When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Neurobehavioral Progress

Brain Sciences

Joan Ferri¹  Belén Moliner¹  Carolina Colomer¹  Enrique Noé¹  José Olaya¹  MaríaDolores Navarro¹  Camilla Ippoliti¹  Myrtha O’Valle¹  Roberto Llorens¹  Anny Maza² 

[1] NEURORHB, Servicio de Neurorrehabilitación de Hospitales Vithas, Fundación Vithas, Callosa d’En Sarrià 12, 46007 València, Spain;Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Camino de Vera s/n, 46011 València, Spain;

关键词: unresponsive wakefulness syndrome;    vegetative state;    minimally conscious state;    disorders of consciousness;    brain damage;    predictors;   

DOI  :  10.3390/brainsci11010126

来源: DOAJ

【 摘 要 】

Accurate estimation of the neurobehavioral progress of patients with unresponsive wakefulness syndrome (UWS) is essential to anticipate their most likely clinical course and guide clinical decision making. Although different studies have described this progress and possible predictors of neurobehavioral improvement in these patients, they have methodological limitations that could restrict the validity and generalization of the results. This study investigates the neurobehavioral progress of 100 patients with UWS consecutively admitted to a neurorehabilitation center using systematic weekly assessments based on standardized measures, and the prognostic factors of changes in their neurobehavioral condition. Our results showed that, during the analyzed period, 34% of the patients were able to progress from UWS to minimally conscious state (MCS), 12% of the total sample (near one third from those who progressed to MCS) were able to emerge from MCS, and 10% of the patients died. Transition to MCS was mostly denoted by visual signs, which appeared either alone or in combination with motor signs, and was predicted by etiology and the score on the Coma Recovery Scale-Revised at admission with an accuracy of 75%. Emergence from MCS was denoted in the same proportion by functional communication and object use. Predictive models of emergence from MCS and mortality were not valid and the identified predictors could not be accounted for.

【 授权许可】

Unknown