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Semin Neurol 2024; 44(03): 271-280
DOI: 10.1055/s-0044-1785507
Review Article

Exploring the Significance of Cognitive Motor Dissociation on Patient Outcome in Acute Disorders of Consciousness

Nicolas Lejeune
1   Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
2   Centre du Cerveau, University Hospital of Liège, Liège, Belgium
3   DoC Care Unit, Centre Hospitalier Neurologique William Lennox, Ottignies-Louvain-la-Neuve, Belgium
4   Institute of NeuroScience, UCLouvain, Brussels, Belgium
,
Pauline Fritz
1   Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
2   Centre du Cerveau, University Hospital of Liège, Liège, Belgium
,
Paolo Cardone 
1   Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
2   Centre du Cerveau, University Hospital of Liège, Liège, Belgium
,
Emilie Szymkowicz
1   Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
2   Centre du Cerveau, University Hospital of Liège, Liège, Belgium
,
Marie M. Vitello
1   Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
2   Centre du Cerveau, University Hospital of Liège, Liège, Belgium
,
Charlotte Martial
1   Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
2   Centre du Cerveau, University Hospital of Liège, Liège, Belgium
,
Aurore Thibaut
1   Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
2   Centre du Cerveau, University Hospital of Liège, Liège, Belgium
,
Olivia Gosseries
1   Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
2   Centre du Cerveau, University Hospital of Liège, Liège, Belgium
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Abstract

Cognitive motor dissociation (CMD) is characterized by a dissociation between volitional brain responses and motor control, detectable only through techniques such as electroencephalography (EEG) and functional magnetic resonance imaging. Hence, it has recently emerged as a major challenge in the assessment of patients with disorders of consciousness. Specifically, this review focuses on the prognostic implications of CMD detection during the acute stage of brain injury. CMD patients were identified in each diagnostic category (coma, unresponsive wakefulness syndrome/vegetative state, minimally conscious state minus) with a relatively similar prevalence of around 20%. Current knowledge tends to indicate that the diagnosis of CMD in the acute phase often predicts a more favorable clinical outcome compared with other unresponsive non-CMD patients. Nevertheless, the review underscores the limited research in this domain, probably at least partially explained by its nascent nature and the lack of uniformity in the nomenclature for CMD-related disorders, hindering the impact of the literature in the field.

Keywords

coma - consciousness - diagnosis - prognosis - outcome - brain imaging - cognitive motor dissociation


Publication History

Article published online:
11 April 2024

© 2024. Thieme. All rights reserved.

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