Minimally Conscious State, Vegetative State
Conditions
Keywords
disorders of consciousness, swallowing, prognosis prediction, minimally conscious state, vegetative state
Brief summary
This study is aimed to detect the initiation of swallowing act in DOC patients, to find if it is a good item as a stimulus and to detect the relationship between the initiation of swallowing act and the prognosis of DOC patients.
Detailed description
Studies suggest that the initiation and patterning of swallowing of the pharyngeal phase is also under active cortical control for both spontaneous as well as volitional swallowing in awake humans and non-human primates. A recent study found that most patients of disorders of consciousness (DOC) would recover their swallowing ability quickly. And there is no study about detecting the initiation of swallowing act in DOC patients. This study is aimed to detect the initiation of swallowing act in DOC patients, to find if it is a good item as a stimulus and to detect the relationship between the initiation of swallowing act and the prognosis of DOC patients. DOC patients were recruited (standard diagnosis procedure is 4 times CRS-R testing within 2 weeks). The different four stimuli were as follows: 1) One command (as recommended in CRS-R) which was open your mouth. 2) Put a spoon in front of the patient's mouth without a command. 3) One command with a spoon in front of the mouth, the command is there is a spoon and open your mouth. 4) One command with a spoon full of water in front of the mouth, the command is there is a spoon with water and open your mouth. We presented these stimuli orderly in front of the patient's mouth and presented any one of them over 4 trials at 15 second intervals.
Interventions
DIAGNOSTIC_TESTComa Recovery Scale-Revised
Patients with disorders of consciousness were assessed by Coma Recovery Scale-Revised (CRS-R). In addition, we selected four stimuli: 1) only a command (as recommended in CRS-R), which was open your mouth; 2) only a spoon without a command; 3) a spoon and a command, the command was there is a spoon and open your mouth; 4) a spoon with water and a command, the command was there is a spoon with water and open your mouth. In brief, we presented these stimuli orderly in front of the patient's mouth and presented any one of them over 4 trials at 15 second intervals.
Sponsors
Hangzhou Normal University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
27 Years to 77 Years
Healthy volunteers
No
Inclusion criteria
* age ≥ 18 years * no administration of central nervous system stimulant, neuro-muscular blocking agents, or sedative within the prior 24 hours * a diagnosis of VS or MCS-, based on the behavioral assessment of standardized CRS-R * periods of eye opening (indicating preserved sleep-wake cycles).
Exclusion criteria
* documented history of prior brain injury * premorbid illness resulting in documented functional disabilities up to time of the injury * acute illness (e.g., pyrexia, pneumonia, diarrhea) * receiving hyperbaric oxygen treatments within 2 hours * fracture of the mandible.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Coma Recovery Scale-Revised （CRS-R） | Six month later | examine the prognostic value of patients, longitudinal behavioral assessments were repeatedly conducted by means of the CRS-R 6-month later |
Countries
China
Outcome results
None listed