title: Detection of visual pursuit in patients in minimally conscious state: a matter of stimuli and visual plane?
abstract: OBJECTIVE
  The aim of this study was to determine whether the assessment of pursuit eye movements in patients in minimally conscious state (MCS) is influenced by the choice of the visual stimulus (study 1) and by the moving plane (study 2).
  
  
  METHODS
  Patients with MCS (MCS- and MCS+) in the acute (<1 month post-injury) or chronic (>1 month) setting were assessed. The Coma Recovery Scale-Revised (CRS-R) procedure was used to test visual pursuit of a moving mirror, object and person (study 1, n = 88) and to test vertical and horizontal visual tracking (study 2, n = 94).
  
  
  RESULTS
  Study 1: Patients with visual pursuit tracked preferentially the moving mirror over the moving person or object. Study 2: Patients displaying visual pursuit, especially in MCS- and in chronic setting, preferentially tracked on the horizontal rather than the vertical plane.
  
  
  CONCLUSIONS
  The findings confirm the importance of using a mirror to assess visual pursuit in patients in MCS and of initiating testing using the horizontal plane, specifically in patients in MCS- and those in chronic setting. Assessment should then be done on the vertical plane if visual pursuit is not detected on the horizontal plane.
authors.affiliation: Coma Science Group, Cyclotron Research Centre & Neurology Department, University and University Hospital of Liege , Liege , Belgium .
authors.forename: Marie
authors.initials: M
authors.lastname: Thonnard
authors.forename: Sarah
authors.initials: S
authors.lastname: Wannez
authors.forename: Shannan
authors.initials: S
authors.lastname: Keen
authors.forename: Serge
authors.initials: S
authors.lastname: Brédart
authors.forename: Marie-Aurélie
authors.initials: MA
authors.lastname: Bruno
authors.forename: Olivia
authors.initials: O
authors.lastname: Gosseries
authors.forename: Athena
authors.initials: A
authors.lastname: Demertzi
authors.forename: Aurore
authors.initials: A
authors.lastname: Thibaut
authors.forename: Camille
authors.initials: C
authors.lastname: Chatelle
authors.forename: Vanessa
authors.initials: V
authors.lastname: Charland-Verville
authors.forename: Lizette
authors.initials: L
authors.lastname: Heine
authors.forename: Dina
authors.initials: D
authors.lastname: Habbal
authors.forename: Steven
authors.initials: S
authors.lastname: Laureys
authors.forename: Audrey
authors.initials: A
authors.lastname: Vanhaudenhuyse
mesh_terms: D001341:Autonomic Nervous System / Q000503:physiopathology*; D001930:Brain Injuries / Q000503:physiopathology*; D004185:Disability Evaluation; D005071:Evoked Potentials; D005133:Eye Movements; D006801:Humans; D009039:Motion Perception; D018458:Persistent Vegetative State / Q000503:physiopathology*; D010775:Photic Stimulation / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function
keywords: Behavioural assessment; disorders of consciousness; minimally conscious state; visual pursuit