PDF(Pubmed)
Abstract：
OBJECTIVE: Severe brain injuries can result in disorders of consciousness, such as the Minimally Conscious State (MCS), where individuals display intermittent yet discernible signs of conscious awareness. The varied levels of responsiveness and awareness observed in this state have spurred the progressive delineation of two subgroups within MCS, termed \"plus\" (MCS+) and \"minus\" (MCS-). However, the clinical validity of these classifications remains uncertain. This study aimed to investigate and compare the likelihood of emergence from MCS, as well as the functional independence after emergence, in individuals categorized as in MCS+ and MCS-.
METHODS: Demographic and behavioral data of 80 participants, admitted as either in MCS+ (n = 30) or MCS- (n = 50) to a long-term neurorehabilitation unit, were retrospectively analyzed. The neurobehavioral condition of each participant was evaluated weekly until discharge, demise, or emergence from MCS. The functional independence of those participants who emerged from MCS was assessed 6 months after emergence.
RESULTS: While only about half of the individuals classified as in MCS- (n = 24) emerged from the MCS, all those admitted as in MCS+ did, and in a shorter postinjury period. Despite these differences, all individuals who emerged from the MCS demonstrated similar high disability and low functional independence 6 months after emergence, regardless of their state at admission.
CONCLUSIONS: Individuals classified as MCS+ exhibited a higher likelihood of emergence and a shorter time to emergence compared to those in MCS-. However, the level of functional independence 6 months after emergence was found to be unrelated to the initial state at admission.
METHODS: Demographic and behavioral data of 80 participants, admitted as either in MCS+ (n = 30) or MCS- (n = 50) to a long-term neurorehabilitation unit, were retrospectively analyzed. The neurobehavioral condition of each participant was evaluated weekly until discharge, demise, or emergence from MCS. The functional independence of those participants who emerged from MCS was assessed 6 months after emergence.
RESULTS: While only about half of the individuals classified as in MCS- (n = 24) emerged from the MCS, all those admitted as in MCS+ did, and in a shorter postinjury period. Despite these differences, all individuals who emerged from the MCS demonstrated similar high disability and low functional independence 6 months after emergence, regardless of their state at admission.
CONCLUSIONS: Individuals classified as MCS+ exhibited a higher likelihood of emergence and a shorter time to emergence compared to those in MCS-. However, the level of functional independence 6 months after emergence was found to be unrelated to the initial state at admission.
摘要：
目的：严重的脑损伤会导致意识障碍，例如最小意识状态(MCS)，个体表现出间歇性但可辨别的有意识意识的迹象。在这种状态下观察到的不同水平的反应性和意识刺激了MCS内两个亚组的逐步划分，称为“加”(MCS+)和“减”(MCS-)。然而,这些分类的临床有效性仍不确定.本研究旨在调查和比较MCS出现的可能性，以及出现后的功能独立性，在分类为MCS+和MCS-的个体中。
方法：80名参与者的人口和行为数据，在MCS+（n=30）或MCS-（n=50）中接受长期神经康复治疗，进行回顾性分析。每周评估每个参与者的神经行为状况，直到出院，消亡,或从MCS中出现。出现后6个月评估那些从MCS中出现的参与者的功能独立性。
结果：虽然只有大约一半分类为MCS-（n=24）的个体从MCS中出现，所有像MCS+一样承认的人，受伤后更短的时间。尽管存在这些差异,所有从MCS中出现的个体在出现后6个月表现出类似的高残疾和低功能独立性，无论他们在入场时的状态如何。
结论：与MCS-相比，被分类为MCS+的个体表现出更高的出现可能性和更短的出现时间。然而,发病后6个月的功能独立性水平与入院时的初始状态无关.
方法：80名参与者的人口和行为数据，在MCS+（n=30）或MCS-（n=50）中接受长期神经康复治疗，进行回顾性分析。每周评估每个参与者的神经行为状况，直到出院，消亡,或从MCS中出现。出现后6个月评估那些从MCS中出现的参与者的功能独立性。
结果：虽然只有大约一半分类为MCS-（n=24）的个体从MCS中出现，所有像MCS+一样承认的人，受伤后更短的时间。尽管存在这些差异,所有从MCS中出现的个体在出现后6个月表现出类似的高残疾和低功能独立性，无论他们在入场时的状态如何。
结论：与MCS-相比，被分类为MCS+的个体表现出更高的出现可能性和更短的出现时间。然而,发病后6个月的功能独立性水平与入院时的初始状态无关.
