We here describe an international multicenter study funded by the European DOCMA project, aimed to identify people with disorders of consciousness most suitable for tailored rehabilitation programs and therapeutic interventions by applying standardized multimodal assessment protocols. The study enrolled 147 patients (70% men; mean age, 49.4 years; mean time post injury, 59.6 days) from 12 centers in North America, Europe, and Asia.
The results showed that younger age, shorter time since injury, higher level of responsiveness and consciousness, and EEG reactivity to eye opening are all factors that can predict 6-month improvement among patients in a vegetative or minimally conscious state from a severe brain injury.
Information on such factors can be gathered at the bedside relatively easily and without sophisticated technical tools — and doing so is not time-consuming or expensive. For this reason the study provided relevant prognostic information for clinicians and can drive an international consensus on prognostic procedures for the clinical care of individuals with prolonged disorders of consciousness.
Key Points:
- A multicentre study investigated factors influencing 6-month outcomes among patients with disorders of consciousness
- 147 patients were enrolled in 12 centers in North America, Europe and Asia
- Younger age, shorter time since injury, higher level of responsiveness and consciousness, and EEG reactivity to eye opening were all factors predicting favorable outcomes.
- An international consensus is needed to uniformize prognostic procedures in the clinical care of disorders of consciousness
References:
Multicenter prospective study on predictors of short-term outcome in disorders of consciousness. Anna Estraneo, Salvatore Fiorenza, Alfonso Magliacano, Rita Formisano, Donatella Mattia, Antonello Grippo, Anna Maria Romoli, Efthymios Angelakis, Helena Cassol, Aurore Thibaut, Olivia Gosseries, Gianfranco Lamberti, Enrique Noé, Sergio Bagnato, Brian L. Edlow, Camille Chatelle, Nicolas Lejeune, Vigneswaran Veeramuthu, Michelangelo Bartolo, Jlenia Toppi, Nathan Zasler, Caroline Schnakers, Luigi Trojano, on behalf of IBIA DoC-SIG. Neurology Sep 2020, 95 (11) e1488-e1499; DOI: 10.1212/WNL.0000000000010254