Minimally conscious state plus versus minus: Likelihood of emergence and long-term functional independence.


Journal

Annals of clinical and translational neurology
ISSN: 2328-9503
Titre abrégé: Ann Clin Transl Neurol
Pays: United States
ID NLM: 101623278

Informations de publication

Date de publication:
17 Feb 2024
Historique:
revised: 07 12 2023
received: 31 07 2023
accepted: 01 01 2024
medline: 17 2 2024
pubmed: 17 2 2024
entrez: 17 2 2024
Statut: aheadofprint

Résumé

Severe brain injuries can result in disorders of consciousness, such as the Minimally Conscious State (MCS), where individuals display intermittent yet discernible signs of conscious awareness. The varied levels of responsiveness and awareness observed in this state have spurred the progressive delineation of two subgroups within MCS, termed "plus" (MCS+) and "minus" (MCS-). However, the clinical validity of these classifications remains uncertain. This study aimed to investigate and compare the likelihood of emergence from MCS, as well as the functional independence after emergence, in individuals categorized as in MCS+ and MCS-. Demographic and behavioral data of 80 participants, admitted as either in MCS+ (n = 30) or MCS- (n = 50) to a long-term neurorehabilitation unit, were retrospectively analyzed. The neurobehavioral condition of each participant was evaluated weekly until discharge, demise, or emergence from MCS. The functional independence of those participants who emerged from MCS was assessed 6 months after emergence. While only about half of the individuals classified as in MCS- (n = 24) emerged from the MCS, all those admitted as in MCS+ did, and in a shorter postinjury period. Despite these differences, all individuals who emerged from the MCS demonstrated similar high disability and low functional independence 6 months after emergence, regardless of their state at admission. Individuals classified as MCS+ exhibited a higher likelihood of emergence and a shorter time to emergence compared to those in MCS-. However, the level of functional independence 6 months after emergence was found to be unrelated to the initial state at admission.

Identifiants

pubmed: 38366789
doi: 10.1002/acn3.51993
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Conselleria de Innovación, Universidades, Ciencia y Sociedad Digital, Generalitat Valenciana
ID : CIDEXG/2022/15

Informations de copyright

© 2024 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.

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Auteurs

Roberto Llorens (R)

Neurorehabilitation and Brain Research Group, Universitat Politècnica de València, València, Spain.

Camilla Ippoliti (C)

SC Neurologia, Salute Pubblica, Disabilità - Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.

María Dolores Navarro (MD)

IRENEA, Instituto de Rehabilitación Neurológica, Fundación Vithas, València, Spain.

Carolina Colomer (C)

IRENEA, Instituto de Rehabilitación Neurológica, Fundación Vithas, València, Spain.

Anny Maza (A)

Neurorehabilitation and Brain Research Group, Universitat Politècnica de València, València, Spain.

Sandra Goizueta (S)

Neurorehabilitation and Brain Research Group, Universitat Politècnica de València, València, Spain.

José Olaya (J)

IRENEA, Instituto de Rehabilitación Neurológica, Fundación Vithas, València, Spain.

Belén Moliner (B)

IRENEA, Instituto de Rehabilitación Neurológica, Fundación Vithas, València, Spain.

Joan Ferri (J)

IRENEA, Instituto de Rehabilitación Neurológica, Fundación Vithas, València, Spain.

Enrique Noé (E)

IRENEA, Instituto de Rehabilitación Neurológica, Fundación Vithas, València, Spain.

Classifications MeSH