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Assessment and Communication for People with Disorders of Consciousness

Assessment and Communication for People with Disorders of Consciousness

Published on: August 1, 2017

Cognitive function in the locked-in syndrome.

Caroline Schnakers¹, Steve Majerus, Serge Goldman

¹Cyclotron Research Center, University of Liège, Belgium. C.Schnakers@student.ulg.ac.be

Journal of Neurology

|March 20, 2008

Summary

Locked-in syndrome (LIS) patients with pure brainstem lesions can regain intact cognitive function. Additional brain injuries often cause cognitive deficits, highlighting the need for systematic neuropsychological assessment to improve patient care.

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Area of Science:

Neuroscience
Neurology
Cognitive Science

Background:

Locked-in syndrome (LIS) results from ventro-pontine lesions, causing quadriparesis and anarthria.
Communication in LIS is typically maintained through eye movements or blinking.
Assessing cognitive function in LIS patients requires specialized communication methods.

Purpose of the Study:

To evaluate cognitive functions in patients with Locked-in syndrome using eye-coded communication.
To determine the impact of lesion location on cognitive outcomes in LIS.
To establish the utility of neuropsychological testing for LIS patient care.

Main Methods:

Neuropsychological testing was administered to ten chronic LIS survivors.
Testing assessed memory, attention, executive functions, language processing, and verbal intelligence.
One subacute patient with a pure brainstem lesion was monitored over 16 months.

Main Results:

No LIS patients exhibited verbal intelligence deficits.
Five patients showed impairments in one or more cognitive tests.
Cognitive deficits correlated with additional cortical/thalamic lesions; fatigue/weakness noted in others.

Conclusions:

LIS patients with pure brainstem lesions can achieve normal cognitive levels.
Associated cognitive deficits in LIS are often linked to secondary brain injuries.
Systematic neuropsychological assessment is crucial for identifying LIS cognitive deficits and enhancing patient quality of life.