title: Behavioral recovery in disorders of consciousness: a prospective study with the Spanish version of the Coma Recovery Scale-Revised.
abstract: OBJECTIVE
  To describe the clinical characteristics and short-term pattern of evolution of a sample of patients within 1 year after acquiring a brain injury that led to a vegetative state (VS) or a minimally conscious state (MCS).
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Inpatient brain injury rehabilitation program.
  
  
  METHODS
  Patients with acquired brain injury (N=32; 47% traumatic, 37.5% hemorrhagic, 15.5% anoxic) who were in a VS or an MCS according to Coma Recovery Scale-Revised (CRS-R) scores.
  
  
  METHODS
  Integrative multisensory program comprising daily physical rehabilitation procedures and multimodal sensory stimulation.
  
  
  METHODS
  All patients were assessed with a Spanish version of the CRS-R at admission and then monthly for at least 6 months or until emergence from MCS.
  
  
  RESULTS
  At the time of admission, 12 patients were diagnosed as being in a VS and 20 as being in an MCS. Eight patients were able to emerge from their MCS during follow-up. Seven of these 8 patients were diagnosed as being in an MCS at inclusion, and only 1 was diagnosed as being in a VS. Emergence from an MCS was mostly associated with improvement in both the communication and motor function scales (n=4). Lesser chronicity (P=.01) and the presence of more than visual behavioral responses at admission (P=.05) were both significant predictors of emergence from an MCS.
  
  
  CONCLUSIONS
  The CRS-R seems appropriate for establishing an immediate prognosis in this population. A quick referral of these patients for specialized assessment and rehabilitation facilities is recommended.
authors.affiliation: Servicio de NeuroRehabilitación y Daño Cerebral de Hospitales NISA y Fundación Hospitales NISA, Valencia, Spain. enoe@comv.es
authors.forename: Enrique
authors.initials: E
authors.lastname: Noé
authors.forename: José
authors.initials: J
authors.lastname: Olaya
authors.forename: M Dolores
authors.initials: MD
authors.lastname: Navarro
authors.forename: Paloma
authors.initials: P
authors.lastname: Noguera
authors.forename: Carolina
authors.initials: C
authors.lastname: Colomer
authors.forename: Javier
authors.initials: J
authors.lastname: García-Panach
authors.forename: Sandra
authors.initials: S
authors.lastname: Rivero
authors.forename: Belén
authors.initials: B
authors.lastname: Moliner
authors.forename: Joan
authors.initials: J
authors.lastname: Ferri
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001519:Behavior / Q000502:physiology*; D001930:Brain Injuries / Q000150:complications* / Q000503:physiopathology; D015331:Cohort Studies; D004185:Disability Evaluation; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation*; D011379:Prognosis; D011446:Prospective Studies; D012737:Sex Factors; D013030:Spain; D013997:Time Factors; D014175:Translating; D015599:Trauma Severity Indices; D055815:Young Adult