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Minimally conscious state plus versus minus: Likelihood of emergence and long-term functional independence.
Llorens, Roberto; Ippoliti, Camilla; Navarro, María Dolores; Colomer, Carolina; Maza, Anny; Goizueta, Sandra; Olaya, José; Moliner, Belén; Ferri, Joan; Noé, Enrique.
Afiliação
  • Llorens R; Neurorehabilitation and Brain Research Group, Universitat Politècnica de València, València, Spain.
  • Ippoliti C; SC Neurologia, Salute Pubblica, Disabilità - Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.
  • Navarro MD; IRENEA, Instituto de Rehabilitación Neurológica, Fundación Vithas, València, Spain.
  • Colomer C; IRENEA, Instituto de Rehabilitación Neurológica, Fundación Vithas, València, Spain.
  • Maza A; Neurorehabilitation and Brain Research Group, Universitat Politècnica de València, València, Spain.
  • Goizueta S; Neurorehabilitation and Brain Research Group, Universitat Politècnica de València, València, Spain.
  • Olaya J; IRENEA, Instituto de Rehabilitación Neurológica, Fundación Vithas, València, Spain.
  • Moliner B; IRENEA, Instituto de Rehabilitación Neurológica, Fundación Vithas, València, Spain.
  • Ferri J; IRENEA, Instituto de Rehabilitación Neurológica, Fundación Vithas, València, Spain.
  • Noé E; IRENEA, Instituto de Rehabilitación Neurológica, Fundación Vithas, València, Spain.
Ann Clin Transl Neurol ; 11(3): 719-728, 2024 Mar.
Article em En | MEDLINE | ID: mdl-38366789
ABSTRACT

OBJECTIVE:

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-.

METHODS:

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.

RESULTS:

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.

INTERPRETATION:

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.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Lesões Encefálicas / Estado Vegetativo Persistente Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Lesões Encefálicas / Estado Vegetativo Persistente Limite: Humans Idioma: En Ano de publicação: 2024 Tipo de documento: Article