Multicentre Registry of Brain-injured Patients with Disorder of Consciousness: Rationale and Preliminary Data

Overview

Journal Funct Neurol

Specialties Neurology
Psychology

Date 2018 Apr 11

PMID 29633693

Citations 7

Authors

A Pascarella

S Fiorenza

O Masotta

V Tibollo

D Vella

Anna Maria Nardone

Marta Rossi

P Volanti

F Madonia

Gaetano Cstronovo

D De Cicco

Caterina Guarnaschelli

M P Achilli

C Chiapparino

M T Angelillo

M A Tommasi

F Pisano

G Grioni

G Vezzadini

G Ferriero

S Salvaderi

R Bellazzi

Anna Estraneo

Affiliations

Soon will be listed here.

Abstract

Diagnostic accuracy and reliable estimation of clinical evolution are challenging issues in the management of patients with disorders of consciousness (DoC). Longitudinal systematic investigations conducted in large cohorts of patients with DoC could make it possible to identify reliable diagnostic and prognostic markers. On the basis of this consideration, we devised a multicentre prospective registry for patients with DoC admitted to ten intensive rehabilitation units. The registry collects homogeneous and detailed data on patients' demographic and clinical features, neurophysiological and neuroimaging findings, and medical and surgical complications. Here we present the rationale and the design of the registry and the preliminary results obtained in 53 patients with DoC (vegetative state or minimally conscious state) enrolled during the first seven months of the study. Data at 6-month post-injury follow-up were available for 46 of them. This registry could be an important tool for collecting high-quality data through the application of rigorous methods, and it could be used in the routine management of patients with DoC admitted to rehabilitation settings.

Citing Articles

Prognosis of patients with prolonged disorders of consciousness after brain injury: a longitudinal cohort study.

Yan D, Simei L, Hongzhao B, Hongyan D, Yuchao D Front Public Health. 2024; 12:1421779.

PMID: 39114510 PMC: 11303146. DOI: 10.3389/fpubh.2024.1421779.

Predicting outcome in disorders of consciousness: A mega-analysis.

Pavlov Y, Spiegelsberger F, Kotchoubey B Ann Clin Transl Neurol. 2024; 11(6):1465-1477.

PMID: 38591650 PMC: 11187962. DOI: 10.1002/acn3.52061.

Long-Term Outcomes among Patients with Prolonged Disorders of Consciousness.

Liu Y, Kang X, Gao Q, Liu Y, Song C, Shi X Brain Sci. 2023; 13(2).

PMID: 36831737 PMC: 9954359. DOI: 10.3390/brainsci13020194.

One-Year Demographical and Clinical Indices of Patients with Chronic Disorders of Consciousness.

Nekrasova J, Kanarskii M, Borisov I, Pradhan P, Shunenkov D, Vorobiev A Brain Sci. 2021; 11(5).

PMID: 34065687 PMC: 8156613. DOI: 10.3390/brainsci11050651.

Multicenter prospective study on predictors of short-term outcome in disorders of consciousness.

Estraneo A, Fiorenza S, Magliacano A, Formisano R, Mattia D, Grippo A Neurology. 2020; 95(11):e1488-e1499.

PMID: 32661102 PMC: 7713739. DOI: 10.1212/WNL.0000000000010254.

References

Grill E, Klein A, Howell K, Arndt M, Bodrozic L, Herzog J . Rationale and design of the prospective German registry of outcome in patients with severe disorders of consciousness after acute brain injury. Arch Phys Med Rehabil. 2013; 94(10):1870-6. DOI: 10.1016/j.apmr.2012.10.040. View

Estraneo A, Moretta P, Cardinale V, De Tanti A, Gatta G, Giacino J . A multicentre study of intentional behavioural responses measured using the Coma Recovery Scale-Revised in patients with minimally conscious state. Clin Rehabil. 2014; 29(8):803-8. DOI: 10.1177/0269215514556002. View

Ganesh S, Guernon A, Chalcraft L, Harton B, Smith B, Pape T . Medical comorbidities in disorders of consciousness patients and their association with functional outcomes. Arch Phys Med Rehabil. 2013; 94(10):1899-907. DOI: 10.1016/j.apmr.2012.12.026. View

Baguley I, Perkes I, Fernandez-Ortega J, Rabinstein A, Dolce G, Hendricks H . Paroxysmal sympathetic hyperactivity after acquired brain injury: consensus on conceptual definition, nomenclature, and diagnostic criteria. J Neurotrauma. 2014; 31(17):1515-20. DOI: 10.1089/neu.2013.3301. View

Trojano L, Moretta P, Loreto V, Santoro L, Estraneo A . Affective saliency modifies visual tracking behavior in disorders of consciousness: a quantitative analysis. J Neurol. 2012; 260(1):306-8. DOI: 10.1007/s00415-012-6717-x. View

Formisano R, Azicnuda E, Sefid M, Zampolini M, Scarponi F, Avesani R . Early rehabilitation: benefits in patients with severe acquired brain injury. Neurol Sci. 2016; 38(1):181-184. DOI: 10.1007/s10072-016-2724-5. View

Schnakers C, Vanhaudenhuyse A, Giacino J, Ventura M, Boly M, Majerus S . Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment. BMC Neurol. 2009; 9:35. PMC: 2718857. DOI: 10.1186/1471-2377-9-35. View

Duncan C, Barry R, Connolly J, Fischer C, Michie P, Naatanen R . Event-related potentials in clinical research: guidelines for eliciting, recording, and quantifying mismatch negativity, P300, and N400. Clin Neurophysiol. 2009; 120(11):1883-1908. DOI: 10.1016/j.clinph.2009.07.045. View

Pistoia F, Sacco S, Franceschini M, Sara M, Pistarini C, Cazzulani B . Comorbidities: a key issue in patients with disorders of consciousness. J Neurotrauma. 2014; 32(10):682-8. DOI: 10.1089/neu.2014.3659. View

10.

Bagnato S, Boccagni C, SantAngelo A, Prestandrea C, Mazzilli R, Galardi G . EEG predictors of outcome in patients with disorders of consciousness admitted for intensive rehabilitation. Clin Neurophysiol. 2014; 126(5):959-66. DOI: 10.1016/j.clinph.2014.08.005. View

11.

Fins J . Neuroethics and Disorders of Consciousness: Discerning Brain States in Clinical Practice and Research. AMA J Ethics. 2016; 18(12):1182-1191. DOI: 10.1001/journalofethics.2016.18.12.ecas2-1612. View

12.

RAPPAPORT M, Hall K, Hopkins K, Belleza T, Cope D . Disability rating scale for severe head trauma: coma to community. Arch Phys Med Rehabil. 1982; 63(3):118-23. View

13.

Giacino J, Kalmar K, Whyte J . The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility. Arch Phys Med Rehabil. 2004; 85(12):2020-9. DOI: 10.1016/j.apmr.2004.02.033. View

14.

Seel R, Douglas J, Dennison A, Heaner S, Farris K, Rogers C . Specialized early treatment for persons with disorders of consciousness: program components and outcomes. Arch Phys Med Rehabil. 2013; 94(10):1908-23. DOI: 10.1016/j.apmr.2012.11.052. View

15.

Vanden Bossche L, Vanderstraeten G . Heterotopic ossification: a review. J Rehabil Med. 2005; 37(3):129-36. DOI: 10.1080/16501970510027628. View

16.

Estraneo A, Moretta P, Loreto V, Santoro L, Trojano L . Clinical and neuropsychological long-term outcomes after late recovery of responsiveness: a case series. Arch Phys Med Rehabil. 2013; 95(4):711-6. DOI: 10.1016/j.apmr.2013.11.004. View

17.

Pascarella A, Trojano L, Loreto V, Bilo L, Moretta P, Estraneo A . Long-term outcome of patients with disorders of consciousness with and without epileptiform activity and seizures: a prospective single centre cohort study. J Neurol. 2016; 263(10):2048-56. DOI: 10.1007/s00415-016-8232-y. View

18.

Katz D, Polyak M, Coughlan D, Nichols M, Roche A . Natural history of recovery from brain injury after prolonged disorders of consciousness: outcome of patients admitted to inpatient rehabilitation with 1-4 year follow-up. Prog Brain Res. 2009; 177:73-88. DOI: 10.1016/S0079-6123(09)17707-5. View

19.

MAHONEY F, BARTHEL D . FUNCTIONAL EVALUATION: THE BARTHEL INDEX. Md State Med J. 1965; 14:61-5. View

20.

Estraneo A, Moretta P, Loreto V, Lanzillo B, Cozzolino A, Saltalamacchia A . Predictors of recovery of responsiveness in prolonged anoxic vegetative state. Neurology. 2013; 80(5):464-70. DOI: 10.1212/WNL.0b013e31827f0f31. View