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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Neurology 1/2018

Personalized objects can optimize the diagnosis of EMCS in the assessment of functional object use in the CRS-R: a double blind, randomized clinical trial

Zeitschrift:
BMC Neurology > Ausgabe 1/2018
Autoren:
Yuxiao Sun, Jianan Wang, Lizette Heine, Wangshan Huang, Jing Wang, Nantu Hu, Xiaohua Hu, Xiaohui Fang, Supeng Huang, Steven Laureys, Haibo Di
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12883-018-1040-5) contains supplementary material, which is available to authorized users.

Abstract

Background

Behavioral assessment has been acted as the gold standard for the diagnosis of disorders of consciousness (DOC) patients. The item “Functional Object Use” in the motor function sub-scale in the Coma Recovery Scale-Revised (CRS-R) is a key item in differentiating between minimally conscious state (MCS) and emergence from MCS (EMCS). However, previous studies suggested that certain specific stimuli, especially something self-relevant can affect DOC patients’ scores of behavioral assessment scale. So, we attempted to find out if personalized objects can improve the diagnosis of EMCS in the assessment of Functional Object Use by comparing the use of patients’ favorite objects and other common objects in MCS patients.

Methods

Twenty-one post-comatose patients diagnosed as MCS were prospectively included. The item “Functional Object Use” was assessed by using personalized objects (e.g., cigarette, paper) and non-personalized objects, which were presented in a random order. The rest assessments were performed following the standard protocol of the CRS-R. The differences between functional uses of the two types of objects were analyzed by the McNemar test.

Results

The incidence of Functional Object Use was significantly higher using personalized objects than non-personalized objects in the CRS-R. Five out of the 21 MCS studied patients, who were assessed with non-personalized objects, were re-diagnosed as EMCS with personalized objects (χ2 = 5, df = 1, p < 0.05).

Conclusions

Personalized objects employed here seem to be more effective to elicit patients’ responses as compared to non-personalized objects during the assessment of Functional Object Use in DOC patients.

Trial registration

Clinical Trials.gov: NCT02988206; Date of registration: 2016/12/12.
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