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

Nicolas Lejeune; Pauline Fritz; Paolo Cardone; Emilie Szymkowicz; Marie M. Vitello; Charlotte Martial; Aurore Thibaut; Olivia Gosseries

doi:10.1055/s-0044-1785507

Seminars in Neurology, Table of Contents

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

¹Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium

²Centre du Cerveau, University Hospital of Liège, Liège, Belgium

³DoC Care Unit, Centre Hospitalier Neurologique William Lennox, Ottignies-Louvain-la-Neuve, Belgium

⁴Institute of NeuroScience, UCLouvain, Brussels, Belgium

,

Pauline Fritz

¹Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium

²Centre du Cerveau, University Hospital of Liège, Liège, Belgium

,

Paolo Cardone

¹Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium

²Centre du Cerveau, University Hospital of Liège, Liège, Belgium

,

Emilie Szymkowicz

¹Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium

²Centre du Cerveau, University Hospital of Liège, Liège, Belgium

,

Marie M. Vitello

¹Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium

²Centre du Cerveau, University Hospital of Liège, Liège, Belgium

,

Charlotte Martial

¹Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium

²Centre du Cerveau, University Hospital of Liège, Liège, Belgium

,

Aurore Thibaut

¹Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium

²Centre du Cerveau, University Hospital of Liège, Liège, Belgium

,

Olivia Gosseries

¹Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium

²Centre du Cerveau, University Hospital of Liège, Liège, Belgium

› Author Affiliations

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

Full Text

References

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