Recovery in cognitive motor dissociation after severe brain injury: A cohort study.

Details

Serval ID
serval:BIB_A919E3EBC98E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Recovery in cognitive motor dissociation after severe brain injury: A cohort study.
Journal
PloS one
Author(s)
Jöhr J., Halimi F., Pasquier J., Pincherle A., Schiff N., Diserens K.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2020
Peer-reviewed
Oui
Volume
15
Number
2
Pages
e0228474
Language
english
Notes
Publication types: Clinical Trial ; Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
To investigate the functional and cognitive outcomes during early intensive neurorehabilitation and to compare the recovery patterns of patients presenting with cognitive motor dissociation (CMD), disorders of consciousness (DOC) and non-DOC.
We conducted a single center observational cohort study of 141 patients with severe acquired brain injury, consecutively admitted to an acute neurorehabilitation unit. We divided patients into three groups according to initial neurobehavioral diagnosis at admission using the Coma Recovery Scale-Revised (CRS-R) and the Motor Behavior Tool (MBT): potential clinical CMD, [N = 105]; DOC [N = 19]; non-DOC [N = 17]). Functional and cognitive outcomes were assessed at admission and discharge using the Glasgow Outcome Scale, the Early Rehabilitation Barthel Index, the Disability Rating Scale, the Rancho Los Amigos Levels of Cognitive Functioning, the Functional Ambulation Classification Scale and the modified Rankin Scale. Confirmed recovery of conscious awareness was based on CRS-R criteria.
CMD patients were significantly associated with better functional outcomes and potential for improvement than DOC. Furthermore, outcomes of CMD patients did not differ significantly from those of non-DOC. Using the CRS-R scale only; approximatively 30% of CMD patients did not recover consciousness at discharge.
Our findings support the fact that patients presenting with CMD condition constitute a separate category, with different potential for improvement and functional outcomes than patients suffering from DOC. This reinforces the need for CMD to be urgently recognized, as it may directly affect patient care, influencing life-or-death decisions.
Keywords
Adult, Brain Injuries/complications, Cognition Disorders/etiology, Cognition Disorders/rehabilitation, Cohort Studies, Consciousness Disorders/etiology, Consciousness Disorders/rehabilitation, Female, Humans, Length of Stay/statistics & numerical data, Male, Middle Aged, Patient Discharge/statistics & numerical data, Prognosis, Recovery of Function
Pubmed
Web of science
Open Access
Yes
Create date
06/02/2020 18:05
Last modification date
16/04/2021 6:35
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