title: Prevalence of coma-recovery scale-revised signs of consciousness in patients in minimally conscious state.
abstract: Different behavioural signs of consciousness can distinguish patients with an unresponsive wakefulness syndrome from patients in minimally conscious state (MCS). The Coma Recovery Scale-Revised (CRS-R) is the most sensitive scale to differentiate the different altered states of consciousness and eleven items detect the MCS. The aim of this study is to document the prevalence of these items. We analysed behavioural assessments of 282 patients diagnosed in MCS based on the CRS-R. Results showed that some items are particularly frequent among patients in MCS, namely fixation, visual pursuit, and reproducible movement to command, which were observed in more than 50% of patients. These responses were also the most probably observed items when the patients only showed one sign of consciousness. On the other hand, some items were rarely or never observed alone, e.g., object localisation (reaching), object manipulation, intelligible verbalisation, and object recognition. The results also showed that limiting the CRS-R assessment to the five most frequently observed items (i.e., fixation, visual pursuit, reproducible movement to command, automatic motor response and localisation to noxious stimulation) detected 99% of the patients in MCS. If clinicians have only limited time to assess patients with disorders of consciousness, we suggest to evaluate at least these five items of the CRS-R.
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Sarah
authors.initials: S
authors.lastname: Wannez
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Olivia
authors.initials: O
authors.lastname: Gosseries
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Deborah
authors.initials: D
authors.lastname: Azzolini
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Martial
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Helena
authors.initials: H
authors.lastname: Cassol
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Charlène
authors.initials: C
authors.lastname: Aubinet
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Jitka
authors.initials: J
authors.lastname: Annen
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Martens
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bodart
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Lizette
authors.initials: L
authors.lastname: Heine
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Charland-Verville
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Aurore
authors.initials: A
authors.lastname: Thibaut
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.|b Department of Neurology , Massachusetts General Hospital, Harvard Medical School , Boston , USA.
authors.forename: Camille
authors.initials: C
authors.lastname: Chatelle
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.|c Department of Algology , University Hospital of Liège , Liège , Belgium.
authors.forename: Audrey
authors.initials: A
authors.lastname: Vanhaudenhuyse
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Athena
authors.initials: A
authors.lastname: Demertzi
authors.affiliation: d Department of Neurosurgery , University of California , Los Angeles , USA.|e Research Department , Casa Colina Hospital and Centers for Healthcare , Pomona , USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Schnakers
authors.affiliation: f Biostatistic Unit, Department of Public Health , University of Liège , Liège , Belgium.
authors.forename: Anne-Françoise
authors.initials: AF
authors.lastname: Donneau
authors.affiliation: a Coma Science Group, GIGA-Consciousness and Neurology Department , University of Liège , Liège , Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Laureys
mesh_terms: D003244:Consciousness Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D005133:Eye Movements; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015995:Prevalence; D021641:Recognition, Psychology; D020127:Recovery of Function; D012189:Retrospective Studies; D013060:Speech
keywords: Coma recovery scale-revised; behavioural assessment; consciousness; minimally conscious state; severe brain injury