title: A long-term intensive behavioral treatment study in patients with persistent vegetative state or minimally conscious state.
abstract: OBJECTIVE
  Persistent vegetative state is regarded as "permanent", if it persists for more than 1 year for traumatic aetiology, or for more than 3 months for other aetiologies. This is also the case for patients in a minimally conscious state. In order to investigate possible improvements after this period we treated and observed 7 such patients over a period of 6 months.
  
  
  METHODS
  An ABA-BAB study design was used, with sensory stimulation and social-tactile intervention as treatment regimes. Changes were documented by clinical evaluation and blind behavioural assessment through video monitoring.
  
  
  RESULTS
  Clinical scores improved significantly after treatment. Video assessment also indicated significant changes in the patients' behaviour. During the initial period of therapy, social tactile interaction improved patients' activity, while sensory stimulation impaired activity. During the main part of therapy, both types of treatment yielded similar positive results.
  
  
  CONCLUSIONS
  This study indicates the possibility of achieving behavioural improvements with regard to the responsiveness of patients with long-lasting persistent vegetative state and minimally conscious state by use of long-term treatment.
authors.affiliation: Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany. martin.lotze@uni-greifswald.de
authors.forename: Martin
authors.initials: M
authors.lastname: Lotze
authors.forename: Karin
authors.initials: K
authors.lastname: Schertel
authors.forename: Niels
authors.initials: N
authors.lastname: Birbaumer
authors.forename: Boris
authors.initials: B
authors.lastname: Kotchoubey
mesh_terms: D000328:Adult; D001519:Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D010812:Physical Stimulation / Q000379:methods*; D020127:Recovery of Function; D012677:Sensation; D013997:Time Factors; D014110:Touch; D014743:Videotape Recording