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Assessment and Communication for People with Disorders of Consciousness
Published on: August 1, 2017
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Brain, Behavior, and Cognitive Interplay in Disorders of Consciousness: A Multiple Case Study
Charlène Aubinet1, Lesley Murphy2, Mohamed A Bahri3
1Coma Science Group, GIGA Consciousness and Neurology Department, University and University Hospital of Liège, Liège, Belgium.
Frontiers in Neurology
|August 30, 2018
Summary
New tools like the Cognitive Assessment by Visual Election (CAVE) help assess residual cognitive and language functions in patients with disorders of consciousness (DoC), aiding rehabilitation planning.
Area of Science:
- Neuroscience
- Neurology
- Cognitive Science
Background:
- Patients with prolonged disorders of consciousness (DoC) often have residual cognitive and behavioral functions, but bedside assessment is challenging.
- Standardized scales like the Coma Recovery Scale-Revised (CRS-R) aid DoC diagnosis, yet neuropsychological assessment needs further development.
- The Cognitive Assessment by Visual Election (CAVE) was created to specifically measure cognitive functions in these patients.
Purpose of the Study:
- To describe the cognitive profiles of five patients in minimally conscious state (MCS) or emerging from MCS (EMCS).
- To correlate these cognitive profiles with neuroimaging findings (MRI and FDG-PET).
- To highlight the utility of the CAVE in assessing residual functions and informing rehabilitation.
Main Methods:
- Assessment of five MCS/EMCS patients using the CRS-R and the newly developed CAVE.
- Neuroimaging analysis including structural MRI and FDG-PET to evaluate brain structure and metabolism.
- Correlation of behavioral/cognitive scores with neuroimaging data.
Main Results:
- CAVE scores correlated with CRS-R total scores, showing consistent patient profiles.
- The patient with the highest CRS-R and CAVE scores exhibited the least extensive cerebral hypometabolism.
- Brain-behavior relationships were observed, with preserved occipital/motor cortex metabolism correlating with visual/motor functions, and temporal/angular cortex metabolism with language comprehension.
Conclusions:
- Brain-behavior relationships are discernible even in severely brain-injured patients.
- The CAVE is a valuable tool for assessing residual cognition and language in MCS/EMCS patients.
- Accurate cognitive profiling is crucial for effective rehabilitation program design and daily care planning.
Keywords:
(emergence from) minimally conscious statebehaviorcognitive functionsneural correlatesneuropsychological assessmentpositron emission tomographystructural magnetic resonance imagingMore Related Videos
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