Recovery from disorders of consciousness: mechanisms, prognosis and emerging therapies. Review uri icon

Overview

abstract

  • Substantial progress has been made over the past two decades in detecting, predicting and promoting recovery of consciousness in patients with disorders of consciousness (DoC) caused by severe brain injuries. Advanced neuroimaging and electrophysiological techniques have revealed new insights into the biological mechanisms underlying recovery of consciousness and have enabled the identification of preserved brain networks in patients who seem unresponsive, thus raising hope for more accurate diagnosis and prognosis. Emerging evidence suggests that covert consciousness, or cognitive motor dissociation (CMD), is present in up to 15-20% of patients with DoC and that detection of CMD in the intensive care unit can predict functional recovery at 1 year post injury. Although fundamental questions remain about which patients with DoC have the potential for recovery, novel pharmacological and electrophysiological therapies have shown the potential to reactivate injured neural networks and promote re-emergence of consciousness. In this Review, we focus on mechanisms of recovery from DoC in the acute and subacute-to-chronic stages, and we discuss recent progress in detecting and predicting recovery of consciousness. We also describe the developments in pharmacological and electrophysiological therapies that are creating new opportunities to improve the lives of patients with DoC.

publication date

  • December 14, 2020

Research

keywords

  • Consciousness
  • Consciousness Disorders
  • Electric Stimulation Therapy
  • Recovery of Function

Identity

PubMed Central ID

  • PMC7734616

Scopus Document Identifier

  • 85101436191

Digital Object Identifier (DOI)

  • 10.1038/s41582-020-00428-x

PubMed ID

  • 33318675

Additional Document Info

volume

  • 17

issue

  • 3