Neurobehavioral Bedside Assessment of Person with DOC: Caveats, Challenges and Novelties

Summary

The last several decades have marked a new era in the field of Disorders of Consciousness (DoC). Thanks to the impressive number of neuroimaging studies performed in the last decades, our better understanding of brain lesions and dysfunctions presented by DOC patients have allowed us to refine diagnosis criteria and define new clinical entities (such as MCS+, MCS- and CMD). Multi-center studies with larger sample sizes are now taking place, gathering precious longitudinal and often surprising information on recovery. The findings of these studies including those patients with severe brain injuries have better outcomes than previously thought has already caused a mind shift in the field. National and international organizations, such as the American Congress of Rehabilitation Medicine (ACRM) and the International Brain Injury Association (IBIA), have created special interest groups dedicated to the study of DoC, creating a worldwide network of experts, and coordinating research efforts faster than ever before. Such platforms have led to the development of the first evidence-based guidelines for diagnosis, prognosis, and treatment of patients with DoC. This is a first step, and more investigations are needed to validate these guidelines; however, they represent a milestone in the field and will, hopefully, help clinicians to better manage such pathology when they face it. Finally, even though the most sensitive and valid scale to diagnose patients with DoC is still currently the CRS-R, this last decade has been fruitful in developing more specialized tools to assess patients, particularly, regarding residual cognition and pain. Such development is particularly crucial since it offers clinicians more options to better diagnose as well as improve treatment for patients with DoC.

Speakers

Caveats and challenges of Bedside assessments in DOC
Katherine O’Brien, USA

Pain Monitoring in DOC Patients
Ingrid Poulsen, Denmark

Assessing Language in Severely Brain Injured Patients
Amy Pundole, UK

Moderator (Intro + Q&A)

Caroline Schnakers, USA