Neurorehabilitation in disorders of consciousness

Seminars in Neurology

Volumn 33, Issue 2, 2013, Pages 142-156

  Giacino, Joseph T ^a,b   Katz, Douglasi ^c,d   Whyte, John ^e  

^a HARVARD MEDICAL SCHOOL   (United States)

^b and Red Sox Foundation and Massachusetts General Hospital Home Base Program   (United States)

^c BOSTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

^d Acquired Brain Injury Program   (United States)

^e MOSS REHABILITATION RESEARCH INSTITUTE   (United States)

Author keywords

disorders of consciousness; minimally conscious state; outcome; rehabilitation; vegetative state

Indexed keywords

AMANTADINE; APOMORPHINE; BACLOFEN; BOTULINUM TOXIN; BROMOCRIPTINE; DOPAMINE RECEPTOR STIMULATING AGENT; LEVODOPA; METHYLPHENIDATE; METOCLOPRAMIDE; PLACEBO; PRAMIPEXOLE; ZOLPIDEM;

ACQUIRED BRAIN INJURY; ALZHEIMER DISEASE; AMNESIA; ARTICLE; BEHAVIOR CHANGE; BRAIN DEPTH STIMULATION; CLINICAL ASSESSMENT; COGNITIVE REHABILITATION; COMA; CONFUSION; CONSCIOUSNESS; CONSCIOUSNESS DISORDER; CONSCIOUSNESS LEVEL; CONTRACTURE; DIAGNOSTIC ACCURACY; DIAGNOSTIC ERROR; DIFFERENTIAL DIAGNOSIS; DRUG DOSE ESCALATION; ELECTROENCEPHALOGRAM; FOLLOW UP; FUNCTIONAL MAGNETIC RESONANCE IMAGING; GLASGOW COMA SCALE; HEALTH CARE SYSTEM; HETEROTOPIC OSSIFICATION; HUMAN; MINIMALLY CONSCIOUS STATE; MORTALITY; MUSCLE HYPERTONIA; NEUROLOGIC EXAMINATION; NEUROMODULATION; OUTCOME ASSESSMENT; PERSISTENT VEGETATIVE STATE; POSTTRAUMATIC AMNESIA; POSTTRAUMATIC COMPLICATION; PRIORITY JOURNAL; PROGNOSIS; SEIZURE; SENSORY STIMULATION; SPASTICITY; STOMACH PARESIS; TRANSCRANIAL DIRECT CURRENT STIMULATION; TRANSCRANIAL MAGNETIC STIMULATION; TRAUMATIC BRAIN INJURY;

EID: 84881109921     PISSN: 02718235     EISSN: 10989021     Source Type: Journal    
DOI: 10.1055/s-0033-1348960     Document Type: Article

References (106)

1. Stuss D. T., Binns M. A., Carruth F. G., et al. The acute period of recovery from traumatic brain injury: posttraumatic amnesia or posttraumatic confusional state? J Neurosurg: 1999; 90 4 635 643 (Pubitemid 29152850)
2. Katz D. I., Polyak M., Coughlan D., Nichols M., Roche A. Natural history of recovery from brain injury after prolonged disorders of consciousness: outcome of patients admitted to inpatient rehabilitation with 1-4 year follow-up. Prog Brain Res: 2009; 177 73 88
3. Sherer M., Yablon S. A., Nakase-Richardson R. Patterns of recovery of posttraumatic confusional state in neurorehabilitation admissions after traumatic brain injury. Arch Phys Med Rehabil: 2009; 90 10 1749 1754
4. Plum F. PJ. The diagnosis of stupor and coma. 3rd ed. Philadelphia, PA F.A. Davis: 1982
5. Medical aspects of the persistent vegetative state (1). The Multi-Society Task Force on PVS. N Engl J Med: 1994; 330 21 1499 1508
6. Giacino J. T., Zasler N. D., Katz D. I., Kelly J. P., Rosenberg J. H., Filley C. M. Development of practice guidelines for assessment and management of the vegetative and minimally conscious states. J Head Trauma Rehabil: 1997; 12 79 89 (Pubitemid 27390158)
7. Laureys S. CG, Cohadon F., Lavrijsen J., et al. The European Task Force on Disorders of Consciousness. Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome. BMC Med: 2010; 8 6 8
8. The Quality Standards Subcommittee of the American Academy of Neurology Practice parameters: assessment and management of patients in the persistent vegetative state (summary statement). Neurology: 1995; 45 5 1015 1018
9. Giacino J. T., Ashwal S., Childs N., et al. The minimally conscious state: definition and diagnostic criteria. Neurology: 2002; 58 3 349 353 (Pubitemid 34150906)
10. Povlishock J. T., Katz D. I. Update of neuropathology and neurological recovery after traumatic brain injury. J Head Trauma Rehabil: 2005; 20 1 76 94 (Pubitemid 40250687)
11. Nakase-Richardson R., Yablon S. A., Sherer M., Evans C. C., Nick T. G. Serial yes/no reliability after traumatic brain injury: implications regarding the operational criteria for emergence from the minimally conscious state. J Neurol Neurosurg Psychiatry: 2008; 79 2 216 218 (Pubitemid 351236562)
12. Teasdale G., Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet: 1974; 2 7872 81 84
13. American Congress of Rehabilitation Medicine, Brain Injury- Interdisciplinary Special Interest Group, Disorders of Consciousness Task Force, et al. Assessment scales for disorders of consciousness: evidence-based recommendations for clinical practice and research. Arch Phys Med Rehabil: 2010; 91 12 1795 1813
14. Giacino J. T., Kalmar K., Whyte J. The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility. Arch Phys Med Rehabil: 2004; 85 12 2020 2029 (Pubitemid 39593531)
15. Wilde E. AWG, Whiteneck G. G., Bogner J., et al. Recommendations for the use of common outcome measures in traumatic brain injury research. Arch Phys Med Rehabil: 2010; 91 11 1650 1660, e17
16. Schnakers C. MS, Majerus S., Giacino J., et al. A French validation study of the Coma Recovery Scale-Revised (CRS-R). Brain Inj: 2008; 22 10 786 792
17. Smart C. M., Giacino J. T., Cullen T., et al. A case of locked-in syndrome complicated by central deafness. Nat Clin Pract Neurol: 2008; 4 8 448 453
18. Coleman M. R., Davis M. H., Rodd J. M., et al. Towards the routine use of brain imaging to aid the clinical diagnosis of disorders of consciousness. Brain: 2009; 132 Pt 9 2541 2552
19. Newcombe V. FWG, Williams G. B., Scoffings D., et al. Aetiological differences in neuroanatomy of the vegetative state: insights from diffusion tensor imaging and functional implications. J Neurol Neurosurg Psychiatry: 2010; 81 5 552 561
20. Giacino J. T., Kalmar K. A. The vegetative and minimally conscious states: a comparison of clinical features and functional outcome during the first year post-injury. J Head Trauma Rehabil: 1997; 12 4 36 51 (Pubitemid 27390155)
21. Vanhaudenhuyse A., Schnakers C., Brédart S., Laureys S. Assessment of visual pursuit in post-comatose states: use a mirror. J Neurol Neurosurg Psychiatry: 2008; 79 2 223 (Pubitemid 351236565)
22. Schnakers C., Hustinx R., Vandewalle G., et al. Measuring the effect of amantadine in chronic anoxic minimally conscious state. J Neurol Neurosurg Psychiatry: 2008; 79 2 225 227 (Pubitemid 351236567)
23. Schiff N. D., Giacino J. T., Kalmar K., et al. Behavioural improvements with thalamic stimulation after severe traumatic brain injury. Nature: 2007; 448 7153 600 603 (Pubitemid 47206940)
24. DiPasquale M. C., Whyte J. The use of quantitative data in treatment planning for minimally conscious patients. J Head Trauma Rehabil: 1996; 11 6 9 17 (Pubitemid 27011239)
25. Whyte J., Dipasquale M. C., Vaccaro M. Assessment of command-following in minimally conscious brain injured. Arch Phys Med Rehabil: 1999; 80 653 660 (Pubitemid 29269647)
26. Schnakers C., Vanhaudenhuyse A., Giacino J., et al. Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment. BMC Neurol: 2009; 9 35
27. Andrews K., Murphy L., Munday R., Littlewood C. Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit. BMJ: 1996; 313 7048 13 16 (Pubitemid 26229881)
28. Childs N. L., Mercer W. N., Childs H. W. Accuracy of diagnosis of persistent vegetative state. Neurology: 1993; 43 8 1465 1467 (Pubitemid 23230525)
29. Tresch D. D., Sims F. H., Duthie E. H., Goldstein M. D., Lane P. S. Clinical characteristics of patients in the persistent vegetative state. Arch Intern Med: 1991; 151 5 930 932
30. Giacino J. T., Schnakers C., Rodriguez-Moreno D., Kalmar K., Schiff N., Hirsch J. Behavioral assessment in patients with disorders of consciousness: gold standard or fool's gold? Prog Brain Res: 2009; 177 33 48
31. Soddu A., Boly M., Nir Y., et al. Reaching across the abyss: recent advances in functional magnetic resonance imaging and their potential relevance to disorders of consciousness. Prog Brain Res: 2009; 177 261 274
32. Goldfine A. M., Victor J. D., Conte M. M., Bardin J. C., Schiff N. D. Determination of awareness in patients with severe brain injury using EEG power spectral analysis. Clin Neurophysiol: 2011; 122 11 2157 2168
33. Schiff N. D., Rodriguez-Moreno D., Kamal A., et al. fMRI reveals large-scale network activation in minimally conscious patients. Neurology: 2005; 64 3 514 523 (Pubitemid 40189872)
34. Owen A. M., Coleman M. R., Boly M., Davis M. H., Laureys S., Pickard J. D. Detecting awareness in the vegetative state. Science: 2006; 313 5792 1402 (Pubitemid 44360261)
35. Monti M. M., Vanhaudenhuyse A., Coleman M. R., et al. Willful modulation of brain activity in disorders of consciousness. N Engl J Med: 2010; 362 7 579 589
36. Migraine: clinical characteristics, epidemiology, and comorbidity. Headache: 2004; 44 628 632
37. Bardin J. C., Fins J. J., Katz D. I., et al. Dissociations between behavioural and functional magnetic resonance imaging-based evaluations of cognitive function after brain injury. Brain: 2011; 134 Pt 3 769 782
38. Ashwal S., Cranford R. Medical aspects of the persistent vegetative state-a correction. The Multi-Society Task Force on PVS. N Engl J Med: 1995; 333 2 130
39. Luauté J., Maucort-Boulch D., Tell L., et al. Long-term outcomes of chronic minimally conscious and vegetative states. Neurology: 2010; 75 3 246 252
40. Estraneo A., Moretta P., Loreto V., Lanzillo B., Santoro L., Trojano L. Late recovery after traumatic, anoxic, or hemorrhagic long-lasting vegetative state. Neurology: 2010; 75 3 239 245
41. Nakase-Richardson R. WJ, Giacino J. T., et al. Longitudinal outcome of patients with disordered consciousness in the NIDRR TBI Model Systems programs. J Neurotrauma: 2012; 29 1 59 65
42. Volker J., Semih A., Sebastian G., et al. System development for spectroscopic optical coherence tomography. Biomed Tech (Berl): 2012
43. Childs N. L., Mercer W. N. Brief report: late improvement in consciousness after post-traumatic vegetative state. N Engl J Med: 1996; 334 1 24 25 (Pubitemid 26012500)
44. Rappaport M., Hall K. M., Hopkins K., Belleza T., Cope D. N. Disability rating scale for severe head trauma: coma to community. Arch Phys Med Rehabil: 1982; 63 3 118 123 (Pubitemid 12190593)
45. Fischer C., Luauté J., Adeleine P., Morlet D. Predictive value of sensory and cognitive evoked potentials for awakening from coma. Neurology: 2004; 63 4 669 673 (Pubitemid 39100823)
46. Nakase-Richardson R., Whyte J., Giacino J. T., et al. Longitudinal outcome of patients with disordered consciousness in the NIDRR TBI Model Systems programs. J Neurotrauma: 2012; 29 1 59 65
47. Lammi M. H., Smith V. H., Tate R. L., Taylor C. M. The minimally conscious state and recovery potential: a follow-up study 2 to 5 years after traumatic brain injury. Arch Phys Med Rehabil: 2005; 86 4 746 754 (Pubitemid 40487842)
48. Hamilton B. BGC, Sherwin F. S., Zielezny M., Tashman J. S. A Uniform National Data System for Medical Rehabilitation. Baltimore, MD Brooks: 1987
49. Whyte J., Nakase-Richardson R., Hammond F., et al. Functional outcomes in traumatic disorders of consciousness: 5-year outcomes from NIDRR traumatic brain injury model systems. Arch Phys Med Rehabil, in press
50. Giacino J. T., Whyte J., Bagiella E., et al. Placebo-controlled trial of amantadine for severe traumatic brain injury. N Engl J Med: 2012; 366 9 819 826
51. Whyte J., Myers R. Incidence of clinically significant responses to zolpidem among patients with disorders of consciousness: a preliminary placebo controlled trial. Am J Phys Med Rehabil: 2009; 88 5 410 418
52. Whyte J., Ponsford J., Watanabe T., Hart T. Traumatic brain injury. In: DeLisa J. A., ed. Physical Medicine and Rehabilitation: Principles and Practice. Philadelphia, PA Lippincott, Williams & Wilkins: 2010; 575 624
53. Whyte J., Nordenbo A., Kalmar K., et al. Medical complications during inpatient rehabilitation among patients with traumatic disorders of consciousness. Arch Phys Med Rehabil, in press
54. Schnakers C., Chatelle C., Vanhaudenhuyse A., et al. The Nociception Coma Scale: a new tool to assess nociception in disorders of consciousness. Pain: 2010; 148 2 215 219
55. Wang M. C., Temkin N. R., Deyo R. A., Jurkovich G. J., Barber J., Dikmen S. Timing of surgery after multisystem injury with traumatic brain injury: effect on neuropsychological and functional outcome. J Trauma: 2007; 62 5 1250 1258 (Pubitemid 46742986)
56. Latronico N., Bolton C. F. Critical illness polyneuropathy and myopathy: a major cause of muscle weakness and paralysis. [Review] Lancet Neurol: 2011; 10 10 931 941
57. Shavelle R. M., Strauss D., Whyte J., Day S. M., Yu Y. L. Long-term causes of death after traumatic brain injury. Am J Phys Med Rehabil: 2001; 80 7 510 516, quiz 517-519 (Pubitemid 32574611)
58. McNamee S., Howe L., Nakase-Richardson R., Peterson M. Treatment of disorders of consciousness in the Veterans Health Administration polytrauma centers. J Head Trauma Rehabil: 2012; 27 4 244 252
59. Eifert B., Maurer-Karattup P., Schorl M. Integration of intensive care treatment and neurorehabilitation in patients with disorders of consciousness. Arch Phys Med Rehabil, in press
60. The Mohonk Report: Disorders of Consciousness: Assessment, Treatment and Research Needs: A Report to Congress. 2006. Available at: http://www. northeastcenter.com/the-mohonk-report-disorders-of-consciousness-assessment- treatment-research-needs.pdf. Accessed October 23, 2012
61. Medical aspects of the persistent vegetative state (2). The Multi-Society Task Force on PVS. N Engl J Med: 1994; 330 22 1572 1579
62. The Multi-Society Task Force on PVS The Multi-Society Task Force Report on PVS: Medical aspects of the persistent vegetative state. N Engl J Med: 1994; 330 21 1499 1508
63. Nakase-Richardson R., Whyte J., Giacino J., et al. Longitudinal outcome of patients with disordered consciousness in the NIDRR TBI Model Systems Programs. J Neurotrauma: 2011; 28 1 8
64. Leong B. The vegetative and minimally conscious states in children: spasticity, muscle contracture and issues for physiotherapy treatment. Brain Inj: 2002; 16 3 217 230 (Pubitemid 34223456)
65. Timmons M., Gasquoine L., Scibak J. W. Functional changes with rehabilitation of very severe traumatic brain injury survivors. J Head Trauma Rehabil: 1987; 2 64 67
66. Tanhehco J., Kaplan P. E. Physical and surgical examination of patient after 6-year coma. Arch Phys Med Rehabil: 1982; 63 1 36 38 (Pubitemid 12219187)
67. Hall M. E., MacDonald S., Young G. C. The effectiveness of directed multisensory stimulation versus non-directed stimulation in comatose CHI patients: pilot study of a single subject design. Brain Inj: 1992; 6 5 435 445
68. Wilson S. LPG, Powell G. E., Elliott K., Thwaites H. Sensory stimulation in prolonged coma: four single case studies. Brain Inj: 1991; 5 4 393 400
69. Pierce J. P., Lyle D. M., Quine S., Evans N. J., Morris J., Fearnside M. R. The effectiveness of coma arousal intervention. Brain Inj: 1990; 4 2 191 197 (Pubitemid 20235388)
70. Wood R. L., Winkowski T. B., Miller J. L., Tierney L., Goldman L. Evaluating sensory regulation as a method to improve awareness in patients with altered states of consciousness: a pilot study. Brain Inj: 1992; 6 5 411 418
71. Formisano R., Vinicola V., Penta F., Matteis M., Brunelli S., Weckel J. W. Active music therapy in the rehabilitation of severe brain injured patients during coma recovery. Ann Ist Super Sanita: 2001; 37 4 627 630 (Pubitemid 34538347)
72. Wilson S. LPG, Powell G. E., Brock D., Thwaites H. Vegetative state and responses to sensory stimulation: an analysis of 24 cases. Brain Inj: 1996; 10 11 807 818 (Pubitemid 26366439)
73. Giacino J. T. Rehabilitation of patients with disorders of consciousness. In: High W., Sander A., Struchen M., Hart K., eds. Rehabilitation for Traumatic Brain Injury. New York, NY Oxford University Press: 2005; 305 337
74. Lombardi F., Taricco M., De Tanti A., Telaro E., Liberati A. Sensory stimulation for brain injured individuals in coma or vegetative state. Cochrane Database Syst Rev: 2002; 2 CD001427
75. Johnson D. A., Roethig-Johnston K., Richards D. Biochemical and physiological parameters of recovery in acute severe head injury: responses to multisensory stimulation. Brain Inj: 1993; 7 6 491 499 (Pubitemid 23288518)
76. Meythaler J. M., Brunner R. C., Johnson A., Novack T. A. 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 (Pubitemid 34809595)
77. Patrick P. D., Blackman J. A., Mabry J. L., Buck M. L., Gurka M. J., Conaway M. R. Dopamine agonist therapy in low-response children following traumatic brain injury. J Child Neurol: 2006; 21 10 879 885 (Pubitemid 46099276)
78. Powell J. H., al-Adawi S., Morgan J., Greenwood R. J. Motivational deficits after brain injury: effects of bromocriptine in 11 patients. J Neurol Neurosurg Psychiatry: 1996; 60 4 416 421 (Pubitemid 26118750)
79. Passler M. ARR, Riggs R. V. Positive outcomes in traumatic brain injury-vegetative state: patients treated with bromocriptine. Arch Phys Med Rehabil: 2001; 82 3 311 315 (Pubitemid 32199561)
80. Martin R. T., Whyte J. The effects of methylphenidate on command following and yes/no communication in persons with severe disorders of consciousness: a meta-analysis of n-of-1 studies. Am J Phys Med Rehabil: 2007; 86 8 613 620 (Pubitemid 47220693)
81. Matsuda W., Komatsu Y., Yanaka K., Matsumura A. Levodopa treatment for patients in persistent vegetative or minimally conscious states. Neuropsychol Rehabil: 2005; 15 3-4 414 427 (Pubitemid 41248347)
82. Koeda T., Takeshita K. A case report of remarkable improvement of motor disturbances with L-dopa in a patient with post-diffuse axonal injury. Brain Dev: 1998; 20 2 124 126 (Pubitemid 28130241)
83. Fridman E. A., Krimchansky B. Z., Bonetto M., et al. Continuous subcutaneous apomorphine for severe disorders of consciousness after traumatic brain injury. Brain Inj: 2010; 24 4 636 641
84. Clauss R., Nel W. Drug induced arousal from the permanent vegetative state. NeuroRehabilitation: 2006; 21 1 23 28
85. Shames J. L., Ring H. Transient reversal of anoxic brain injury-related minimally conscious state after zolpidem administration: a case report. Arch Phys Med Rehabil: 2008; 89 2 386 388
86. Brefel-Courbon C., Payoux P., Ory F., et al. Clinical and imaging evidence of zolpidem effect in hypoxic encephalopathy. Ann Neurol: 2007; 62 1 102 105 (Pubitemid 47240911)
87. Cohen S. I., Duong T. T. Increased arousal in a patient with anoxic brain injury after administration of zolpidem. Am J Phys Med Rehabil: 2008; 87 3 229 231 (Pubitemid 351301589)
88. Whyte J., Myers R. Incidence of clinically significant responses to zolpidem among patients with disorders of consciousness: a preliminary placebo controlled trial. Am J Phys Med Rehabil: 2009; 88 5 410 418
89. Singh R., McDonald C., Dawson K., et al. Zolpidem in a minimally conscious state. Brain Inj: 2008; 22 1 103 106
90. Sarà M., Pistoia F., Mura E., Onorati P., Govoni S. Intrathecal baclofen in patients with persistent vegetative state: 2 hypotheses. Arch Phys Med Rehabil: 2009; 90 7 1245 1249
91. Taira T. Intrathecal administration of GABA agonists in the vegetative state. Prog Brain Res: 2009; 177 317 328
92. Giacino J. T., Whyte J., Bagiella E., et al. Placebo-controlled trial of amantadine for severe traumatic brain injury. N Engl J Med: 2012; 366 9 819 826
93. Hagen C., Durham P. Levels of cognitive function. In: Rehabilitation of the Head-Injured Adult: Comprehensive Physical Management. Downey, CA Professional Staff Association of Rancho Los Amigos Hospital Inc: 1979
94. Rappaport M., Dougherty A. M., Kelting D. L. Evaluation of coma and vegetative states. Arch Phys Med Rehabil: 1992; 73 7 628 634
95. Ansell B. J., Keenan J. E. The Western Neuro Sensory Stimulation Profile: a tool for assessing slow-to-recover head-injured patients. Arch Phys Med Rehabil: 1989; 70 2 104 108 (Pubitemid 19066470)
96. Taira T., Hori T. Intrathecal baclofen in the treatment of post-stroke central pain, dystonia, and persistent vegetative state. Acta Neurochir Suppl (Wien): 2007; 97 Pt 1 227 229
97. Kawecki Z., Kwiatkowski S., Grzegorzewski P., Szlachta Jezioro I. [Sudden improvement of all neurological functions after general anesthesia and two-day intrathecal infusion of baclofen in a child with primary brain-stem injury]. Przegl Lek: 2007; 64 02 13 14
98. Schiff N. D. Recovery of consciousness after brain injury: a mesocircuit hypothesis. Trends Neurosci: 2010; 33 1 1 9
99. Moruzzi G., Magoun H. W. Brain stem reticular formation and activation of the EEG. Electroencephalogr Clin Neurophysiol: 1949; 1 4 455 473
100. Kanno T., Kamei Y., Yokoyama T., Jain V. K. Neurostimulation for patients in vegetative status. Pacing Clin Electrophysiol: 1987; 10 1 Pt 2 207 208 (Pubitemid 17012971)
101. Tsubokawa T., Yamamoto T., Katayama Y., Hirayama T., Maejima S., Moriya T. Deep-brain stimulation in a persistent vegetative state: follow-up results and criteria for selection of candidates. Brain Inj: 1990; 4 4 315 327 (Pubitemid 20345987)
102. Yamamoto T., Katayama Y. Deep brain stimulation therapy for the vegetative state. Neuropsychol Rehabil: 2005; 15 3-4 406 413 (Pubitemid 41248346)
103. Kanno T., Morita I., Yamaguchi S., et al. Dorsal column stimulation in persistent vegetative state. Neuromodulation: 2009; 12 1 33 38
104. Kobayashi M., Pascual-Leone A. Transcranial magnetic stimulation in neurology. Lancet Neurol: 2003; 2 3 145 156 (Pubitemid 37443319)
105. Louise-Bender Pape T., Rosenow J., Lewis G., Ahmed G., et al. Repetitive transcranial magnetic stimulation-associated neurobehavioral gains during coma recovery. Brain Stimul: 2009; 2 22 35
106. Piccione F., Cavinato M., Manganotti P., et al. Behavioral and neurophysiological effects of repetitive transcranial magnetic stimulation on the minimally conscious state: a case study. Neurorehabil Neural Repair: 2011; 25 1 98 102