Article
Rehabilitation
Jennifer A. Weaver, John Liu, Ann Guernon, Theresa Bender Pape, Trudy Mallinson
Summary: The study aimed to investigate the construct validity and measurement precision of the Coma Near-Coma scale in measuring neurobehavioral function in patients with disorders of consciousness. Results showed that the items of the CNC reflected good construct validity and acceptable interrater reliability. The CNC achieved good measurement precision in the full sample.
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
(2021)
Article
Rehabilitation
Charlene Aubinet, Helena Cassol, Olivier Bodart, Leandro R. D. Sanz, Sarah Wannez, Charlotte Martial, Aurore Thibaut, Geraldine Martens, Manon Carriere, Olivia Gosseries, Steven Laureys, Camille Chatelle
Summary: The study introduced a new tool, SECONDs, which is faster and showed substantial agreement compared to the gold standard CRS-R in assessing consciousness in individuals with DoC.
ANNALS OF PHYSICAL AND REHABILITATION MEDICINE
(2021)
Article
Critical Care Medicine
Natasha N. Ludwig, Stacy J. Suskauer, Sandra Rodgin, Julia Chen, Allison Borda, Kara Jones, Sarah Lahey, Beth S. Slomine
Summary: This study examines the initial feasibility and utility of a battery of measures administered via telephone interview with a caregiver to describe long-term outcomes in individuals with disorders of consciousness after pediatric acquired brain injury. The Vineland-3 and GOS-E were found to be feasible and complementary in this cohort, with the GOS-E providing a quick and easy measure of gross functional outcome, and the Vineland-3 providing a greater level of detail about functioning. Using both measures together maximized the range and variability of scores.
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Article
Neurosciences
Alfonso Magliacano, Piergiuseppe Liuzzi, Rita Formisano, Antonello Grippo, Efthymios Angelakis, Aurore Thibaut, Olivia Gosseries, Gianfranco Lamberti, Enrique Noe, Sergio Bagnato, Brian L. Edlow, Nicolas Lejeune, Vigneswaran Veeramuthu, Luigi Trojano, Nathan Zasler, Caroline Schnakers, Michelangelo Bartolo, Andrea Mannini, Anna Estraneo
Summary: This study compared the prognostic accuracy of Clinical Diagnosis and Coma Recovery Scale-Revised (CRS-R) total score with that of a novel Consciousness Domain Index (CDI) for recovery of full consciousness in patients with prolonged Disorders of Consciousness (pDoC). The CDI, obtained by combining the CRS-R subscales using unsupervised machine learning, showed the highest prediction accuracy and sensitivity.
Article
Health Care Sciences & Services
Ognjen Arandjelovic
Summary: This study proposes a sentientist approach to address the ethical challenges in providing care to patients in a persistent vegetative state (PVS). By systematically analyzing and discussing different cases, the study argues that the object of care can shift between the patient, their kin, or the healthcare staff. This is the first comprehensive proposal regarding decision-making processes in the provision of life-sustaining treatment to PVS patients.
JOURNAL OF EVALUATION IN CLINICAL PRACTICE
(2023)
Article
Clinical Neurology
Jennifer Egbebike, Qi Shen, Kevin Doyle, Caroline A. Der-Nigoghossian, Lucy Panicker, Ian Jerome Gonzales, Lauren Grobois, Jerina C. Carmona, Athina Vrosgou, Arshnell Kaur, Amelia Boehme, Angela Velazquez, Benjamin Rohaut, David Roh, Sachin Agarwal, Soojin Park, E. Sander Connolly, Jan Claassen
Summary: The study found that cognitive-motor dissociation plays a predictive role in the recovery time of patients with acute brain injury, and patients diagnosed with cognitive-motor dissociation have better functional recovery than those without the diagnosis. The recovery effects can be observed as early as 3 months after discharge.
Article
Behavioral Sciences
Jennifer A. Weaver, Vera Pertsovskaya, Jasmine Tran, Allan J. Kozlowski, Ann Guernon, Theresa Bender Pape, Trudy Mallinson
Summary: This study aimed to establish the responsiveness indices for the CNC scale with and without pain stimuli. The study found that the CNC 8-item and 10-item scales show comparable responsiveness in measuring neurobehavioral function recovery.
BRAIN AND BEHAVIOR
(2023)
Review
Clinical Neurology
Leandro R. D. Sanz, Aurore Thibaut, Brian L. Edlow, Steven Laureys, Olivia Gosseries
Summary: Neuroimaging has become an important tool in assessing disorders of consciousness, with technologies like magnetic resonance imaging, high-density electroencephalography, and positron emission tomography providing valuable information on brain connectivity, language function, covert consciousness detection, and prognostic markers. A multimodal approach is recommended to assess consciousness, with a focus on integrating different techniques to provide comprehensive diagnostic and prognostic information. Methods like transcranial magnetic stimulation and near-infrared spectroscopy show promise in clinical applications for assessing consciousness in severely brain-injured patients.
CURRENT OPINION IN NEUROLOGY
(2021)
Article
Critical Care Medicine
Catherine Duclos, Charlotte Maschke, Yacine Mahdid, Danielle Nadin, Alexander Rokos, Caroline Arbour, Mohamed Badawy, Justin Letourneau, Adrian M. Owen, Gilles Plourde, Stefanie Blain-Moraes
Summary: Using electroencephalography (EEG) and propofol, researchers have developed an adaptive reconfiguration index that can accurately predict whether patients with disorders of consciousness will recover consciousness. This measure has significant implications for clinical decision-making and can be implemented in acute clinical settings.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2022)
Article
Clinical Neurology
Stefano Masiero, Humberto Antonio Cerrel Bazo, Marcello Rattazzi, Laura Bernardi, Marina Munari, Elisabetta Faggin, Manuela Cattelan, Paolo Pauletto, Alessandra Del Felice
Summary: The study protocol aims to develop prediction models for functional and cognitive outcomes in patients with severe acquired brain injury by collecting clinical data and various assessment measures, in order to identify early signs of favorable recovery during the acute phase.
NEUROLOGICAL SCIENCES
(2021)
Article
Clinical Neurology
Anna Estraneo, Alfonso Magliacano, Salvatore Fiorenza, Rita Formisano, Antonello Grippo, Efthymios Angelakis, Helena Cassol, Aurore Thibaut, Olivia Gosseries, Gianfranco Lamberti, Enrique Noe, Sergio Bagnato, Brian L. Edlow, Camille Chatelle, Nicolas Lejeune, Vigneswaran Veeramuthu, Michelangelo Bartolo, Donatella Mattia, Jlenia Toppi, Nathan Zasler, Caroline Schnakers, Luigi Trojano
Summary: This study found that patients with prolonged disorders of consciousness have a high mortality rate within 24 months post-injury, with different predictors of mortality in patients with vegetative state/unresponsive wakefulness syndrome compared to those with minimally conscious state.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Aurore Thibaut, Rajanikant Panda, Jitka Annen, Leandro R. D. Sanz, Lionel Naccache, Charlotte Martial, Camille Chatelle, Charlene Aubinet, Estelle A. C. Bonin, Alice Barra, Marie-Michele Briand, Benedetta Cecconi, Sarah Wannez, Johan Stender, Steven Laureys, Olivia Gosseries
Summary: A study investigated brain activity in non-responsive brain-injured patients, finding that a significant proportion of them showed partial preservation of brain metabolism, labeled as MCS*. Patients with MCS* had better outcomes, global functional connectivity, and grey matter preservation compared to those with VS/UWS. MCS* patients had lower brain metabolism in posterior brain regions compared to MCS patients.
ANNALS OF NEUROLOGY
(2021)
Article
Clinical Neurology
Michele Farisco, Rita Formisano, Olivia Gosseries, Yoko Kato, Shigeki Koboyashi, Steven Laureys, Nicolas Lejeune, Charlotte Martial, Amal Matar, Ann-Marie Morrisey, Caroline Schnakers, Maidinamu Yakufujiang, Tomohiro Yamaki, Vigneswaran Veeramuthu, Matteo Zandalasini, Nathan Zasler, Alfonso Magliacano, Anna Estraneo, IBIA Special Interest Group DoCs
Summary: Clinical practices for patients with prolonged disorders of consciousness (pDoCs) vary across countries and settings. Two international guidelines have been developed to promote consistent practice. The survey revealed that some recommendations are followed, while others need more clarity and utility.
JOURNAL OF NEUROLOGY
(2023)
Review
Clinical Neurology
Alfonso Magliacano, Francesco De Bellis, Francesco Panico, Laura Sagliano, Luigi Trojano, Claudio Sandroni, Anna Estraneo
Summary: This study assessed the long-term outcome and predictive value of demographic and clinical information for patients with prolonged disorders of consciousness caused by anoxic brain injury. The results showed that the mortality rate was 26%, the rate of any clinical improvement was 26%, and the rate of full recovery of consciousness was 17%. Younger age, a baseline diagnosis of minimally conscious state, higher Coma Recovery Scale Revised total score, and earlier admission to intensive rehabilitation units were associated with a higher likelihood of survival, clinical improvement, and recovery of full consciousness.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Cardiac & Cardiovascular Systems
Daniel Kondziella
Summary: There are two key aspects to master the prognostication of comatose cardiac arrest survivors: a detailed understanding of the clinical trajectories of consciousness recovery and the ability to interpret the multimodal investigations accurately. The 'grey zone', which refers to the intermediate stage of post-cardiac arrest encephalopathy, requires cautious interpretation and prolonged clinical observation. Recent studies have shown late recovery in patients with initially ambiguous diagnostic results and unresponsive patients with residual consciousness, making the prognostication of post-anoxic coma highly complex. This paper aims to provide busy clinicians with a concise overview of neuroprognostication after cardiac arrest, highlighting the notable developments in the field since 2020.
EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE
(2023)
Article
Critical Care Medicine
Joan Machamer, Nancy Temkin, Sureyya Dikmen, Lindsay D. Nelson, Jason Barber, Phillip Hwang, Kim Boase, Murray B. Stein, Xiaoying Sun, Joseph Giacino, Michael A. McCrea, Sabrina R. Taylor, Sonia Jain, Geoff Manley
Summary: Symptom endorsement is common after traumatic brain injury (TBI), especially in mild cases. The prevalence of persistent symptoms has been debated. This study found that persistent symptoms are common at least a year after TBI, and TBI participants have a higher symptom burden compared to other groups.
JOURNAL OF NEUROTRAUMA
(2022)
Article
Critical Care Medicine
David A. Zuckerman, Joseph T. Giacino, Yelena G. Bodien
Summary: The outcomes of TBI are diverse and not standardized, with dichotomization of outcomes into favorable and unfavorable categories potentially limiting detection of treatment effects and impacting decision-making processes.
JOURNAL OF NEUROTRAUMA
(2022)
Article
Critical Care Medicine
Raimund Helbok, Verena Rass, Ettore Beghi, Yelena G. Bodien, Giuseppe Citerio, Joseph T. Giacino, Daniel Kondziella, Stephan A. Mayer, David Menon, Tarek Sharshar, Robert D. Stevens, Hanno Ulmer, Chethan P. Venkatasubba Rao, Paul Vespa, Molly McNett, Jennifer Frontera
Summary: There is wide heterogeneity among health care professionals regarding the clinical definition of coma and limited routine use of advanced coma assessment techniques in acute care settings. Coma management practices vary across sites, and mechanisms for coordinated and sustained follow-up after acute treatment are inconsistent. There is an urgent need for the development of evidence-based guidelines and a collaborative, coordinated approach to advance both the science and the practice of coma management globally.
NEUROCRITICAL CARE
(2022)
Article
Critical Care Medicine
Annelise M. Kulpanowski, William A. Copen, Brandon L. Hancock, Eric S. Rosenthal, David A. Schoenfeld, Jacob A. Dodelson, Brian L. Edlow, W. Taylor Kimberly, Edilberto Amorim, M. Brandon Westover, Ming Ming Ning, Pamela W. Schaefer, Rajeev Malhotra, Joseph T. Giacino, David M. Greer, Ona Wu
Summary: Studies show that patients with substance-related cardiac arrests (SRCA) are more likely to develop severe cerebral edema and brain death compared to non-SRCA patients. However, there were no significant differences in discharge outcomes or survival between the two groups, potentially due to the higher rate of withdrawal of life-sustaining treatment in the non-SRCA group.
Article
Medicine, General & Internal
Emerson M. Wickwire, Jennifer S. Albrecht, Vincent F. Capaldi, Sonia O. Jain, Raquel C. Gardner, J. Kent Werner, Pratik Mukherjee, Ashlee B. McKeon, Michael T. Smith, Joseph T. Giacino, Lindsay D. Nelson, Scott G. Williams, Jacob Collen, Xiaoying Sun, David M. Schnyer, Amy J. Markowitz, Geoffrey T. Manley, Andrew D. Krystal
Summary: This study identifies unique trajectories of insomnia in adults after traumatic brain injury (TBI) using latent class mixed models (LCMM). The results show that there is heterogeneity in the course of insomnia after TBI, with different trajectory classes including persistent mild insomnia, initially mild insomnia that resolves over time, persistent severe insomnia, initially severe insomnia that resolves by 12 months, and initially no insomnia symptoms but develop severe symptoms by 12 months. Factors such as female sex, Black race, history of psychiatric illness, and intracranial injury are significantly associated with insomnia trajectory class membership.
Article
Psychology, Clinical
Daniel W. Klyce, Paul B. Perrin, Lauren B. Fisher, Flora M. Hammond, Shannon B. Juengst, Thomas F. Bergquist, Amanda R. Rabinowitz, Amy K. Wagner, Charles H. Bombardier, Janet P. Niemeier, Kelli W. Gary, Joseph T. Giacino, Ross D. Zafonte
Summary: The study identified group-based patterns in suicidal ideation over the first 10 years after traumatic brain injury (TBI), with four distinct patterns emerging. The findings highlight the importance of mental health and suicide risk assessment during chronic recovery from TBI.
JOURNAL OF CLINICAL PSYCHOLOGY
(2022)
Article
Critical Care Medicine
Samuel B. Snider, Robert G. Kowalski, Flora M. Hammond, Saef Izzy, Shirley L. Shih, Craig Rovito, Brian L. Edlow, Ross D. Zafonte, Joseph T. Giacino, Yelena G. Bodien
Summary: This study aims to evaluate the accuracy of different assessment scales in measuring functional dependency in patients with disorders of consciousness. The results show that commonly used GOSE and DRS scales have limited specificity or sensitivity, while the DRSDepend scale is relatively more accurate but requires further validation.
JOURNAL OF NEUROTRAUMA
(2022)
Article
Critical Care Medicine
Jennifer A. Weaver, Alison M. Cogan, Katherine A. O'Brien, Piper Hansen, Joseph T. Giacino, John Whyte, Theresa Bender Pape, Philip van der Wees, Trudy Mallinson
Summary: This study evaluated the hierarchical structure of the Coma Recovery Scale-Revised (CRS-R) rating scale categories and their alignment with the Aspen consensus criteria for determining disorders of consciousness (DoC). The study found that most of the rating scale categories were aligned with the consensus criteria, but there were a few deviations. The study also found a strong correlation between the individual measures and states of consciousness. The findings provide empirical evidence for revising the diagnostic criteria for certain states of consciousness.
JOURNAL OF NEUROTRAUMA
(2022)
Article
Behavioral Sciences
William H. Curley, Yelena G. Bodien, David W. Zhou, Mary M. Conte, Andrea S. Foulkes, Joseph T. Giacino, Jonathan D. Victor, Nicholas D. Schiff, Brian L. Edlow
Summary: This study demonstrates the use of the ABCD framework to assess EEG dynamics and track changes in thalamocortical network function in patients with acute severe traumatic brain injury. The findings suggest that ABCD classifications can provide valuable information for monitoring recovery and predicting outcomes.
Article
Critical Care Medicine
Nancy Temkin, Joan Machamer, Sureyya Dikmen, Lindsay D. Nelson, Jason Barber, Phillip H. Hwang, Kim Boase, Murray B. Stein, Xiaoying Sun, Joseph Giacino, Michael A. McCrea, Sabrina R. Taylor, Sonia Jain, Geoff Manley, RACK-TBI Investigators
Summary: Factors such as TBI-related and post-traumatic stress symptom levels at 2 weeks have large effect sizes when predicting 3-month symptom burden, allowing for more efficient clinical trials by enriching the included sample with individuals reporting a high early symptom burden.
JOURNAL OF NEUROTRAUMA
(2022)
Article
Biochemistry & Molecular Biology
Victor M. Castro, Jonathan Rosand, Joseph T. Giacino, Thomas H. McCoy, Roy H. Perlis
Summary: Neuropsychiatric symptoms may persist following acute COVID-19 illness, but they are not specific to COVID-19 and occur at similar rates among individuals hospitalized for other indications.
MOLECULAR PSYCHIATRY
(2022)
Correction
Critical Care Medicine
Shraddha Mainali, Venkatesh Aiyagari, Sheila Alexander, Yelena Bodien, Varina Boerwinkle, Melanie Boly, Emery Brown, Jeremy Brown, Jan Claassen, Brian L. Edlow, Ericka L. Fink, Joseph J. Fins, Brandon Foreman, Jennifer Frontera, Romergryko G. Geocadin, Joseph Giacino, Emily J. Gilmore, Olivia Gosseries, Flora Hammond, Raimund Helbok, J. Claude Hemphill, Karen Hirsch, Keri Kim, Steven Laureys, Ariane Lewis, Geoffrey Ling, Sarah L. Livesay, Victoria McCredie, Molly McNett, David Menon, Erika Molteni, DaiWai Olson, Kristine O'Phelan, Soojin Park, Len Polizzotto, Jose Javier Provencio, Louis Puybasset, Chethan P. Venkatasubba Rao, Courtney Robertson, Benjamin Rohaut, Michael Rubin, Tarek Sharshar, Lori Shutter, Gisele Sampaio Silva, Wade Smith, Robert D. Stevens, Aurore Thibaut, Paul Vespa, Amy K. Wagner, Wendy C. Ziai, Elizabeth Zink, Jose I. Suarez
NEUROCRITICAL CARE
(2022)
Article
Neurosciences
Jacqueline R. Kulbe, Sonia Jain, Lindsay D. Nelson, Frederick K. Korley, Pratik Mukherjee, Xiaoying Sun, David O. Okonkwo, Joseph T. Giacino, Mary J. Vassar, Claudia S. Robertson, Michael A. McCrea, Kevin K. W. Wang, Nancy Temkin, Christine L. Mac Donald, Sabrina R. Taylor, Adam R. Ferguson, Amy J. Markowitz, Ramon Diaz-Arrastia, Geoffrey T. Manley, Murray B. Stein, Ann-Christine Duhaime, V. Ramana Feeser, C. Dirk Keene, Christopher Madden, Randall Merchant, Ava Puccio, David Schnyer, Sabrina R. Taylor, Alex Valadka, John K. Yue, Esther L. Yuh, Ross Zafonte
Summary: This study aimed to determine whether two day-of-injury blood-based biomarkers are predictive of posttraumatic stress disorder (PTSD). The results showed that elevated day-of-injury serum GFAP levels are associated with a reduced risk of PTSD after mild TBI.
NEUROPSYCHOPHARMACOLOGY
(2022)
Article
Health Care Sciences & Services
Jolie N. Haun, Risa Nakase-Richardson, Christine Melillo, Jacob Kean, C. Benzinger, Tali Schneider, Mary Jo Pugh, Rachel C. Benzinger
Summary: This study aims to evaluate the implementation determinants of the traumatic brain injury (TBI) Intensive Evaluation and Treatment Program (IETP). The study will describe the IETP services and implementation status, evaluate outcomes for participants, and support the expansion of IETP. The results of this study will contribute to the improvement and dissemination of IETP.
JMIR RESEARCH PROTOCOLS
(2023)
Article
Clinical Neurology
Shawn R. Eagle, Ava M. Puccio, Lindsay D. Nelson, Michael McCrea, Joseph Giacino, Ramon Diaz-Arrastia, William Conkright, Sonia Jain, Xiaoying Sun, Geoffrey Manley, David O. Okonkwo
Summary: Obesity is associated with higher symptomatology and blood inflammatory markers in recovery following mTBI. The study found that obese patients had higher concentrations of hsCRP and IL-6 at multiple time points after injury, as well as higher RPQ scores at 6 and 12 months.
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
(2023)