The vegetative and minimally conscious states: current knowledge and remaining questions
- PMID: 15668569
- DOI: 10.1097/00001199-200501000-00005
The vegetative and minimally conscious states: current knowledge and remaining questions
Abstract
In the last 2 decades, the minimally conscious state has been distinguished conceptually from the vegetative state and operational criteria for these diagnoses have been published. Standardized and individualized assessment tools have been developed to assist with the diagnosis of severe disorders of consciousness and the measurement of clinical improvement. The natural course of recovery and the importance of key prognostic predictors have been elucidated. Important advances have also been made in defining the similarities and differences in the pathophysiology of these two states, and functional imaging modalities have begun to explicate the neural substrate underlying the behavioral features of these disorders. Research on the efficacy of treatments for severe disorders of consciousness lags behind, due to the practical and ethical difficulties in executing large rigorously controlled clinical trials. The past and future scientific developments in this area provide an important background for continuing discussions of the ethical controversies surrounding end-of-life decision making and resource allocation.
Similar articles
-
[Vegetative or minimally conscious state?].Ned Tijdschr Geneeskd. 2010;154(45):A1890. Ned Tijdschr Geneeskd. 2010. PMID: 21118584 Dutch.
-
What is it like to be vegetative or minimally conscious?Curr Opin Neurol. 2007 Dec;20(6):609-13. doi: 10.1097/WCO.0b013e3282f1d6dd. Curr Opin Neurol. 2007. PMID: 17992077 Review.
-
Minimally Conscious State: Evolution of Concept, Diagnosis and Treatment.MEDICC Rev. 2016 Oct;18(4):43-46. doi: 10.37757/MR2016.V18.N4.9. MEDICC Rev. 2016. PMID: 27829654 Review.
-
Neuroethics and Disorders of Consciousness: Discerning Brain States in Clinical Practice and Research.AMA J Ethics. 2016 Dec 1;18(12):1182-1191. doi: 10.1001/journalofethics.2016.18.12.ecas2-1612. AMA J Ethics. 2016. PMID: 28009244
-
The vegetative and minimally conscious states: diagnosis, prognosis and treatment.Neurol Clin. 2011 Nov;29(4):773-86. doi: 10.1016/j.ncl.2011.07.009. Neurol Clin. 2011. PMID: 22032660 Review.
Cited by
-
Predicting Functional Dependency in Patients with Disorders of Consciousness: A TBI-Model Systems and TRACK-TBI Study.Ann Neurol. 2023 Dec;94(6):1008-1023. doi: 10.1002/ana.26741. Epub 2023 Oct 5. Ann Neurol. 2023. PMID: 37470289
-
Effect of high-frequency repetitive transcranial magnetic stimulation over M1 for consciousness recovery after traumatic brain injury.Brain Behav. 2023 May;13(5):e2971. doi: 10.1002/brb3.2971. Epub 2023 Mar 28. Brain Behav. 2023. PMID: 36977194 Free PMC article. Clinical Trial.
-
The Outcome of Neurorehabilitation Efficacy and Management of Traumatic Brain Injury.Front Hum Neurosci. 2022 Jun 22;16:870190. doi: 10.3389/fnhum.2022.870190. eCollection 2022. Front Hum Neurosci. 2022. PMID: 35814948 Free PMC article. Review.
-
"Fluctuation is the norm": Rehabilitation practitioner perspectives on ambiguity and uncertainty in their work with persons in disordered states of consciousness after traumatic brain injury.PLoS One. 2022 Apr 21;17(4):e0267194. doi: 10.1371/journal.pone.0267194. eCollection 2022. PLoS One. 2022. PMID: 35446897 Free PMC article.
-
Resting-State fMRI in Chronic Patients with Disorders of Consciousness: The Role of Lower-Order Networks for Clinical Assessment.Brain Sci. 2022 Mar 7;12(3):355. doi: 10.3390/brainsci12030355. Brain Sci. 2022. PMID: 35326311 Free PMC article.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous
