Relationship between etiology and covert cognition in the minimally conscious state

Functional neuroimaging has shown that the absence of externally observable signs of consciousness and cognition in severely brain-injured patients does not necessarily indicate the true absence of such abilities. However, relative to traumatic brain injury, nontraumatic injury is known to be associ...

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Vydané v:Neurology Ročník 78; číslo 11; s. 816
Hlavní autori: Cruse, D, Chennu, S, Chatelle, C, Fernández-Espejo, D, Bekinschtein, T A, Pickard, J D, Laureys, S, Owen, A M
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States 13.03.2012
Predmet:
Adolescent
Adult
Aged
Arousal - physiology
Automatic Data Processing
Awareness - physiology
Brain Injuries - complications
Child
Cognition - physiology
Coma - psychology
Communication
Consciousness - physiology
Electroencephalography
Female
Hearing - physiology
Humans
Imagination - physiology
Male
Middle Aged
Movement - physiology
Persistent Vegetative State - etiology
Persistent Vegetative State - psychology
Prognosis
Reflex - physiology
Support Vector Machine
Verbal Behavior - physiology
Vision, Ocular - physiology
Young Adult
ISSN:1526-632X, 1526-632X
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Shrnutí:Functional neuroimaging has shown that the absence of externally observable signs of consciousness and cognition in severely brain-injured patients does not necessarily indicate the true absence of such abilities. However, relative to traumatic brain injury, nontraumatic injury is known to be associated with a reduced likelihood of regaining overtly measurable levels of consciousness. We investigated the relationships between etiology and both overt and covert cognitive abilities in a group of patients in the minimally conscious state (MCS). Twenty-three MCS patients (15 traumatic and 8 nontraumatic) completed a motor imagery EEG task in which they were required to imagine movements of their right-hand and toes to command. When successfully performed, these imagined movements appear as distinct sensorimotor modulations, which can be used to determine the presence of reliable command-following. The utility of this task has been demonstrated previously in a group of vegetative state patients. Consistent and robust responses to command were observed in the EEG of 22% of the MCS patients (5 of 23). Etiology had a significant impact on the ability to successfully complete this task, with 33% of traumatic patients (5 of 15) returning positive EEG outcomes compared with none of the nontraumatic patients (0 of 8). The overt behavioral signs of awareness (measured with the Coma Recovery Scale-Revised) exhibited by nontraumatic MCS patients appear to be an accurate reflection of their covert cognitive abilities. In contrast, one-third of a group of traumatically injured patients in the MCS possess a range of high-level cognitive faculties that are not evident from their overt behavior.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1526-632X
1526-632X
DOI:10.1212/WNL.0b013e318249f764