washout (+4.3 points) periods, compared to the 30-day baseline. All items evaluated in the clinical survey were rated higher after treatment than before treatment, both by the family (+30.9% mean difference) and the healthcare staff (+20.5%). The family and the staff observed the most important improvements in the patients’ communication abilities and spontaneous motricity, respectively. 4/6 patients demonstrated increased alpha-band hdEEG functional connectivity measured by network centrality after therapy, while the two patients who had already emerged during treatment did not improve (+23.1% average increase in connectivity when considering only the four “responders"). Wholebrain metabolism measured by FDG-PET increased in the same four patients and decreased in the two remaining (+20.1% on average after treatment, when considering only the four “responders”). Conclusion: Long-lasting behavioral improvements were observed in these patients with chronic DoC who received 30-day apomorphine therapy. Multimodal neuroimaging measures such as hdEEG connectivity and FDG-PET metabolism may help tracking responsiveness to therapy and identifying potential responders. However, the clinical profile of patients (e.g., those who already emerged) may influence the dynamics of specific neuroimaging biomarkers. Future studies should confirm these preliminary results and guide the selection of adequate multimodal outcome measures following a precision medicine approach. [less ▲]

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See detailTherapies to Restore Consciousness in Patients with Severe Brain Injuries: A Gap Analysis and Future Directions
Edlow, Brian; Sanz, Leandro ULiege; Polizzotto, Len et al

in Neurocritical Care (2021), 35

Background/Objective For patients with disorders of consciousness (DoC) and their families, the search for new therapies has been a source of hope and frustration. Almost all clinical trials in patients ... [more ▼]

Background/Objective For patients with disorders of consciousness (DoC) and their families, the search for new therapies has been a source of hope and frustration. Almost all clinical trials in patients with DoC have been limited by small sample sizes, lack of placebo groups, and use of heterogeneous outcome measures. As a result, few therapies have strong evidence to support their use; amantadine is the only therapy recommended by current clinical guidelines, specifically for patients with DoC caused by severe traumatic brain injury. To foster and advance development of consciousness-promoting therapies for patients with DoC, the Curing Coma Campaign convened a Coma Science Work Group to perform a gap analysis. Methods We consider five classes of therapies: (1) pharmacologic; (2) electromagnetic; (3) mechanical; (4) sensory; and (5) regenerative. For each class of therapy, we summarize the state of the science, identify gaps in knowledge, and suggest future directions for therapy development. Results Knowledge gaps in all five therapeutic classes can be attributed to the lack of: (1) a unifying conceptual framework for evaluating therapeutic mechanisms of action; (2) large-scale randomized controlled trials; and (3) pharmacodynamic biomarkers that measure subclinical therapeutic effects in early-phase trials. To address these gaps, we propose a precision medicine approach in which clinical trials selectively enroll patients based upon their physiological receptivity to targeted therapies, and therapeutic effects are measured by complementary behavioral, neuroimaging, and electrophysiologic endpoints. Conclusions This personalized approach can be realized through rigorous clinical trial design and international collaboration, both of which will be essential for advancing the development of new therapies and ultimately improving the lives of patients with DoC. [less ▲]

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See detailSwallowing in individuals with disorders of consciousness: A cohort study
MELOTTE, Evelyne ULiege; MAUDOUX, Audrey ULiege; DELHALLE, Sabrina ULiege et al

in Annals of Physical and Rehabilitation Medicine (2021), 64(4), 101403

Background. After a period of coma, a proportion of individuals with severe brain injury remain in an altered state of consciousness before regaining partial or complete recovery. Individuals with ... [more ▼]

Background. After a period of coma, a proportion of individuals with severe brain injury remain in an altered state of consciousness before regaining partial or complete recovery. Individuals with disorders of consciousness (DOC) classically receive hydration and nutrition through an enteral feeding tube. However, the real impact of the level of consciousness on an individual’s swallowing ability remains poorly investigated. Objective. We aimed to document the incidence and characteristics of dysphagia in DOC individuals and to evaluate the link between different components of swallowing and the level of consciousness. Methods. We analyzed clinical data on the respiratory status, oral feeding and otolaryngologic examination of swallowing in DOC individuals. Univariate and multivariate logistic regression was used to analyse the association of components of swallowing and participant groups (i.e., unresponsive wakefulness syndrome [UWS] and minimally conscious state [MCS]). Results. We included 92 individuals with DOC (26 UWS and 66 MCS). Overall, 99% of the participants showed deficits in the oral and/or pharyngeal phase of swallowing. As compared with the MCS group, the UWS group more frequently had a tracheostomy (69% vs 24%), with diminished cough reflex (27% vs 54%) and no effective oral phase (0% vs 21%). Conclusion. Almost all DOC participants had severe dysphagia. Some components of swallowing (i.e., tracheostomy, cough reflex and efficacy of the oral phase of swallowing) were related to consciousness. In particular, no UWS participant had an efficient oral phase, which suggests that its presence may be a sign of consciousness. In addition, no UWS participant could be fed entirely orally, whereas no MCS participant orally received ordinary food. Our study also confirms that objective swallowing assessment can be successfully completed in DOC individuals and that specific care is needed to treat severe dysphagia in DOC. [less ▲]

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See detailCircadian and ultradian rhythms depend on the level of consciousness in disorders of consciousness
van der Lande, Glenn ULiege; Sanz, Leandro ULiege; Frasso, Gianluca ULiege et al

Conference (2021, June 01)

Background and aims: Eye opening in patients with disorders of consciousness (DOC) marks the onset of a cyclic pattern with and without arousal. In minimally conscious state (MCS) arousal may be ... [more ▼]

Background and aims: Eye opening in patients with disorders of consciousness (DOC) marks the onset of a cyclic pattern with and without arousal. In minimally conscious state (MCS) arousal may be accompanied with awareness, unlike in unresponsive wakefulness syndrome (UWS). The presence of circadian and/or ultradian rhythmicity in patients with DOC has not been well established. To this end, we analyzed actigraphy data with a method well-suited to account for the variable rhythms within and across days observed in this population. Methods: We collected actigraphy data from 73 subjects (19 controls, 35 MCS, 19 UWS) over seven days and performed analyses using PyActigraphy. Singular Spectrum Analysis, a data-driven technique, was used to decompose the signal into circadian and ultradian rhythms. Next, we will evaluate these results statistically and correlate patients’ clinical diagnoses using the Coma Recovery Scale-Revised with the phase of detected circadian rhythms. Results: Data cleaning resulted in exclusion of one control (5.3%), 10 MCS (28.6%) and nine UWS (45%) subject(s). Our preliminary results show that the strength of circadian and ultradian rhythms in actigraphy data decreases with consciousness from healthy controls to MCS and almost disappearing in UWS (Figure 1).Conclusion: Preservation of circadian/ultradian rhythms seems associated with the level of consciousness. Rhythms appear almost absent in UWS patients, which suggests limited behavioral evidence for a sleep/wake cycle although eye opening is observed. Overall, the use of actigraphy could contribute to clinical assessments in DOC, and although data quality might be suboptimal, acquisition can be repeated easily. [less ▲]

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See detailApomorphine therapy for patients with disorders of consciousness: a multimodal open-label study
Sanz, Leandro ULiege; Lejeune, Nicolas ULiege; Bonin, Estelle ULiege et al

Conference (2021, June 01)

Introduction: Apomorphine, a repurposed dopaminergic drug, is a promising therapy to improve the recovery of patients with disorders of consciousness (DOC), with a postulated action on the mesocircuit ... [more ▼]

Introduction: Apomorphine, a repurposed dopaminergic drug, is a promising therapy to improve the recovery of patients with disorders of consciousness (DOC), with a postulated action on the mesocircuit. This prospective open-label study aimed to confirm preliminary results on clinical efficacy and investigate its action on brain function. Methods: 6 patients with chronic DOC (4 male, 4 traumatic, 38.8 year-old average, 99 days post-onset average) received daily subcutaneous apomorphine therapy for 30 days. Multimodal monitoring was performed from 30 days before to 30 days after treatment. Outcome measures included repeated behavioural scales, high-density electroencephalography (hdEEG) and positron emission tomography (PET). Results: Compared to baseline, 3 patients improved their behavioural diagnosis during treatment, 2 additional patients improved during the 12-month follow-up and the last patient emerged before treatment start but improved on all rehabilitation scales during treatment. Mean Coma Recovery Scale-Revised scores improved during treatment (2.1 points) and 30-day washout (5.2 points) periods, compared to baseline (Table 1). Healthcare staff and family rated the patient’s clinical condition 20.5% and 30.9% better after treatment, respectively (Table 2). Alpha-band hdEEG functional connectivity measured by network centrality increased by 13.6% on average after treatment (Figure 1). Wholebrain fluorodeoxyglucose metabolism increased by 12.4% on average between PET before and after treatment. Conclusion: Multimodal improvements were observed in chronic DOC patients after a 30-day treatment regimen with apomorphine. These results suggest a beneficial action on consciousness that is associated with increased brain connectivity and metabolism. These results will need to be confirmed in a subsequent multicentre randomized placebo-controlled trial (EudraCT: 2018-003144-23; Clinicaltrials.gov: NCT03623828). [less ▲]

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See detailLa transe cognitive auto-induite : caractéristiques et applications thérapeutiques potentielles.
Grégoire, Charlotte ULiege; Sombrun, Corine; Gosseries, Olivia ULiege et al

in HEGEL: Penser par Soi-Même (2021), 2(2), 192-201

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See detailPreservation of brain activity in unresponsive patients identifies MCS star
Thibaut, Aurore ULiege; Panda, Rajanikant ULiege; Annen, Jitka ULiege et al

in Annals of Neurology (2021), 90(1), 89-100

Objectives: Brain-injured patients who are unresponsive at the bedside (i.e., vegetative state/unresponsive wakefulness syndrome – VS/UWS) may present brain activity similar to patients in minimally ... [more ▼]

Objectives: Brain-injured patients who are unresponsive at the bedside (i.e., vegetative state/unresponsive wakefulness syndrome – VS/UWS) may present brain activity similar to patients in minimally conscious state (MCS). This peculiar condition has been termed “nonbehavioural MCS” or “MCS*”. In the present study we aimed to investigate the proportion and underlying brain characteristics of patients in MCS*. Methods: Brain 18F-fluorodeoxyglucose Positron Emission Tomography (FDG-PET) was acquired on 135 brain-injured patients diagnosed in prolonged VS/UWS (n=48) or MCS (n=87). From an existing database, relative metabolic preservation in the fronto-parietal network (measured with standardized uptake value) was visually inspected by 3 experts. Patients with hypometabolism of the fronto-parietal network were labelled “VS/UWS”, while its (partial) preservation either confirmed the behavioural diagnosis of “MCS” or, in absence of behavioural signs of consciousness, suggested a diagnosis of “MCS*”. Clinical outcome at 1-year follow-up, functional connectivity, grey matter atrophy, and regional brain metabolic patterns were investigated in the three groups (VS/UWS, MCS* and MCS). Results: 67% of behavioural VS/UWS presented a partial preservation of brain metabolism (i.e., MCS*). Compared to VS/UWS patients, MCS* patients demonstrated a better outcome, global functional connectivity and grey matter preservation more compatible with the diagnosis of MCS. MCS* patients presented lower brain metabolism mostly in the posterior regions compared to MCS patients. Interpretation: MCS* is a frequent phenomenon that is associated with better outcome and better brain preservation than the diagnosis of VS/UWS. Complementary exams should be provided to all unresponsive patients before taking medical decisions. [less ▲]

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See detailThe Development and Validation of the SWADOC: A Study Protocol for a Multicenter Prospective Cohort Study
MELOTTE, Evelyne ULiege; Belorgeot, Marion; Herr, Roxanne et al

in Frontiers in Neurology (2021), 12

Background: After a coma, patients with severe brain injury may present disorders of consciousness (DOC). A substantial proportion of these patients also suffer from severe dysphagia. Assessment of and ... [more ▼]

Background: After a coma, patients with severe brain injury may present disorders of consciousness (DOC). A substantial proportion of these patients also suffer from severe dysphagia. Assessment of and therapy for swallowing disabilities of patients with DOC are essential because dysphagia has major functional consequences and comorbidities. Dysphagia evaluation in patients with DOC is impeded by the lack of adapted tools. The first aim of this study was to create a new tool, the SWallowing Assessment in Disorders Of Consciousness (SWADOC), and propose a validation protocol. The SWADOC was developed to help therapists assess factors related to swallowing in patients with DOC. The second aim was to investigate the relationship between patients' level of consciousness and SWADOC items and scores. Method/Design: In this multicenter prospective cohort, 104 patients with DOC will be tested three times over five consecutive days with the SWADOC. Statistical analyses will focus on the reliability and validity of the SWADOC, especially the intrarater and interrater reliability, internal consistency, measures of dispersion, and concurrent validity with the Facial Oral Tract Therapy Swallowing Assessment of Saliva (FOTT-SAS). The level of consciousness will be assessed with the Simplified Evaluation of CONsciousness Disorders (SECONDs) and the Coma Recovery Scale-Revised (CRS-R). Discussion: The assessment of swallowing abilities among patients with DOC is the first necessary step toward the development of a customized dysphagia care plan. A validated scoring tool will be essential for clinicians to better assess dysphagia in patients with DOC and document the evolution of their disorders. [less ▲]

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See detailSECONDs administration guidelines: A fast tool for assessing consciousness in brain-injured patients
Sanz, Leandro ULiege; Aubinet, Charlène ULiege; Cassol, Helena ULiege et al

in Journal of Visualized Experiments (2021), (168), 61968

Establishing an accurate diagnosis is crucial for patients with disorders of consciousness (DoC) following a severe brain injury. The Coma Recovery Scale-Revised (CRS-R) is the recommended behavioral ... [more ▼]

Establishing an accurate diagnosis is crucial for patients with disorders of consciousness (DoC) following a severe brain injury. The Coma Recovery Scale-Revised (CRS-R) is the recommended behavioral scale for assessing the level of consciousness among these patients, but its long administration duration is a major hurdle in clinical settings. The Simplified Evaluation of CONsciousness Disorders (SECONDs) is a shorter scale that was developed to tackle this issue. It consists of six mandatory items, observation, command-following, visual pursuit, visual fixation, oriented behaviors, and arousal, and two conditional items, communication and localization to pain. The score ranges between 0 and 8 and corresponds to a specific diagnosis (i.e., coma, unresponsive wakefulness syndrome, minimally conscious state minus/plus, or emergence from the minimally conscious state). A first validation study on patients with prolonged DoC showed high concurrent validity and intra- and inter-rater reliability. The SECONDs requires less training than the CRS-R and its administration lasts about 7 minutes (interquartile range: 5-9 minutes). An additional index score allows the more precise tracking of a patient’s behavioral fluctuation or evolution over time. The SECONDs is therefore a fast and valid tool for assessing the level of consciousness in patients with severe brain injury. It can easily be used by healthcare staff and implemented in time-constrained clinical settings, such as intensive care units, to help decrease misdiagnosis rates and to optimize treatment decisions. These administration guidelines provide detailed instructions for administering the SECONDs in a standardized and reproducible manner, which is an essential requirement for achieving a reliable diagnosis. [less ▲]

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See detailThe Use of Psychedelics in the Treatment of Disorders of Consciousness
Gosseries, Olivia ULiege; Martial, Charlotte ULiege

in ALIUS BULLETIN: Exploring the diversity of consciousness (n°4) (2021)

In this interview, we discuss the use of psychedelic drugs as a promising treatment in disorders of consciousness. Psilocybin, a classic psychedelic, is currently undergoing substantial clinical ... [more ▼]

In this interview, we discuss the use of psychedelic drugs as a promising treatment in disorders of consciousness. Psilocybin, a classic psychedelic, is currently undergoing substantial clinical investigations in healthy volunteers, but also in clinical populations. Recently, experts in the field of psychedelics have addressed the attractive possibility to use such psychedelics on patients suffering from disorders of consciousness. Building on her empirical and theoretical research on disorders of consciousness, Olivia Gosseries gives us her opinion. Implementing rigorous clinical trials with psychedelics on patients with disorders of consciousness will allow their clinical efficacy to be tested. We finish the interview by briefly addressing the ethical and legal challenges and discussing other related non-pathological modified states of consciousness. [less ▲]

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