A multicentre study of intentional behavioural responses measured using the Coma Recovery Scale-Revised in patients with minimally conscious state

作者：Estraneo Anna^*; Moretta Pasquale; Cardinale Viviana; De Tanti Antonio; Gatta Giordano; Giacino Joseph T; Trojano Luigi

来源：Clinical Rehabilitation, 2015, 29(8): 803-808.

DOI：10.1177/0269215514556002

• Minimally conscious state
• Coma Recovery Scale-Revised
• rehabilitation
• brain injury
• intentional behaviours

Objective: To investigate which conscious behaviour is most frequently detected using the Coma Recovery Scale-Revised in patients with minimally conscious state.
Design: Multicentre, cross-sectional study.
Setting: One intensive care unit, 8 post-acute rehabilitation centres and 2 long-term facilities.
Subjects: Fifty-two patients with established diagnosis of minimally conscious state of different aetiology.
Main measures: All patients were assessed by the Coma Recovery Scale-Revised.
Results: In most patients (34/52) non-reflexive responses were identified by two or more subscales of the Coma Recovery Scale-Revised, whereas in 14 patients only the visual subscale could identify cortically-mediated behaviours, and in the remaining 4 patients only the motor subscale did so. The clinical signs of intentional behaviour were most often detected by the visual subscale (43/52 patients) and by the motor subscale (31/52), and least frequently by the oromotor/verbal subscale (3/52) of the Coma Recovery Scale-Revised. This clinical pattern was observed independently from time post-onset and aetiology.
Conclusions: Non-reflexive visual behaviour, identified by the visual subscale of Coma Recovery Scale-Revised, is the most frequently detected intentional sign consistent with the diagnosis of minimally conscious state, independently from aetiology and time post-onset.

• 出版日期2015-8