期刊
NEUROREHABILITATION
卷 46, 期 1, 页码 65-74出版社
IOS PRESS
DOI: 10.3233/NRE-192860
关键词
Brain injury; traumatic brain injury; consciousness; confusion
资金
- National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR), Administration for Community Living (NIDILRR) [90DP0039]
- James S. McDonnell Foundation
- Belgian National Funds for Scientific Research (FRS-FNRS)
- European Commission [EU-H2020-fetopen-ga686764]
- Human Brain Project [EU-H2020-fetflagship-hbpsga1-ga720270]
- DOCMA project [EU-H2020MSCA-RISE-778234]
- IAP research network of the Belgian Government (Belgian Science Policy) [P7/06]
- Wallonie-Bruxelles International (WBI.World)
- Wallonia-Brussels Federation Travel Grant
- National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) [90DP0039]
- National Institutes of Health
- U.S. Department of Defense
- National Institute of Neurological Disorders and Stroke
- University Hospital of Li`ege
BACKGROUND: Although emergence from the minimally conscious state (eMCS) is associated with symptoms including disorientation, memory and attention impairment, restlessness, and significant functional disability, the neurobehavioral profile of eMCS has not been empirically characterized. OBJECTIVE: Determine degree of cognitive impairment, presence of clinical symptoms and functional disability at time eMCS in patients with traumatic and non-traumatic brain injury (TBI, nTBI). METHODS: Retrospective observational study of 169 adults (median [interquartile range] age: 51 [29, 62] years; male: 116; TBI: 103) who emerged from MCS based on the Coma Recovery Scale-Revised while in an inpatient Disorders of Consciousness program. Outcome measures include the Confusion Assessment Protocol (CAP) and Disability Rating Scale (DRS). RESULTS: CAP administration was attempted in 54 subjects. Twenty-eight subjects had valid scores on all CAP items, with a median [interquartile range] of 4 [3-5] symptoms of confusion. Scores in 93% of this subsample were consistent with an acute confusional state. The most common symptoms were cognitive impairment (98% of subjects), disorientation (93%), and agitation (69%). The median DRS score upon emergence from MCS was 14.5 [13, 16], indicating severe disability (n = 140). CONCLUSIONS: eMCS is associated with an acute confusional state and severe disability. This finding may inform the lower boundary of confusion as well as approach to treatment and caregiver education.
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