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New outcomes reported for patients in the minimallly conscious state and those in the persistent vegetative state

By Michael Kaplen

Results of 2 new studies provide valuable new information on the prognosis of minimally conscious (MCS) and vegetative states (VS).

The reports will appear in the July 20th issue of the Journal Neurology.

A retrospective study was utilized to examine long-term outcomes of MCS and VS patients up to 5 years after injury and found that in contrast to the VS patients, one third of MCS patients improved more than a year after coma onset.

"This emphasizes the need to define reliable boundaries between VS and MCS using repeated clinical evaluations, and all imaging and neurophysiologic tools available today," the authors conclude.

Vegetative state of wakefulness without awareness was first described in 1972 by Jennett and Plum  The minimally conscious state (MCS), formerly and more accurately called the minimally responsive state, was defined diagnostically in 2002 as profound unresponsiveness despite nominal and intermittent evidence of awareness.

In cases of individuals in the vegetative state following a  traumatic brain injury, the authors report that although the outcome for recovery is poor, the chances are better for this group of patients as compared to those who are in this state from other causes.

The unexpectedly high rates of recovery of responsiveness and consciousness, albeit with severe impairments, may have important ethical implications, the study authors conclude.

The present follow-up study demonstrates the necessity of long-term monitoring for patients with chronic disorders of consciousness and of new research on specific interventions in the hope of promoting recovery from VS or MCS, according to the authors.  "Multicenter, prospective studies on large cohorts of patients are needed to answer the questions about the evolution, management, and care of long-lasting VS and MCS renewed by the present study."

Full post as published by Brain Injury News and Information on June 20, 2010 (boomark / email).