ArticleJournal of neurology2021
Early discrimination of cognitive motor dissociation from disorders of consciousness: pitfalls and clues.
Article in Journal of neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Deep Brain Stimulation for Disorders of Consciousness: From Mesocircuit Mechanisms to Circuit-Guided Precision Neuromodulation.Neuroscience bulletin · 2026Review
- Multisensory integration in peripersonal space indexes consciousness states in sleep and disorders of consciousness.Cell reports. Medicine · 2026Article
- Detection of EEG dynamic complex patterns in disorders of consciousness.Communications biology · 2025Article
- Cortical signatures linked to behavior quantitatively track arousal levels.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- The Role of Life History Questionnaires in Defining Individualised Goals of Care for Clinical Cognitive Motor Dissociation Patients: A Pilot Study.Brain sciences · 2025Article
- Explaining recovery from coma with multimodal neuroimaging.Journal of neurology · 2024Observational
- Brain-Computer Interfaces for Communication in Patients with Disorders of Consciousness: A Gap Analysis and Scientific Roadmap.Neurocritical care · 2024Review
- Research considerations for prospective studies of patients with coma and disorders of consciousness.Brain communications · 2024Review
- A Focus on Subtle Signs and Motor Behavior to Unveil Awareness in Unresponsive Brain-Impaired Patients: The Importance of Being Clinical.Neurology · 2023Article
- A Biopsychosocial Evaluation of Post-Acute Outcome of Patients with Severe Brain Lesions Recovering from Coma: An Exploratory Study.Journal of clinical medicine · 2023Article
- EEG complexity correlates with residual consciousness level of disorders of consciousness.BMC neurology · 2023Article
- Early Neurorehabilitation and Recovery from Disorders of Consciousness After Severe COVID-19.Neurocritical care · 2022Article
- Clinical Cognitive Motor Dissociation: A Case Report Showing How Pitfalls Can Hinder Early Clinical Detection of Awareness.Brain sciences · 2022Article
- When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Neurobehavioral Progress.Brain sciences · 2021Article
- Editorial: New Advances in Diagnostic Tools and Rehabilitation of Disorders of Consciousness in the Acute Phase.Frontiers in neurology · 2021Article
- Importance, limits and caveats of the use of "disorders of consciousness" to theorize consciousness.Neuroscience of consciousness · 2021Review
- Discriminating cognitive motor dissociation from disorders of consciousness using structural MRI.NeuroImage. Clinical · 2021Article
- When, How, and to What Extent Are Individuals with Unresponsive Wakefulness Syndrome Able to Progress? Functional Independence.Brain sciences · 2020Article
- Covert Cognition in Disorders of Consciousness: A Meta-Analysis.Brain sciences · 2020Article
- Robust alternative to the righting reflex to assess arousal in rodents.Scientific reports · 2020Article
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8 authors.
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Abstract
Bedside assessment of consciousness and awareness after a severe brain injury might be hampered by confounding clinical factors (i.e., pitfalls) interfering with the production of behavioral or motor responses to external stimuli. Despite the use of validated clinical scales, a high misdiagnosis rate is indeed observed. We retrospectively analyzed a cohort of 49 patients with severe brain injury admitted to an acute neuro-rehabilitation program. Patients' behavior was assessed using the Motor Behavior Tool and Coma Recovery Scale Revised. All patients underwent systematic assessment for pitfalls including polyneuropathy and/or myopathy and/or myelopathy, major cranial nerve palsies, non-convulsive status epilepticus, aphasia (expressive or comprehensive), cortical blindness, thalamic involvement and frontal akinetic syndrome. A high prevalence (75%) of pitfalls potentially interfering with sensory afference (polyneuropathy, myopathy, myelopathy, and sensory aphasia), motor efference (polyneuropathy, myopathy, motor aphasia, and frontal akinetic syndrome), and intrinsic brain activity (thalamic involvement and epilepsy) was found. Nonetheless, the motor behavior tool identified residual cognition (i.e. a cognitive motor dissociation condition) regardless of the presence of these pitfalls in 70% of the patients diagnosed as unresponsive using the Coma Recovery Scale Revised. On one hand, pitfalls might contribute to misdiagnosis. On the other, it could be argued that they are clues for diagnosing cognitive motor dissociation rather than true disorders of consciousness given their prominent effect on the sensory-motor input-output balance.
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