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Cognitive Motor Dissociation in Disorders of Consciousness.
Bodien, Yelena G; Allanson, Judith; Cardone, Paolo; Bonhomme, Arthur; Carmona, Jerina; Chatelle, Camille; Chennu, Srivas; Conte, Mary; Dehaene, Stanislas; Finoia, Paola; Heinonen, Gregory; Hersh, Jennifer E; Kamau, Evelyn; Lawrence, Phoebe K; Lupson, Victoria C; Meydan, Anogue; Rohaut, Benjamin; Sanders, William R; Sitt, Jacobo D; Soddu, Andrea; Valente, Mélanie; Velazquez, Angela; Voss, Henning U; Vrosgou, Athina; Claassen, Jan; Edlow, Brian L; Fins, Joseph J; Gosseries, Olivia; Laureys, Steven; Menon, David; Naccache, Lionel; Owen, Adrian M; Pickard, John; Stamatakis, Emmanuel A; Thibaut, Aurore; Victor, Jonathan D; Giacino, Joseph T; Bagiella, Emilia; Schiff, Nicholas D.
Afiliación
  • Bodien YG; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Allanson J; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Cardone P; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Bonhomme A; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Carmona J; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Chatelle C; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Chennu S; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Conte M; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Dehaene S; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Finoia P; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Heinonen G; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Hersh JE; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Kamau E; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Lawrence PK; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Lupson VC; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Meydan A; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Rohaut B; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Sanders WR; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Sitt JD; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Soddu A; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Valente M; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Velazquez A; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Voss HU; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Vrosgou A; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Claassen J; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Edlow BL; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Fins JJ; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Gosseries O; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Laureys S; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Menon D; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Naccache L; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Owen AM; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Pickard J; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Stamatakis EA; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Thibaut A; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Victor JD; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Giacino JT; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Bagiella E; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
  • Schiff ND; From the Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital (Y.G.B., J.T.G.), and the Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital (B.L.E.), Charlestown, and the Center for Neurotechnology and Neurorecovery, Massachusetts Gene
N Engl J Med ; 391(7): 598-608, 2024 Aug 15.
Article en En | MEDLINE | ID: mdl-39141852
ABSTRACT

BACKGROUND:

Patients with brain injury who are unresponsive to commands may perform cognitive tasks that are detected on functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). This phenomenon, known as cognitive motor dissociation, has not been systematically studied in a large cohort of persons with disorders of consciousness.

METHODS:

In this prospective cohort study conducted at six international centers, we collected clinical, behavioral, and task-based fMRI and EEG data from a convenience sample of 353 adults with disorders of consciousness. We assessed the response to commands on task-based fMRI or EEG in participants without an observable response to verbal commands (i.e., those with a behavioral diagnosis of coma, vegetative state, or minimally conscious state-minus) and in participants with an observable response to verbal commands. The presence or absence of an observable response to commands was assessed with the use of the Coma Recovery Scale-Revised (CRS-R).

RESULTS:

Data from fMRI only or EEG only were available for 65% of the participants, and data from both fMRI and EEG were available for 35%. The median age of the participants was 37.9 years, the median time between brain injury and assessment with the CRS-R was 7.9 months (25% of the participants were assessed with the CRS-R within 28 days after injury), and brain trauma was an etiologic factor in 50%. We detected cognitive motor dissociation in 60 of the 241 participants (25%) without an observable response to commands, of whom 11 had been assessed with the use of fMRI only, 13 with the use of EEG only, and 36 with the use of both techniques. Cognitive motor dissociation was associated with younger age, longer time since injury, and brain trauma as an etiologic factor. In contrast, responses on task-based fMRI or EEG occurred in 43 of 112 participants (38%) with an observable response to verbal commands.

CONCLUSIONS:

Approximately one in four participants without an observable response to commands performed a cognitive task on fMRI or EEG as compared with one in three participants with an observable response to commands. (Funded by the James S. McDonnell Foundation and others.).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Imagen por Resonancia Magnética / Trastornos de la Conciencia / Electroencefalografía Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: N Engl J Med Año: 2024 Tipo del documento: Article
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Imagen por Resonancia Magnética / Trastornos de la Conciencia / Electroencefalografía Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: N Engl J Med Año: 2024 Tipo del documento: Article