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What names for covert awareness? A systematic review
Caroline Schnakers1, Chase Bauer2, Rita Formisano3
1Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, CA, United States.
Frontiers in Human Neuroscience
|August 22, 2022
Summary
Clinicians lack consensus on naming patients with severe brain injuries who show no behavioral signs of consciousness but respond to neuroimaging. This review identified 25 terms, highlighting the need for a standardized taxonomy for these disorders of consciousness.
Area of Science:
- Neuroscience
- Clinical Neurology
Background:
- Brain Computer Interfaces (BCI) enable identification of patients with severe acquired brain injury.
- These patients exhibit no behavioral signs of consciousness but respond to neuroimaging or electrophysiological paradigms.
- A lack of consensus exists regarding the nomenclature for this clinical entity.
Approach:
- Systematic review of peer-reviewed articles and reviews published between 2006 and 2021.
- Searches conducted on PubMed and Google Scholar following PRISMA guidelines.
- Analysis included 161 manuscripts focusing on human adults (>18 years).
Key Points:
- 25 different names were identified for this clinical entity.
- Only 58% of manuscripts used a specific name, with 32% using multiple names interchangeably.
- The most frequent terms include covert awareness, cognitive motor dissociation, and functional locked-in.
Conclusions:
- No agreement on taxonomy for unresponsive patients with preserved neurophysiological responses has been reached since 2006.
- Developing a standard taxonomy is crucial for future research and clinical translation.
- A Delphi study is recommended to establish consensus on nomenclature.
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