Pain in Persons with Disorders of Consciousness

Overview

Journal Brain Sci

Publisher MDPI

Date 2022 Mar 25

PMID 35326257

Authors

Nathan D Zasler

Rita Formisano

Marta Aloisi

Affiliations

Soon will be listed here.

Abstract

Pain and suffering in persons with disorders of consciousness (DoC) remain poorly understood, frequently unaddressed or inadequately addressed, and controversial on numerous levels. This narrative literature review will address a number of critical issues germane to pain and suffering in this challenging group of patients, providing an introductory overview of the topic, perspectives on current knowledge regarding pain pathoanatomy and pathophysiology, and a review of common pain generators and factors that can lead to the chronifcation of pain. Caveats on bedside pain assessment challenges, as well as electrophysiologic and neuroimaging findings in these patients, will also be explored. Pain management techniques, including non-pharmacological and pharmacological, will be reviewed. Ethical considerations in the context of pain and suffering in persons with disorders of consciousness will round out the review prior to our concluding comments.

Citing Articles

The Consciousness of Pain: A Thalamocortical Perspective.

Sgourdou P NeuroSci. 2024; 3(2):311-320.

PMID: 39483367 PMC: 11523681. DOI: 10.3390/neurosci3020022.

Nociception Coma Scale-Revised with Personalized Painful Stimulus Versus Standard Stimulation in Persons with Disorders of Consciousness: An International Multicenter Study.

Formisano R, Aloisi M, Ferri G, Schiattone S, Estraneo A, Magliacano A J Clin Med. 2024; 13(18).

PMID: 39337015 PMC: 11432094. DOI: 10.3390/jcm13185528.

Analgesia for the Bayesian Brain: How Predictive Coding Offers Insights Into the Subjectivity of Pain.

Lersch F, Frickmann F, Urman R, Burgermeister G, Siercks K, Luedi M Curr Pain Headache Rep. 2023; 27(11):631-638.

PMID: 37421540 PMC: 10713672. DOI: 10.1007/s11916-023-01122-5.

Comparing indices of responsiveness for the Coma Near-Coma Scale with and without pain items: An Exploratory study.

Weaver J, Pertsovskaya V, Tran J, Kozlowski A, Guernon A, Bender Pape T Brain Behav. 2023; 13(8):e3120.

PMID: 37303294 PMC: 10454260. DOI: 10.1002/brb3.3120.

Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review.

Bonin E, Lejeune N, Szymkowicz E, Bonhomme V, Martial C, Gosseries O Front Syst Neurosci. 2023; 17:1112206.

PMID: 37021037 PMC: 10067681. DOI: 10.3389/fnsys.2023.1112206.

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