The vegetative and minimally conscious states: Current knowledge and remaining questions

Journal of Head Trauma Rehabilitation

Volumn 20, Issue 1, 2005, Pages 30-50

  Giacino, Joseph ^a   Whyte, John ^b  

^a JFK JOHNSON REHABILITATION INSTITUTE   (United States)

^b MOSS REHABILITATION RESEARCH INSTITUTE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

AMANTADINE; BROMOCRIPTINE; LAMOTRIGINE; METHYLPHENIDATE; TRICYCLIC ANTIDEPRESSANT AGENT;

BEHAVIOR; BEHAVIOR DISORDER; BRAIN DEPTH STIMULATION; COMA; CONCEPT FORMATION; CONSCIOUSNESS DISORDER; CONVALESCENCE; DIAGNOSTIC IMAGING; DISEASE COURSE; HEALTH CARE COST; HUMAN; HYPERBARIC OXYGEN; LEGAL ASPECT; MEDICAL DECISION MAKING; MEDICAL ETHICS; MINIMALLY CONSCIOUS STATE; MORALITY; NEUROPATHOLOGY; NUCLEAR MAGNETIC RESONANCE IMAGING; OUTCOMES RESEARCH; PATHOPHYSIOLOGY; PERSISTENT VEGETATIVE STATE; POSITRON EMISSION TOMOGRAPHY; PROGNOSIS; PUBLICATION; REVIEW; SENSORY STIMULATION; SURVIVAL; TERMINAL CARE;

EID: 13844273221     PISSN: 08859701     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001199-200501000-00005     Document Type: Review

References (92)

1. Berroll S, Rosenthal M. The persistent vegetative state. J Head Trauma Rebabil. 1986;1(1).
2. The Multi-Society Task Force Report on PVS. Medical aspects of the persistent vegetative state. N Engl J Med. 1994;330:1499-1508, 1572-1579.
3. American Congress of Rehabilitation Medicine. Recommendations for use of uniform nomenclature pertinent to persons with severe alterations in consciousness. Arch Phys Med Rebabil. 1995;76:205-209.
4. Andrews K. International Working Party on the management of the vegetative state: summary report. Brain Inj. 1996;10(11):797-806.
5. Giacino JT, Zasler ND, Katz DI, Kelly JP, Rosenberg JH, Filley CM. Development of practice guidelines for assessment and management of the vegetative and minimally conscious states. J Head Trauma Rehabil. 1997;12(4):79-89.
6. Ashwal S, Cranford R. The minimally conscious state in children. Semin Pediatr Neurol. 2002;9(1):19-34.
7. Giacino J, Ashwal S, Childs N, et al. The minimally conscious state: definition and diagnostic criteria. Neurology. 2002;58:349-353.
8. Plum F, Posner J. The Diagnosis of Stupor and Coma. Philadelphia, Pa: FA Davis; 1982.
9. Jennett B. A quarter century of the vegetative state: an international perspective. J Head Trauma Rehabil. 1997;12(4):1-12.
10. Arnould M, Vigoureux R, Vigouroux M. Etats frontiers entre la vie et la mort en neurotraumatologie. Neurocbirurgica (Stuttg). 1963;6:1-21.
11. Vapahlati M, Troupp H. Prognosis for patients with severe head injuries. Br Med J. 1971;iii:404-407.
12. Jennett B, Plum F. Persistent vegetative state after brain damage: a syndrome in search of a name. Lancet. 1972;1:734-737.
13. Childs NL, Mercer WN. Brief report: late improvement in consciousness after port-traumatic vegetative state. N Engl J Med. 1996;334(1):24-25.
14. Haig AJ, Ruess JM. Recovery from vegetative state of six months duration associated with Sinemet (levadopa/carbidopa). Arch Phys Med Rehabil. 1990;71:1081-1083.
15. Arts WFM, Van Dongen HR, Van-Hof-Van-Duin J, Lammens E. Unexpected improvement after prolonged post-traumatic vegetative state. J Neurol Neurosurg Psychiatry. 1985;48:1300-1303.
16. Shewmon DA. The minimally conscious state: definition and diagnostic criteria. Neurology. 2002;58:506-507.
17. Coleman D. The minimally conscious state: definition and diagnostic criteria. Neurology. 2002;58:506-507.
18. Adams JH, Graham DI, Jennett B. The neuropathology of the vegetative state after an acute brain insult. Brain. 2000;123(7):1327-1338.
19. Kampfl A, Schmutzhard E, Franz G, et al. Prediction of recovery from post-traumatic vegetative state with cerebral magnetic-resonance imaging. Lancet. June 13, 1998;351(9118):1763-1767.
20. Menon DK, Owen AM, Williams EJ, Minhas PS, Allen CM, Boniface SJ, Pickard JD. Cortical processing in persistent vegetative state. Lancet. July 18, 1998;352(9123):200.
21. Laureys S, Faymonville ME, Degueldre C, et al. Auditory processing in the vegetative state. Brain. 2000;123(8):1589-1601.
22. Laureys S, Faymonville ME, Peigneux P, et al. Cortical processing of noxious somatosensory stimuli in the persistent vegetative state. Neuroimage. 2002;17:732-741.
23. Schiff ND, Ribary U, Moreno DR, et al. Residual cerebral activity and behavioural fragments can remain in the persistently vegetative brain. Brain. 2002;125(Pt 6):1210-1234.
24. Jennett B, Adams JH, Murray LS, Graham DI. Neuropathology in vegetative and severely disabled patients after head injury. Neurology. 2001;56(4):486-490.
25. Jennett B, Bond MR. Assessment of outcome after severe brain damage: a practical scale. Lancet. 1975;1:480-484.
26. Laureys S, Perrin F, Faymonville M-E, et al. Cerebral processing in the minimally conscious state. Neurology. September 2004;63:916-918.
27. Boly M, Faymonville ME, Peigneux P, et al. Auditory processing in severely brain injured patients: differences between the minimally conscious state and the persistent vegetative state. Arch Neurol. 2004;61:233-238.
28. Hirsch J, Kamal A, Rodriguez-Moreno D, et al. fMRI reveals intact cognitive systems in two minimally conscious patients. Soc Neurosci Abstr. 2001;529:14.
29. Giacino J. fMRI studies of language and visual processing in the minimally conscious state. Paper presented at: 15th Annual JKF Medical Center Conference on Rebuilding Shattered Lives; November 5, 2003.
30. Jennett B, Snoek J, Bond MR, Brooks N. Disability after severe head injury: observations on the use of the Glasgow Outcome Scale. J Neurol Neurosurg Psychiatry. 1981;44:285-293.
31. Born JD, Albert A, Hans P, Bonnal J. Relative prognostic value of best motor response and brain stem reflexes in patients with severe head injury. Neurosurgery. 1985;16:595-600.
32. Shavelle RM, Strauss D, Whyte J, Day SM, Yu YL. Long-term causes of death after traumatic brain injury. Am J Phys Med Rehabil. 2001;80:510-516.
33. Higashi K, Hatano M, Abiko S, et al. Five-year follow-up study of patients with persistent vegetative state. J Neurol Neurosurg Psychiatry. 1981;44:552-554.
34. Strauss DJ, Shavell RM, Ashwal SA. Life expectancy and median survival time in the permanent vegetative state. Pediatr Neurol. 1999;21:626-631.
35. Whyte J, Katz D, DiPasquale MC, et al. Predictors of outcome and effect of psychoactive medications in prolonged posttraumatic disorders of consciousness: a multicenter study. Arch Phys Med Rehabil. In press.
36. Beck M, Smith VE. To him, it was still 1988. Newsweek. February 26, 1996;(26):56.
37. Arrillage P. Mom begins slow recovery from 16-year-long coma. The Detroit News. March 12, 2000.
38. Whyte J, Cifu D, Dikmen S, Temkin N. Prediction of functional outcomes after traumatic brain injury: a comparison of 2 measures of duration of unconsciousness. Arch Phys Med Rehabil. 2001;82:1355-1359.
39. Hans P, Albert A, Franssen C, Born J. Improved outcome prediction based on CSF extrapolated creatine kinase BB isoenzyme activity and other risk factors in severe head injury. J Neurosurg. 1989;71:54-58.
40. Fleming J, Thy B, Maas F. Prognosis of rehabilitation outcome in head injury using the Disability Rating Scale. Arch Phys Med Rehabil. 1994;75:156-163.
41. Judson JA, Cant BR, Shaw NA. Early prediction of outcome from cerebral trauma by somatosensory evoked potentials. Crit Care Med. 1990;18:363-368.
42. Shin DY, Ehrenberg B, Whyte J, Bach J, DeLisa JA. Evoked potential assessment: utility in prognosis of chronic head injury. Arch Phys Med Rehabil. 1989;70(3):189-193.
43. Lew HL, Dikmen S, Slimp J, et al. Use of somatosensory-evoked potentials and cognitive event-related potentials in predicting outcomes of patients with severe traumatic brain injury. Am J Phys Med Rehabil. 2003;82(1):53-61.
44. Brenner T, Freier MC, Holshouser BA, Burley T, Ashwal S. Predicting neuropsychological outcome after traumatic brain injury in children. Pediatr Neurol. 2003;28(2):104-114.
45. Garnett MR, Cadoux-Hudson TA, Styles P. How useful is magnetic resonance imaging in predicting severity and outcome in traumatic brain injury? Curr Opin Neurol. 2001;14(6):753-757.
46. Giacino JT, Kezmarsky MA, DeLuca J, Cicerone KD. Monitoring rate of recovery to predict outcome in minimally-responsive patients. Arch Phys Med Rehabil. 1991;72:897-901.
47. Andrews K, Murphy L, Munday R, Littfewood C. Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit. Br Med J. 1996;313(7048):13-16.
48. Childs NL, Mercer WN, Childs HW. Accuracy of diagnosis of persistent vegetative state. Neurology. 1993;43(8):1465-1467.
49. Giacino JT, Kalmar K, Whyte J. The JFK Coma Recovery Scale - Revised: measurement characteristics and diagnostic utility. Arch Phys Med Rehabil. 2004;85(12):2020-2029.
50. Rappaport M, Dougherty AM, Kelting DL. Evaluation of coma and vegetative states. Arch Phys Med Rehabil. 1992;73:628-634.
51. Ansell BJ, Keenan JE. The Western Neuro Sensory Stimulation Profile: a tool for assessing slow-to-recover head-injured patients. Arch Phys Med Rehabil. 1989;70:104-108.
52. DiPasquale M, Whyte J. The use of quantitative data in treatment planning for minimally responsive patients. J Head Trauma Rehabil. 1996;11(6):9-17.
53. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. Lancet. 1974;2:81-84.
54. Starmark JE, Stalhammar D, Holmgren E. The Reaction Level Scale: manual and guidelines. Acta Neurochir. 1998;91:12-20.
55. Hagan C, Malkmus D, Durham P. Levels of Cognitive Function. Rehabilitation of the Head Injured Adult: Comprehensive Physical Management. Downey, CA: Professional Staff Association of Rancho Los Amigos Hospital, Inc; 1979.
56. Rappaport M, Hall KM, Hopkins K, Belleza T, Cope DN. Disability Rating Scale for severe head trauma: coma to community. Arch Phys Med Rehabil. 1982;63:118-123.
57. Stanczak DE, White JG, Gouvier WD, et al. Assessment of level of consciousness following severe neurological insult: a comparison of the psychometric qualities of the Glasgow Coma Scale and the Comprehensive Level of Consciousness Scale. J Neurosurg. 1984;60:955-960.
58. Talbot LR, Whitaker HA. Brain injured persons in an altered state of consciousness: measures and intervention strategies. Brain Inj. 1994;8(8):689-699.
59. Giacino JT, Kalmar K. The vegetative and minimally conscious states: a comparison of clinical features and functional outcome. J Head Trauma Rehabil. 1997;12(4):36-51.
60. Giacino JT, Trott C. Rehabilitative management of patients with disorders of consciousness: grand rounds. J Head Trauma Rehabil. 2004;19(3):262-273.
61. Rader MA, Alston JB, Ellis DW. Sensory stimulation of severely brain injured patients. Brain Inj. 1989;3:141-147.
62. Rader M, Ellis D. The Sensory Stimulation Assessment Measure (SSAM): a tool for early evaluation of severely brain-injured patients. Brain Inj. 1994;8(4):309-324.
63. Gill-Thwaites H. The Sensory Modality Assessment Rehabilitation Technique- a tool for assessment and treatment of patients with severe brain injury in a vegetative state. Brain Inj. 1997;10:723-724.
64. Gill-Thwaites H, Munday R. The Sensory Modality Assessment Rehabilitation Technique (SMART): a valid and reliable assessment for vegetative state and minimally conscious state patients. Brain Inj. 2004;18(12):1255-1270.
65. Wilson SL, Gill-Thwaites H. Early indications of emergence from vegetative state derived from assessment with the SMART - a preliminary report. Brain Inj. 2000;14(4):319-331.
66. Wilson SL, Powell GE, Elliott K, Thwaites H. Sensory stimulation in prolonged coma: four single case studies. Brain Inj. 1991;4(5):393-400.
67. Horn S, Watson M, Wilson BA, McLellan DL. The development of new techniques in the assessment and monitoring of recovery from severe head injury: a preliminary report and case history. Brain Inj. 1992;6(4):321-325.
68. Majerus S, Van der Linden M, Sheil A. Wessex Head Injury Matrix and Glasgow/Glasgow-Liege Coma Scale: a validation and comparison study. Neuropsychol Rehabil. 2000;10(2):167-184.
69. Patrick PD, Buck ML, Conaway MR, Blackman JA. The use of dopamine enhancing medications with children in low response states following brain injury. Brain Inj. 2003;17(6):497-506.
70. Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. How to Practice and Teach EBM. New York: Churchill Livingstone; 2000.
71. Whyte J, DiPasquale M. Assessment of vision and visual attention in minimally responsive brain injured patients. Arch Phys Med Rehabil. 1995;76(9):804-810.
72. Whyte J, DiPasquale M, Vaccaro M. Assessment of command-following in minimally conscious brain injured patients. Arch Phys Med Rehabil. 1999;80:1-8.
73. Whyte J, Laborde A, DiPasquale MC. Assessment and treatment of the vegetative and minimally conscious patient. In: Rosenthal M, Griffith ER, Kreutzer JS, Pentland B, eds. Rehabilitation of the Adult and Child With Traumatic Brain Injury. Philadelphia, Pa: FA Davis; 1999:435-452.
74. Giacino J. Rehabilitation of patients with disorders of consciousness: an evidence-based review. In: High W, Hart K, eds. Rehabilitation Interventions Following TBI: State of the Science. New York: Oxford University Press. In press.
75. Meythaler JM, Brunner RC, Johnson A, Novack TA. Amantadine to improve neurorecovery in traumatic brain injury-associated diffuse axonal injury: a pilot double-blind randomized trial. J Head Trauma Rehabil. 2002;17(4):300-313.
76. Passler MA, Riggs RV. Positive outcomes in traumatic brain injury-vegetative state: patients treated with bromocriptine. Arch Phys Med Rehabil. 2001;82(3):311-315.
77. Reinhard DL, Whyte J, Sandel ME. Improved arousal and initiation following tricyclic antidepressant use in severe brain injury. Arch Phys Med Rehabil. 1996;77:80-83.
78. Chatham-Showalter PE, Netsky-Kimmel D. Stimulating consciousness and cognition following severe brain injury: a new potential clinical use for lamotrigine. Brain Inj. 2000;14(11):997-1001.
79. Mitchell S, Bradley VA, Welch JL, et al. Coma arousal procedure: a therapeutic intervention in the treatment of head injury. Brain Inj. 1990;3:273-279.
80. Pierce JP, Lyle DM, Quine S, et al. The effectiveness of coma arousal intervention. Brain Inj. 1990;4(2):191-197.
81. Mackay LE, Bernstein BB, Chapman PE, Morgan AS, Milazzo LS. Early intervention in severe head injury: long-term benefits of a formalized program. Arch Phys Med Rehabil. 1992;73:635-641.
82. Rockswold GL, Ford SE, Anderson DC, Bergman TA, Sherman RE. Results of a prospective randomized trial for treatment of severely brain-injured patients with hyperbaric oxygen. J Neurosurg. 1992;76:929-934.
83. Tsubokawa T, Yamamoto T, Katayama Y, Hirayama T, Maljima S, Moriya T. Deep-brain stimulation in a persistent vegetative state: follow-up results and criteria for selection of candidates. Brain Inj. 1990;4:315-327.
84. Yamamoto T, Katayama Y, Oshima H, Fukaya C, Kawamata T, Tsubokawa T. Deep brain stimulation therapy for a persistent vegetative state. Acta Neurochir. 2001;79(suppl):79-82.
85. Danis M, Garrett J, Haris R, Paternik DL. Stability of choices about life-sustaining treatments. Ann Intern Med. 1994;120:567-573.
86. Phipps E, Whyte J. Medical decision-making with persons who are minimally conscious. Am J Phys Med Rehabil. 1999;78(1):77-82.
87. McMillan TM. Neuropsychological assessment after extremely severe head injury in a case of life or death. Brain Inj. 1996;11:483-490.
88. McMillan TM, Herbert CM. Neuropsychological assessment of a potential "euthanasia" case: a 5 year follow up. Brain Inj. 2000;14(2):197-203.
89. Catholic Bishops of Pennsylvania. Statement on Nutrition and Hydration (Revised): Moral Considerations. Harrisburg, PA. 1999.
90. Gostin LO. Deciding life and death in the courtroom: From Quinlan to Cruzan, Glucksberg, and Vacco- A brief history and analysis of constitutional protection of the "right to die." JAMA. 1997;278(18):1523-1529.
91. Giacino J. Clinical diagnosis of patients in the vegetative and minimally conscious states. Paper presented at: International Congress on Life-Sustaining Treatments and the Vegetative State; March 19, 2004; Rome, Italy.
92. Pope John Paul II. Life-sustaining treatments and the vegetative state: Scientific advances and ethical dilemmas. Available at: http://www. vegetativestate.org/discorso_papa.htm. Accessed September 25, 2004.