Modern intensive care medicine has greatly increased the rates of survival after severe
brain injury (BI). Nonetheless, a number of patients fail to fully recover from coma,
and awaken to a disorder of consciousness (DOC) such as the vegetative state (VS)
or the minimally conscious state (MCS) [
[1]
]. In these conditions, which can be transient or last indefinitely, patients can lose
virtually all autonomy and have almost no treatment options [
1
,
2
]. In addition, these conditions place great emotional and financial strain on families,
lead to increased burn-out rates among care-takers, impose financial stress on medical
structures and public finances due to the costs of prolonged intensive care, and raise
difficult legal and ethical questions [
[3]
].To read this article in full you will need to make a payment
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References
- The vegetative state.Br Med J. 2000; 341: c3765
- Placebo-controlled trial of amantadine for severe traumatic brain injury.N Engl J Med. 2012; 366: 819-826
- Brain function and responsiveness in disorders of consciousness.Springer International Publishing, Switzerland2016
- Recovery of consciousness after brain injury: a mesocircuit hypothesis.Trends Neurosci. 2010; 33: 1-9
- Behavioural improvements with thalamic stimulation after severe traumatic brain injury.Nature. 2007; 448: 600-603
- tDCS in patients with disorders of consciousness Sham-controlled randomized double-blind study.Neurology. 2014; 82: 1112-1118
- Transcranial focused ultrasound to the thalamus alters anesthesia time in rats.Neuroreport. 2011; 22: 783
- A review of low-intensity focused ultrasound pulsation.Brain Stimul. 2011; 4: 125-136
- Transcranial focused ultrasound modulates the activity of primary somatosensory cortex in humans.Nat Neurosci. 2014; 17: 322-329
- The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility.Arch Phys Med Rehabil. 2004; 85: 2020-2029
Article info
Publication history
Published online: July 22, 2016
Received:
July 7,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.