Recent advances in disorders of consciousness: Focus on the diagnosis

Gosseries, Olivia; Zasler, Nathan D.; Laureys, Steven

doi:10.3109/02699052.2014.920522

Cited by 116 publications

(110 citation statements)

References 117 publications

(125 reference statements)

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“…The present study therefore hypothesized that fLiS should be kept as a separate nomenclature for this state and as one member of the LiS sequence. To be consistent with the classification of other MCS (MCS-and MCS+), Gosseries et al (13) proposed MCS* as an indicator of VS with covert awareness. However, para-clinical tests indicate no functional communication and no between-network anti-correlation in patients with fMCS (12).…”

Section: Controversy Over the Concept Of Consciousnessmentioning

confidence: 98%

Chronic disorders of consciousness

Xie

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Over the last 20 years, studies have provided greater insight into disorders of consciousness (DOC), also known as altered state of consciousness. Increased brain residual functions have been identified in patients with DOC due to the successful application of novel next-generation imaging technologies. Many unconscious patients have now been confirmed to retain considerable cognitive functions. It is hoped that greater insight regarding the psychological state of patients may be achieved through the use of functional magnetic resonance imaging and brain-computer interfaces. However, issues surrounding the research and treatment of DOC remain problematic. These include differing opinions on the definition of consciousness, difficulties in diagnosis, assessment, prognosis and/or treatment, and newly emerging ethical, legal and social issues. To overcome these, appropriate care must be offered to patients with DOC by clinicians and families, as DOC patients may now be considered to live in more than just a vegetative state. The present article reviews the controversy surrounding the definition of consciousness and the reliability of novel technologies, prognostic prediction, communication with DOC patients and treatment methods. The ethical and social issues surrounding the treatment of DOC and future perspectives are also considered.

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Section: Controversy Over the Concept Of Consciousnessmentioning

confidence: 98%

Chronic disorders of consciousness

Xie

et al. 2017

Experimental and Therapeutic Medicine

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“…De plus, l'implémentation de cette échelle doit se faire avec des outils appropriés. Par exemple, la poursuite visuelle sera significativement plus souvent observée si elle est testée avec un miroir et le patient localisera davantage un son s'il est appelé par son prénom [21][22][23][24]. Une récente étude a également montré que certains items étaient plus fréquemment observés chez les patients en ECM : la réponse à la commande, la poursuite visuelle, la fixation, les comportements moteurs automatiques et la localisation à la douleur.…”

Section: éChelles Comportementalesunclassified

“…Ainsi, jusqu'à 30 % des patients ne montrent cliniquement aucun signe de conscience, mais présentent une activité cérébrale compatible avec une conscience résiduelle [13]. Ces patients sont considérés en ECM non comportemental [23]. À l'inverse, si malgré les diffé-rents examens aucune activité cérébrale compatible avec une conscience résiduelle n'est détectée, cela exclut la possibilité d'un ECM non comportemental et plaide en faveur d'un ENR ou d'un coma (en fonction de si le patient ouvre les yeux ou non, respectivement).…”

Section: Neuro-imagerieunclassified

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Diagnostic, pronostic et traitements des troubles de la conscience

Cassol

Aubinet

Thibaut

et al. 2018

NPG Neurologie - Psychiatrie - Gériatrie

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ARTICLE IN PRESSSummary Advances in medicine and intensive care have led to an increase in the number of patients surviving a severe brain injury. Although some patients recover quickly, others remain in a state of altered consciousness. These patients can progress from a coma to a vegetative state or unresponsive wakefulness syndrome (VS/UWS) and later to a minimally conscious state (MCS). In this review, we first describe the different behavioral and neuroimaging methods used in the diagnosis of patients in an altered state of consciousness. We then describe the factors that can influence the prognosis and recovery of these patients, as well as the treatment and therapeutic management that can be proposed in order to improve their state of consciousness. Finally, we conclude this review by highlighting ethical considerations and end-of-life issues.

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“…Thus, patients who demonstrate covert awareness using mental imagery, or other neural responses, still satisfy the behavioural definition of the vegetative state. For this reason, it has been suggested that functional neuroimaging data be incorporated into the diagnostic criteria for vegetative state, in concert with behavioural diagnostic tools (Coleman et al 2009;Laureys and Schiff 2012;Gosseries et al 2014;Peterson et al 2015). However, these techniques remain investigational in this patient population, and changes to the diagnostic criteria of the vegetative state have yet to gain wide acceptance.…”

mentioning

confidence: 99%