title: Increased behavioural responsiveness with complex stimulation in VS and MCS: preliminary results.
abstract: OBJECTIVE
  Even in non-communicative disorders of consciousness such as vegetative and minimally conscious states, increasing the personal relevance and complexity of stimuli appears to enhance their activating effect in patients. It was hypothesized that enriched stimulation in an immersive environment could increase the number and/or the goal-directed quality of active movements.
  Twelve patients with severe disorders of consciousness in the post-acute phase underwent an experimental protocol of sensory stimulation based on biographically meaningful objects. Enriched stimulation was compared to both a pattern of stimulation without augmented context and to standard interactions in a clinical setting. An A-B-C-B-A paradigm was applied to minimize the confounding effects of clinical changes during the protocol. The motor behaviours were recorded using the Wessex Head Injury Matrix (WHIM) and analysed with standard parametric statistics.
  
  
  CONCLUSIONS
  The results show a difference in patient response as a function of stimulation context: familiar objects in an augmented environment elicited a greater range of behavioural responses. These results support the hypothesis that the emotional richness and complexity of environmental stimuli can play a key role in evoking active behaviours.
authors.affiliation: Casa dei Risvegli Luca De Nigris, Azienda USL - Centro Studi per la Ricerca sul Coma, Bologna, Italy. c.distefano@ausl.bologna.it
authors.forename: Cristina
authors.initials: C
authors.lastname: Di Stefano
authors.forename: Alessandra
authors.initials: A
authors.lastname: Cortesi
authors.forename: Stefano
authors.initials: S
authors.lastname: Masotti
authors.forename: Loredana
authors.initials: L
authors.lastname: Simoncini
authors.forename: Roberto
authors.initials: R
authors.lastname: Piperno
mesh_terms: D000328:Adult; D001307:Auditory Perception; D001364:Awareness; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D018458:Persistent Vegetative State / Q000503:physiopathology* / Q000534:rehabilitation*; D014110:Touch; D055815:Young Adult