Chronic disorders of consciousness

  title={Chronic disorders of consciousness},
  author={James L. Bernat},
  journal={The Lancet},
  • J. Bernat
  • Published 8 April 2006
  • Psychology, Medicine
  • The Lancet
In recent years, neuroimaging studies have shed light on the underlying pathogenesis of both minimally conscious state and vegetative state and providing insights into the basis of the neural network subserving consciousness, which may potentially provide a substrate for experimental interventional therapies, such as drugs and neurotrophic factors.
Neuroimaging and Outcome Assessment in Vegetative and Minimally Conscious State
The MCS patients do not meet diagnostic criteria for coma or VS because they demonstrate some inconsistent but clear evidence of consciousness, but MR may provide an adjunctive diagnostic role when behavioural findings are very limited or ambiguous.
Chronic disorders of consciousness following coma: Part one: medical issues.
  • J. Luce
  • Psychology, Medicine
  • 2013
Clinical investigations have revealed that some vegetative patients can become minimallyconscious and that some minimally conscious patients can gain increased awareness, and the overall prognosis for neurologic recovery remains poor.
Current controversies in states of chronic unconsciousness
The vegetative state (VS) and minimally conscious state (MCS) are the principal clinical syndromes of patients with chronically disordered consciousness and can be the consequence of a variety of brain injuries and illnesses.
Deep brain stimulation for prolonged disorders of consciousness
Deep brain stimulation has emerged as a “last resort” therapy for patients with prolonged disorders of consciousness. The latter encompasses a range of conditions including minimal conscious state
Evaluating brain function in patients with disorders of consciousness.
Findings from normal volunteers and pathologies of consciousness show that widely distributed networks such as thalamofrontal and parietofrontal systems may be critical, and current knowledge supports a model of extended brain tissue damage from the midbrain to the cortex in anoxia patients and a models of focal or multifocal cortical lesions in trauma patients.
Functional Neuroimaging of Disorders of Consciousness
It is suggested that the future integration of emerging functional neuroimaging techniques with existing clinical and behavioral methods of assessment will be essential in reducing the current rate of misdiagnosis.
Functional MRI in disorders of consciousness: advantages and limitations
In this review, recent developments in the use of neuroimaging and, in particular, functional MRI in the assessment of patients diagnosed as vegetative state or minimally conscious state are discussed.
How should functional imaging of patients with disorders of consciousness contribute to their clinical rehabilitation needs?
Purpose of reviewWe discuss the problems of evidence-based neurorehabilitation in disorders of consciousness, and recent functional neuroimaging data obtained in the vegetative state and minimally
Brain imaging as a diagnostic and as a communicative tool in disorders of consciousness
It is argued that neuroimaging is more likely to contribute to medical diagnosis and decision making if two requirements are met - neural correlates of consciousness proper, as defined by current philosophy and neuroscience, are the only admissible non-behavioral signs of awareness.


Medical aspects of the minimally conscious state in children
  • S. Ashwal
  • Psychology, Medicine
    Brain and Development
  • 2003
Cerebral metabolism during vegetative state and after recovery to consciousness
The findings offer an insight into the neural correlates of “awareness”, pointing to a critical role for posterior associative cortices in consciousness.
Medical aspects of the persistent vegetative state (1).
This consensus statement of the Multi-Society Task Force summarizes current knowledge of the medical aspects of the persistent vegetative state in adults and children. The vegetative state is a
Questions remaining about the minimally conscious state.
The persistent vegetative state (PVS), a condition whose name and essential features were described in 1972 by Plum and Jennett3 and further delineated in a 1994 multi-society task force report, features the tragic and ironic dissociation of the two cardinal elements of human consciousness: wakefulness and awareness.
Effect of posture on levels of arousal and awareness in vegetative and minimally conscious state patients: a preliminary investigation
At present, the pathophysiology underlying the vegetative and minimally conscious states is unclear, a standard treatment approach is lacking, and very little has been discovered to advance rehabilitation techniques.
The vegetative and minimally conscious states: current knowledge and remaining questions.
The past and future scientific developments in this area provide an important background for continuing discussions of the ethical controversies surrounding end-of-life decision making and resource allocation.