Brain, Behavior, and Cognitive Interplay in Disorders of Consciousness: A Multiple Case Study

  title={Brain, Behavior, and Cognitive Interplay in Disorders of Consciousness: A Multiple Case Study},
  author={Charl{\`e}ne Aubinet and Lesley Murphy and Mohamed Ali Bahri and Stephen Karl Larroque and Helena Cassol and Jitka Annen and Manon Carri{\`e}re and Sarah Wannez and Aurore Thibaut and Steven Laureys and Olivia Gosseries},
  journal={Frontiers in Neurology},
Patients with prolonged disorders of consciousness (DoC) after severe brain injury may present residual behavioral and cognitive functions. Yet the bedside assessment of these functions is compromised by patients' multiple impairments. Standardized behavioral scales such as the Coma Recovery Scale-Revised (CRS-R) have been developed to diagnose DoC, but there is also a need for neuropsychological measurement in these patients. The Cognitive Assessment by Visual Election (CAVE) was therefore… 
Covert Cognition in Disorders of Consciousness: A Meta-Analysis
Patients clinically diagnosed as being in a vegetative state and in a minimally conscious state minus (MCS−) show similar likelihood in responding to active paradigm and responders are most likely suffering from a traumatic brain injury.
Brain metabolism but not grey matter volume underlies the presence of language function in the minimally conscious state
Background. The minimally conscious state (MCS) is subcategorized into MCSand MCS+, depending on the absence or presence of high-level behavioral responses such as commandfollowing. Objective. We aim
Brain Metabolism but Not Gray Matter Volume Underlies the Presence of Language Function in the Minimally Conscious State (MCS): MCS+ Versus MCS− Neuroimaging Differences
The clinical subcategorization of MCS is supported by differences in brain metabolism but not in gray matter structure, suggesting that brain function in the language network is the main support for recovery of command-following, intelligible verbalization and/or intentional communication in the MCS.
The Brief Evaluation of Receptive Aphasia test for the detection of language impairment in patients with severe brain injury
The Brief Evaluation of Receptive Aphasia (BERA) tool for assessing phonological, semantic and morphosyntactic abilities in patients with severe brain injury based on visual fixation responses may complement the widely used CRS-R for assessing and diagnosing patients with disorders of consciousness.
General Anesthesia: A Probe to Explore Consciousness
The picture of the current state of knowledge in anesthesia-induced unconsciousness is drawn, from insights gathered on propofol, halogenated vapors, ketamine, dexmedetomidine, benzodiazepines and xenon, and how anesthesia can help understanding consciousness is described.
The influence of the CRS-R score on functional outcome in patients with severe brain injury receiving early rehabilitation
The study confirms the relevance of the CRS-R score for functional outcome prediction and indicates that recovery might occur over a period of time that extends beyond acute care.
Update on diagnosis in disorders of consciousness
  • C. Schnakers
  • Medicine, Psychology
    Expert review of neurotherapeutics
  • 2020
This review will discuss recent updates on the clinical entities of DOC, the challenges for an accurate diagnosis and the last developments in diagnostic tools.
Ethical Issues in Neurotrauma
This chapter delves into the possibility of impaired cognitive and sensory function in a patient who has experienced a traumatic neural injury, notably a traumatic brain injury, and many ethical issues surrounding informed consent, goals of care, and discussion of end-of-life measures with the patient or surrogate.
Post-comatose patients with minimal consciousness tend to preserve reading comprehension skills but neglect syntax and spelling
The results indicate that post-comatose patients with minimal consciousness can read words and sentences, hence some useful hints may be provided for the development of gaze tracking-based human-computer interfaces for these people.


Impact of Aphasia on Consciousness Assessment
Background. Previous findings suggest that language disorders may occur in severely brain-injured patients and could interfere with behavioral assessments of consciousness. However, no study
Structural brain injury in patients with disorders of consciousness: A voxel-based morphometry study
The findings indicate that both traumatic and non-traumatic DOC are associated with widespread structural brain injury, although differences exist that could lead to aetiology-specific treatment strategies.
Neurophysiological assessment for evaluating residual cognition in vegetative and minimally conscious state patients: a pilot study.
The findings seem to show the value of ERP monitoring in VS and MCS patients as a means of investigating residual cognitive function, and could guide early therapeutic and rehabilitation interventions, and contribute to identifying better diagnostic and prognostic markers for use in unresponsive or low-responsive patients.
The problem of aphasia in the assessment of consciousness in brain-damaged patients.
A network approach to assessing cognition in disorders of consciousness
Objective: Conventional assessments of consciousness rely on motor responses to indicate awareness. However, overt behaviors may be absent or ambiguous in patients with disorders of consciousness
Functional neuroanatomy underlying the clinical subcategorization of minimally conscious state patients
The proposed subcategorization of MCS based on the presence or absence of command following showed a different functional neuroanatomy and patients in MCS+ showed preserved metabolism and functional connectivity in language networks arguably reflecting some additional higher order or extended consciousness albeit devoid of clinical verbal or nonverbal expression.