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Assessment and Communication for People with Disorders of Consciousness
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Visual processing during recovery from vegetative state to consciousness: comparing behavioral indices to brain
V J M Wijnen1, H J Eilander2, B de Gelder3
1Rehabilitation Centre Leijpark, Tilburg, The Netherlands; Tilburg University, Department of Psychology, Tilburg, The Netherlands.
Neurophysiologie Clinique = Clinical Neurophysiology
|December 3, 2014
Summary
Patients recovering from a vegetative state show improved visual responses. Visual evoked potentials (VEPs) indicate poorer visual processing in these patients compared to controls, but initial VEPs predict long-term outcomes.
Area of Science:
- Neuroscience
- Clinical Neurology
Background:
- Auditory stimulation is common for unresponsive patients with severe brain injury.
- Visual responses in these patients are less understood.
- This study investigates visual evoked potentials (VEPs) and behavioral responses during recovery of consciousness.
Purpose of the Study:
- To examine visual evoked potentials (VEPs) and behavioral responses in vegetative patients recovering consciousness.
- To compare VEPs between patients and healthy controls.
- To assess the relationship between initial VEPs and long-term patient outcomes.
Main Methods:
- Eleven vegetative patients were assessed bi-weekly for 2.6 months.
- Evaluated behavioral responses: visual localization, command comprehension, object manipulation.
- Measured flash VEPs and compared them to a healthy control group.
- Assessed long-term outcomes 2-3 years post-injury.
Main Results:
- All behavioral visual response scores improved as patients recovered consciousness.
- Patients exhibited smaller VEP amplitudes and longer latencies than controls.
- Initial VEP characteristics correlated with long-term outcomes up to three years.
Conclusions:
- Visual responding improves with recovery from vegetative to conscious states.
- Vegetative and minimally conscious states show poorer elementary visual processing via VEPs compared to controls.
- Initial VEPs serve as a predictor of long-term outcomes.
