Abstract:
OBJECTIVE:To determine the potential prognostic value of using functional magnetic resonance imaging (fMRI) to identify patients with disorders of consciousness, who show potential for recovery. DESIGN:Observational study. SETTING:Unit for acute rehabilitation care. PARTICIPANTS:Patients (N=22) in a vegetative state (VS; n=10) and minimally conscious state (MCS; n=12) during the first 200 days after the initial incident. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURE:Further course on the Coma Recovery Scale-Revised. RESULTS:Participants performed a mental imagery fMRI paradigm. They were asked to alternately imagine playing tennis and navigating through their home. In 14 of the 22 examined patients (VS, n=5; MCS, n=9), a significant activation of the regions of interest (ROIs) of the mental imagery paradigm could be found. All 5 patients with activation of a significant blood oxygen level dependent signal, who were in a VS at the time of the fMRI examination, reached at least an MCS at the end of the observation period. In contrast, 5 participants in a VS who failed to show activation in ROIs, did not (sensitivity 100%, specificity 100%). Six of 9 patients in an MCS with activation in ROIs emerged from an MCS. Of 3 patients in an MCS who did not show activation, 2 patients stayed in an MCS and 1 patient emerged from the MCS (sensitivity 85%, specificity 40%). CONCLUSIONS:The fMRI paradigm mental imagery displays a high concordance with the further clinical course of patients in a VS. All 5 patients in a VS who showed significant activation of ROIs had a favorable further course until the end of the observation period. We therefore propose the term "functional minimally conscious state" for these patients. They may benefit from rehabilitation treatment. In cases where no significant activation was seen, the method has no prognostic value. Prediction of the clinical course of patients in an MCS by fMRI was considerably less accurate than in patients in a VS.
journal_name
Arch Phys Med Rehabiljournal_title
Archives of physical medicine and rehabilitationauthors
Vogel D,Markl A,Yu T,Kotchoubey B,Lang S,Müller Fdoi
10.1016/j.apmr.2012.11.053subject
Has Abstractpub_date
2013-10-01 00:00:00pages
1891-8issue
10eissn
0003-9993issn
1532-821Xpii
S0003-9993(13)00416-4journal_volume
94pub_type
杂志文章abstract::The effects of pending litigation for compensation on treatment outcomes of patients with chronic low back pain, were assessed. The 81 patients with chronic low back pain who participated in a six-week behavioral treatment program organized around the theme of self-control, were differentiated according to whether the...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
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abstract:OBJECTIVE:To assess muscle passive stiffness in medicated Parkinson's disease patients using myotonometry. DESIGN:Case-control study. SETTING:Kinesiology laboratory. PARTICIPANTS:Women with Parkinson's disease (PD) (n=8) and healthy matched elderly women (controls) (n=10) (mean age: PD, 77+/-3y; controls, 77+/-4y). ...
journal_title:Archives of physical medicine and rehabilitation
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2013.08.243
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abstract:OBJECTIVES:To delineate the frequency, clinical risk factors, and urodynamic mechanisms of incomplete bladder emptying (IBE) among patients with recent stroke. DESIGN:Retrospective study. SETTING:Inpatient setting in the rehabilitation ward of a university hospital. PARTICIPANTS:All patients with acute stroke admitt...
journal_title:Archives of physical medicine and rehabilitation
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abstract:OBJECTIVE:To evaluate a strategy of home-based testing to diagnose sleep-disordered breathing and nocturnal hypercapnia in individuals with spinal cord injury (SCI). DESIGN:Case series. SETTING:Referral center. PARTICIPANTS:Adults with C1-T6 SCI (N=81). Individuals were eligible if ≥ 18 years old, with SCI of ≥ 3 mo...
journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2015.07.026
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1981-12-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
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journal_title:Archives of physical medicine and rehabilitation
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doi:10.1016/j.apmr.2015.06.007
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journal_title:Archives of physical medicine and rehabilitation
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journal_title:Archives of physical medicine and rehabilitation
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doi:10.1016/j.apmr.2012.10.032
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2011.11.023
更新日期:2012-04-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
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doi:10.1016/0003-9993(92)90010-t
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2017.10.003
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pub_type: 杂志文章
doi:
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,meta分析,评审
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更新日期:2016-09-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2004.05.022
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,多中心研究
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,meta分析
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章,多中心研究
doi:10.1016/s0003-9993(99)90188-0
更新日期:1999-05-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:10.1016/j.apmr.2010.07.219
更新日期:2010-11-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
更新日期:1990-08-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
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更新日期:2005-02-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
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更新日期:2002-12-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
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journal_title:Archives of physical medicine and rehabilitation
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更新日期:2005-03-01 00:00:00
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journal_title:Archives of physical medicine and rehabilitation
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journal_title:Archives of physical medicine and rehabilitation
pub_type: 杂志文章
doi:
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