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Minimally conscious state

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https://www.readbyqxmd.com/read/29684751/shedding-new-light-on-disorders-of-consciousness-diagnosis-the-dynamic-functional-connectivity
#1
Antonino Naro, Alessia Bramanti, Antonino Leo, Alberto Cacciola, Alfredo Manuli, Placido Bramanti, Rocco S Calabrò
It has been proposed that awareness may depend on the highly-dynamic functional connectivity of large-scale cortico-thalamo-cortical networks. We investigated how brain connectivity changes over time in the resting state in a group of patients with chronic disorders of consciousness (DoC). To this end, we assessed dynamic functional connectivity (DFC) in the resting state by analyzing the time-dependent EEG phase synchronization in five frequency bands (δ, θ, α, β, and γ). Patients in Minimally Conscious State (MCS) showed changes in DFC matrices and topography over time (mainly in the γ range), which were significantly different from those observed in patients with Unresponsive Wakefulness Syndrome (UWS)...
April 4, 2018: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
https://www.readbyqxmd.com/read/29666960/consciousness-indexing-and-outcome-prediction-with-resting-state-eeg-in-severe-disorders-of-consciousness
#2
Sabina Stefan, Barbara Schorr, Alex Lopez-Rolon, Iris-Tatjana Kolassa, Jonathan P Shock, Martin Rosenfelder, Suzette Heck, Andreas Bender
We applied the following methods to resting-state EEG data from patients with disorders of consciousness (DOC) for consciousness indexing and outcome prediction: microstates, entropy (i.e. approximate, permutation), power in alpha and delta frequency bands, and connectivity (i.e. weighted symbolic mutual information, symbolic transfer entropy, complex network analysis). Patients with unresponsive wakefulness syndrome (UWS) and patients in a minimally conscious state (MCS) were classified into these two categories by fitting and testing a generalised linear model...
April 17, 2018: Brain Topography
https://www.readbyqxmd.com/read/29661479/the-minimally-conscious-state-the-disability-bias-and-the-moral-authority-of-advance-directives
#3
Stephen Napier
No abstract text is available yet for this article.
April 13, 2018: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/29653106/assessment-of-nociception-and-pain-in-participants-with-unresponsive-or-minimally-conscious-state-after-acquired-brain-injury-the-relationship-between-the-coma-recovery-scale-revised-and-the-nociception-coma-scale-revised
#4
Camille Chatelle, Solveig L Hauger, Charlotte Martial, Frank Becker, Bernd Eifert, Dana Boering, Joseph T Giacino, Steven Laureys, Marianne Løvstad, Petra Maurer-Karattup
OBJECTIVE: Investigate the relationship between consciousness and nociceptive responsiveness (i.e., Nociception Coma Scale-Revised [NCS-R]), examine the suitability of the NCS-R for assessing nociception in participants with disorders of consciousness (DoC) and replicate previous findings on psychometric properties of the scale. DESIGN: We prospectively assessed consciousness with the Coma Recovery Scale-Revised (CRS-R). Responses during baseline, non-noxious and noxious stimulations were scored with the NCS-R, CRS-R oromotor and motor subscales...
April 10, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29649978/personalized-objects-can-optimize-the-diagnosis-of-emcs-in-the-assessment-of-functional-object-use-in-the-crs-r-a-double-blind-randomized-clinical-trial
#5
Yuxiao Sun, Jianan Wang, Lizette Heine, Wangshan Huang, Jing Wang, Nantu Hu, Xiaohua Hu, Xiaohui Fang, Supeng Huang, Steven Laureys, Haibo Di
BACKGROUND: Behavioral assessment has been acted as the gold standard for the diagnosis of disorders of consciousness (DOC) patients. The item "Functional Object Use" in the motor function sub-scale in the Coma Recovery Scale-Revised (CRS-R) is a key item in differentiating between minimally conscious state (MCS) and emergence from MCS (EMCS). However, previous studies suggested that certain specific stimuli, especially something self-relevant can affect DOC patients' scores of behavioral assessment scale...
April 12, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29623396/resistance-to-eye-opening-in-patients-with-disorders-of-consciousness
#6
Hjalmar Jochem van Ommen, Aurore Thibaut, Audrey Vanhaudenhuyse, Lizette Heine, Vanessa Charland-Verville, Sarah Wannez, Olivier Bodart, Steven Laureys, Olivia Gosseries
INTRODUCTION: Resistance to eye opening (REO) is a commonly encountered phenomenon in clinical practice. We aim to investigate whether REO is a sign of consciousness or a reflex in severely brain-injured patients. METHODS: We recorded REO in chronic patients with disorders of consciousness during a multimodal diagnostic assessment. REO evaluations were performed daily in each patient and clinical diagnosis of unresponsive wakefulness syndrome (UWS), minimally conscious state with (MCS+) or without (MCS-) preserved language processing was made using the Coma Recovery Scale-Revised (CRS-R)...
April 5, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29607777/the-cognitive-assessment-by-visual-election-cave-a-pilot-study-to-develop-a-cognitive-assessment-tool-for-people-emerging-from-disorders-of-consciousness
#7
Lesley Murphy
Instruments for assessing people with disorders of consciousness have been developed over the last 15 years, but there remains a dearth of suitable assessment paradigms for those who have emerged from disorders of consciousness. This paper presents a pilot study for the development of the Cognitive Assessment by Visual Election (CAVE), a short assessment designed to investigate a number of cognitive domains in very severely brain injured patients who are in or have emerged from minimally conscious states (EMCS)...
April 2, 2018: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/29575425/degrees-of-functional-connectome-abnormality-in-disorders-of-consciousness
#8
Dmitry O Sinitsyn, Liudmila A Legostaeva, Elena I Kremneva, Sofya N Morozova, Alexandra G Poydasheva, Elizaveta G Mochalova, Oksana G Chervyakova, Julia V Ryabinkina, Natalia A Suponeva, Michael A Piradov
Understanding the neuronal basis of disorders of consciousness can help improve the accuracy of their diagnosis, indicate potential targets for therapeutic interventions, and provide insights into the organization of normal conscious information processing. Measurements of brain activity have been used to find associations of the levels of consciousness with brain complexity, topological features of functional connectomes, and disruption of resting-state networks. However, obtainment of a detailed picture of activity patterns underlying the vegetative state/unresponsive wakefulness syndrome and the minimally conscious state remains a work in progress...
March 25, 2018: Human Brain Mapping
https://www.readbyqxmd.com/read/29572926/regional-brain-volumetry-and-brain-function-in-severely-brain-injured-patients
#9
Jitka Annen, Gianluca Frasso, Julia Sophia Crone, Lizette Heine, Carol Di Perri, Charlotte Martial, Helena Cassol, Athena Demertzi, Lionel Naccache, Steven Laureys
OBJECTIVE: The relationship between residual brain tissue in patients with disorders of consciousness (DOC) and the clinical condition is unclear. This observational study aimed to quantify gray (GM) and white matter (WM) atrophy in states of (altered) consciousness. METHODS: Structural T1-weighted magnetic resonance images were processed for 102 severely brain-injured and 52 healthy subjects. Regional brain volume was quantified for 158 (sub)cortical regions using Freesurfer...
March 24, 2018: Annals of Neurology
https://www.readbyqxmd.com/read/29569993/deaths-after-feeding-tube-withdrawal-from-patients-in-vegetative-and-minimally-conscious-states-a-qualitative-study-of-family-experience
#10
Jenny Kitzinger, Celia Kitzinger
BACKGROUND: Families of patients in vegetative or minimally conscious states are often horrified by the suggestion of withdrawing a feeding tube, even when they believe that their relative would not have wanted to be maintained in their current condition. Very little is known about what it is like to witness such a death. AIM: To understand these families' experience of their relatives' deaths. DESIGN: Qualitative study using in-depth narrative interviews analyzed inductively with thematic analysis...
March 1, 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29565697/music-interventions-in-disorders-of-consciousness-doc-a-systematic-review
#11
Teresa Grimm, Gunter Kreutz
OBJECTIVES: The effects of music interventions including active and receptive music therapy for people living with neurogenic disorders of consciousness (DOC) have been subject to empirical studies in the past. The aim of this systematic review was to find and analyse the current research about the effects of musical interventions on people with DOC. METHODS: For this purpose, studies with music interventions and patients with DOC from the year 1900 to 2017 were searched in English, German, and French in different databases...
March 22, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29562552/physical-therapy-in-patients-with-disorders-of-consciousness-impact-on-spasticity-and-muscle-contracture
#12
A Thibaut, S Wannez, T Deltombe, G Martens, S Laureys, C Chatelle
BACKGROUND: Spasticity is a frequent complication after severe brain injury, which may prevent the rehabilitation process and worsen the patients' quality of life. OBJECTIVES: In this study, we investigated the correlation between spasticity, muscle contracture, and the frequency of physical therapy (PT) in subacute and chronic patients with disorders of consciousness (DOC). METHODS: 109 patients with subacute and chronic disorders of consciousness (Vegetative state/Unresponsive wakefulness syndrome - VS/UWS; minimally conscious state - MCS and patients who emerged from MCS - EMCS) were included in the study (39 female; mean age: 40±13...
2018: NeuroRehabilitation
https://www.readbyqxmd.com/read/29551989/could-arterial-spin-labeling-distinguish-patients-in-minimally-conscious-state-from-patients-in-vegetative-state
#13
Bing Wu, Yi Yang, Shuai Zhou, Wei Wang, Zizhen Wang, Gang Hu, Jianghong He, Xinhuai Wu
Purpose: Diagnostic error is common among patients with vegetative state (VS) and minimally conscious state (MCS). The purpose of this article is to use three-dimensional pseudo-continuous arterial spin labeling (pcASL) to compare cerebral blood flow (CBF) patterns in patients in MCS with those in VS. Methods: Patients meeting MCS and VS criteria were identified. Two post-labeling delay (PLD) time pcASL on 3.0-Tesla magnetic resonance imaging scanner system were performed with patients in the resting awake state...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29521735/are-you-there-the-growing-need-to-get-the-right-diagnosis-in-disorder-of-consciousness
#14
Michele Torrisi, Adriana Piccolo, Rosaria De Luca, Matteo Berenati, Antonella Olivo, Giuseppa Maresca, Antonino Naro, Rocco Salvatore Calabrò
Disorder of consciousness (DOC) can be either an acute and reversible condition or a chronic condition, including vegetative state or minimally conscious state. Herein, we describe a patient who has unexpectedly recovered consciousness after being in a misdiagnosed vegetative state for a long period. A 63-year-old woman was admitted to our rehabilitation center in vegetative state (Coma Recovery Scale-Revised score, 6) and treated with a standard rehabilitation program, including physical therapy and multisensory stimulation, besides psychoactive drugs...
April 2018: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/29502098/researching-about-us-without-us-exploring-research-participation-and-the-politics-of-disability-rights-in-the-context-of-the-mental-capacity-act-2005
#15
Gillian Loomes
The right to active participation by disabled people in academic research has been discussed at length in recent years, along with the potential for such research to function as a tool in challenging oppression and pursuing disability rights. Significant ethical, legal and methodological dilemmas arise, however, in circumstances where a disabled person loses the capacity to provide informed consent to such participation. In this article, I consider disability politics and academic research in the context of the Mental Capacity Act (MCA) 2005, which sets out in Anglo-Welsh law the circumstances and requirements for research participation by individuals lacking the capacity to provide informed consent...
March 3, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29492651/are-visual-functions-diagnostic-signs-of-the-minimally-conscious-state-an-integrative-review
#16
REVIEW
Berno U H Overbeek, Henk J Eilander, Jan C M Lavrijsen, Raymond T C M Koopmans
Visual pursuit (VP) and visual fixation (VF) have been recognized as the first signs of emerging consciousness and, therefore, are considered indicative of the minimally conscious state (MCS). However, debate exists about their status as they are considered either conscious reactions or reflexes. The aim of this study is to review the evidence of the definition, operationalization, and assessment of VP and VF in unconscious patients. PubMed and EMBASE were searched for relevant papers between May 26, 1994 and October 1, 2016...
February 28, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29486984/cardiac-autonomic-responses-to-nociceptive-stimuli-in-patients-with-chronic-disorders-of-consciousness
#17
Eleonora Tobaldini, Edgar Toschi-Dias, Pietro Davide Trimarchi, Nicola Brena, Angela Comanducci, Silvia Casarotto, Nicola Montano, Guya Devalle
OBJECTIVES: Patients with chronic disorders of consciousness (DOC) may show alterations of autonomic function; however, in this clinical population, no data are available on the specific effects of nociceptive stimuli on cardiac autonomic control. Thus, we aimed at investigating the effects of a noxious stimulation on heart rate variability (HRV) in a population of patients with chronic DOC, taking into account different states of consciousness (vegetative state/unresponsive wakefulness syndrome, VS/UWS and minimally conscious state, MCS)...
February 14, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29482376/score-on-coma-recovery-scale-revised-at-admission-predicts-outcome-at-discharge-in-intensive-rehabilitation-after-severe-brain-injury
#18
Emilio Portaccio, Azzurra Morrocchesi, Anna Maria Romoli, Bahia Hakiki, Maria Pia Taglioli, Elena Lippi, Martina Di Renzone, Antonello Grippo, Claudio Macchi
OBJECTIVE: To assess the prognostic utility of the Coma Recovery Scale-Revised (CRS-R) in rehabilitation of patients surviving from severe brain injury. METHODS: In this prospective cohort study, all patients consecutively admitted to an Italian Intensive Rehabilitation Unit, with a diagnosis of unresponsive wakefulness syndrome (UWS) or minimally conscious state (MCS) due to acquired brain injury, underwent clinical evaluations using the Italian version of the CRS-R...
February 26, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29459847/novel-approaches-to-the-diagnosis-of-chronic-disorders-of-consciousness-detecting-peripersonal-space-by-using-ultrasonics
#19
Antonino Naro, Antonino Chillura, Simona Portaro, Alessia Bramanti, Rosaria De Luca, Placido Bramanti, Rocco Salvatore Calabrò
The assessment of behavioral responsiveness in patients suffering from chronic disorders of consciousness (DoC), including Unresponsive Wakefulness Syndrome (UWS) and Minimally Conscious State (MCS), is challenging. Even if a patient is unresponsive, he/she may be covertly aware in reason of a cognitive-motor dissociation, i.e., a preservation of cognitive functions despite a solely reflexive behavioral responsiveness. The approach of an external stimulus to the peripersonal space (PPS) modifies some biological measures (e...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29428346/improvement-on-the-coma-recovery-scale-revised-during-the-first-four-weeks-of-hospital-stay-predicts-outcome-at-discharge-in-intensive-rehabilitation-after-severe-brain-injury
#20
Emilio Portaccio, Azzurra Morrocchesi, Anna Maria Romoli, Bahia Hakiki, Maria Pia Taglioli, Elena Lippi, Martina Di Renzone, Antonello Grippo, Claudio Macchi
OBJECTIVES: to evaluate the prognostic utility of serial assessment on the Coma Recovery Scale-Revised (CRS-R) during the first 4 weeks of intensive rehabilitation in patients surviving from severe brain injury DESIGN: prospective cohort study PARTICIPANTS: Patients consecutively admitted to the Intensive Rehabilitation Unit at the IRCCS Don Gnocchi Foundation (Florence, Italy). Inclusion criteria were diagnosis of unresponsive wakefulness syndrome (UWS) or minimally conscious state (MCS) due to acquired brain injury, age older than 18 years...
February 8, 2018: Archives of Physical Medicine and Rehabilitation
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