Cognitive Motor Dissociation: Gap Analysis and Future Directions
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Cognitive Motor Dissociation : Gap Analysis and Future Directions. / Claassen, Jan; Kondziella, Daniel; Alkhachroum, Ayham; Diringer, Michael; Edlow, Brian L.; Fins, Joseph J.; Gosseries, Olivia; Hannawi, Yousef; Rohaut, Benjamin; Schnakers, Caroline; Stevens, Robert D.; Thibaut, Aurore; Monti, Martin; the Curing Coma Campaign, and Its Contributing Collaborators.
I: Neurocritical Care, Bind 40, Nr. 1, 2024, s. 81-98.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Cognitive Motor Dissociation
T2 - Gap Analysis and Future Directions
AU - Claassen, Jan
AU - Kondziella, Daniel
AU - Alkhachroum, Ayham
AU - Diringer, Michael
AU - Edlow, Brian L.
AU - Fins, Joseph J.
AU - Gosseries, Olivia
AU - Hannawi, Yousef
AU - Rohaut, Benjamin
AU - Schnakers, Caroline
AU - Stevens, Robert D.
AU - Thibaut, Aurore
AU - Monti, Martin
AU - the Curing Coma Campaign, and Its Contributing Collaborators
N1 - Publisher Copyright: © 2023, Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.
PY - 2024
Y1 - 2024
N2 - Background: Patients with disorders of consciousness who are behaviorally unresponsive may demonstrate volitional brain responses to motor imagery or motor commands detectable on functional magnetic resonance imaging or electroencephalography. This state of cognitive motor dissociation (CMD) may have prognostic significance. Methods: The Neurocritical Care Society’s Curing Coma Campaign identified an international group of experts who convened in a series of monthly online meetings between September 2021 and April 2023 to examine the science of CMD and identify key knowledge gaps and unmet needs. Results: The group identified major knowledge gaps in CMD research: (1) lack of information about patient experiences and caregiver accounts of CMD, (2) limited epidemiological data on CMD, (3) uncertainty about underlying mechanisms of CMD, (4) methodological variability that limits testing of CMD as a biomarker for prognostication and treatment trials, (5) educational gaps for health care personnel about the incidence and potential prognostic relevance of CMD, and (6) challenges related to identification of patients with CMD who may be able to communicate using brain–computer interfaces. Conclusions: To improve the management of patients with disorders of consciousness, research efforts should address these mechanistic, epidemiological, bioengineering, and educational gaps to enable large-scale implementation of CMD assessment in clinical practice.
AB - Background: Patients with disorders of consciousness who are behaviorally unresponsive may demonstrate volitional brain responses to motor imagery or motor commands detectable on functional magnetic resonance imaging or electroencephalography. This state of cognitive motor dissociation (CMD) may have prognostic significance. Methods: The Neurocritical Care Society’s Curing Coma Campaign identified an international group of experts who convened in a series of monthly online meetings between September 2021 and April 2023 to examine the science of CMD and identify key knowledge gaps and unmet needs. Results: The group identified major knowledge gaps in CMD research: (1) lack of information about patient experiences and caregiver accounts of CMD, (2) limited epidemiological data on CMD, (3) uncertainty about underlying mechanisms of CMD, (4) methodological variability that limits testing of CMD as a biomarker for prognostication and treatment trials, (5) educational gaps for health care personnel about the incidence and potential prognostic relevance of CMD, and (6) challenges related to identification of patients with CMD who may be able to communicate using brain–computer interfaces. Conclusions: To improve the management of patients with disorders of consciousness, research efforts should address these mechanistic, epidemiological, bioengineering, and educational gaps to enable large-scale implementation of CMD assessment in clinical practice.
KW - Acute brain injury
KW - Cognitive motor dissociation
KW - Coma
KW - Consciousness
KW - Covert consciousness
KW - Curing Coma Campaign
KW - Outcome
KW - Prognostication
KW - Vegetative state
U2 - 10.1007/s12028-023-01769-3
DO - 10.1007/s12028-023-01769-3
M3 - Journal article
C2 - 37349602
AN - SCOPUS:85163171001
VL - 40
SP - 81
EP - 98
JO - Neurocritical Care
JF - Neurocritical Care
SN - 1541-6933
IS - 1
ER -
ID: 366989200