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Vegetative State

Q: What is a Vegetative State?

A Vegetative State is a clinical condition characterized by complete loss of higher cortical functions. Patients in this state appear awake, with their eyes open, but they lack any purposeful response to stimuli and are unable to interact with their environment. This state typically arises from severe brain injury, such as traumatic brain injury, stroke, or hypoxic-ischemic encephalopathy.

Q: What are the different types or variations of Vegetative State?

While Vegetative State is the most common term, there are some variations that are important to understand. Minimally Conscious State is a related condition where the patient shows minimal but definite behavioral evidence of self-awareness or environmental awareness. Brain Death is a separate and irreversible condition where there is complete and permanent cessation of all brain function. Recognizing these distinctions is key for appropriate treatment and management.

Q: How can PubCompare.ai assist with Vegetative State research?

PubCompare.ai's AI-driven platform can enhance reproducibility and accuracy in Vegetative State research. The platform allows you to screen protocol literature more efficiently, and leverage AI to pinpoint critical insights. This helps researchers identify the most effective protocols related to Vegetative State for their specific research goals. The platform's AI-driven analysis can highlight key differences in protocol effectiveness, enabling you to choose the best option for reproducibility and accuracy in your studies.

Q: What are some common challenges in using Vegetative State protocols?

One of the main challenges in using Vegetative State protocols is ensuring reproducibility. Slight variations in patient assessment, diagnostic criteria, or data analysis can lead to inconsistent results across studies. Additionally, the complex nature of Vegetative State, with its potential for gradual improvement or fluctuations, can make it difficult to standardize protocols. Careful attention to detail and the use of AI-driven comparisons, as offered by PubCompare.ai, can help overcome these hurdles.

Vegetative State is a clinical condition characterized by complete loss of higher cortical functions, with the patient exhibiting only reflex and autonomic activities.
Patients may appear awake, with their eyes open, but they lack any purposeful response to stimuli and are unable to interact with their environment.
This state typically arises from severe brain injury, such as traumatic brain injury, stroke, or hypoxic-ischemic encephalopathy.
Accurate assessment and diagnosis of Vegetative State is crucial for prognosis and treatment planning.
PubComapre.ai's AI-driven platform can enhance reproducibility and accuracy in Vegetative State research by helping researchers locate relevant protocols from literature, preprints, and patents, and use AI-driven comparisons to identify the best protocols and products for their studies.

Most cited protocols related to «Vegetative State»

Prognostic Model Validation for Traumatic Brain Injury

The IMPACT database includes patients with moderate and severe TBI (GCS ≤ 12) from eight randomized controlled trials and three observational studies conducted between 1984 and 1997 [11 (link)]. Detailed characteristics of these 11 studies and data management have been described previously [15 (link)]. The endpoint for the prognostic analyses was the 6 mo GOS, which is an ordered outcome with five categories: 1, dead; 2, vegetative state; 3, severe disability; 4, moderate disability; and 5, good recovery. In patients whose 6 mo assessment was not available we used the 3 mo GOS (n = 1,611, 19% of the patients). We selected 8,509 patients aged ≥ 14 y [12 (link)].
We externally validated prognostic models using patients enrolled in the Medical Research Council Corticosteroid Randomisation after Significant Head Injury (MRC CRASH) trial (trial registration ISRCTN74459797, ISRCTN Register, http://www.controlled-trials.com/), who were recruited between 1999 and 2004 [13 (link)]. This was a large international double-blind, randomized placebo-controlled trial of the effect of early administration of a 48-h infusion of methylprednisolone on outcome after head injury. It was found that the risks of death and disability were higher in the corticosteroid group than in the placebo group. The trial included 10,008 adults with GCS ≤ 14, who were enrolled within 8 h after injury. We selected 6,681 patients with a GCS ≤ 12 and with complete 6 mo GOS. Secondary analyses considered only placebo patients (n = 3,287) and patients from high-income countries (n = 1,588). For the validation we focused on prediction of mortality (GOS 1) versus survival (GOS 2–5) and of unfavorable (GOS 1–3) versus favorable outcome (GOS 4–5).

Steyerberg E.W., Mushkudiani N., Perel P., Butcher I., Lu J., McHugh G.S., Murray G.D., Marmarou A., Roberts I., Habbema J.D, & Maas A.I. (2008). Predicting Outcome after Traumatic Brain Injury: Development and International Validation of Prognostic Scores Based on Admission Characteristics. PLoS Medicine, 5(8), e165.

Publication 2008

Adrenal Cortex Hormones Adult Craniocerebral Trauma Disabled Persons Injuries Methylprednisolone Patients Placebos Vegetative State

Neuroimaging Insights into Disorders of Consciousness

A sample of 71 patients with disorders of consciousness was included in this study. Patients were recruited from specialised long-term care centres. To be invited to the study, patients must have had a DOC diagnosis, written informed consent to participation from their legal representative, and were capable of being transported to Addenbrooke’s Hospital. The exclusion criteria included any medical condition that made it unsafe for the patient to participate (decision made by clinical personnel blinded to the specific aims of the study) or any reason they are unsuitable to enter the MRI scanner environment (e.g. non-MRI-safe implants), significant pre-existing mental health problems, or insufficient English pre injury. After admission, each patient underwent clinical and neuroimaging testing. Patients spent a total of five days (including arrival and departure days) at Addenbrooke’s Hospital. Coma recovery scale-revised (CRS-R) assessments were recorded at least daily for the five days of admission. If behaviours were indicative of awareness at any time, patients were classified as MCS; otherwise UWS. We assigned MCS− or MCS+ sub-classification if behaviours were consistent throughout the week. The most frequent signs of consciousness in MCS− patients are visual fixation and pursuit, automatic motor reactions (e.g. scratching, pulling the bed sheet) and localisation to noxious stimulation whereas MCS+ patients can, in addition, follow simple commands, intelligibly verbalise or intentionally communicate^{58 (link),65 (link)}. Scanning occurred at the Wolfson Brain Imaging Centre, Addenbrooke’s Hospital, between January 2010 and December 2015; medication prescribed to each patient was maintained during scanning. All clinical investigations were conducted in accordance with the Declaration of Helsinki and all relevant ethical guidelines. Ethical approval for testing patients was provided by the National Research Ethics Service (National Health Service, UK; LREC reference 99/391).
As a focus of this study was on graph-theoretical properties of the brain, patients were systematically excluded from the final cohort analysed in this study based on the following criteria: (1) large focal brain damage (i.e. more than 1/3 of one hemisphere) as stated by an expert in neuroanatomy blinded to the patients’ diagnoses; (2) excessive head motion during resting state scanning (i.e. greater than 3 mm in translation and/or 3 degrees in rotation); (3) suboptimal segmentation and normalization of images. A total of 22 adults (14 males; 17–70 years; mean time post injury: 13 months) meeting diagnostic criteria for Unresponsive Wakefulness Syndrome/Vegetative State or Minimally Conscious State due to brain injury were included in this study (Table 1).Table 1

Demographic information for patients with Disorders of Consciousness

Sex	Age	Months post injury	Aetiology	Diagnosis	CRS-R Score
M	46	23	TBI	UWS	6
M	57	14	TBI	MCS−	12
M	46	4	TBI	MCS	10
M	35	34	Anoxic	UWS	8
M	17	17	Anoxic	UWS	8
F	31	9	Anoxic	MCS−	10
F	38	13	TBI	MCS	11
M	29	68	TBI	MCS	10
M	23	4	TBI	MCS	7
F	70	11	Cerebral bleed	MCS	9
F	30	6	Anoxic	MCS−	9
F	36	6	Anoxic	UWS	8
M	22	5	Anoxic	UWS	7
M	40	14	Anoxic	UWS	7
F	62	7	Anoxic	UWS	7
M	46	10	Anoxic	UWS	5
M	21	7	TBI	MCS	11
M	67	14	TBI	MCS−	11
F	55	6	Hypoxia	UWS	12
M	28	14	TBI	MCS	8
M	22	12	TBI	MCS	10
F	28	8	ADEM	UWS	6

CRS-R coma recovery scale-revised, UWS unresponsive wakefulness syndrome, MCS minimally conscious state, TBI traumatic brain injury

Luppi A.I., Craig M.M., Pappas I., Finoia P., Williams G.B., Allanson J., Pickard J.D., Owen A.M., Naci L., Menon D.K, & Stamatakis E.A. (2019). Consciousness-specific dynamic interactions of brain integration and functional diversity. Nature Communications, 10, 4616.

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Publication 2019

Adult Awareness Brain Brain Injuries Brain Injuries, Focal Comatose Consciousness Consciousness Disorders Diagnosis Fixation, Ocular Head Health Services, National Injuries Long-Term Care Males Mental Health Minimally Conscious State Patients Pharmaceutical Preparations Syndrome Traumatic Brain Injury Vegetative State Wakefulness

Systematic Review of Voluntary Stopping of Eating and Drinking

A systematic search and review [35 (link)] was performed to give a comprehensive overview about VSED as an option to hasten death in adults with decision-making capacity at the end of life. This includes (1) clarifying the definition, the prevalence and magnitude, and the ethical aspects and moral standards of VSED, (2) exploring the experience of patients, family members and healthcare professionals with VSED, (3) explaining the physiological processes during VSED and (4) identifying accurate interventions for healthcare professionals to support patients during the process of VSED.
We conducted a systematic literature search for English and non-English articles according to the PRISMA guideline [36 (link)] in the following databases: PubMed (1947–2013), EBSCOhost CINAHL (1981–2013) and Ovid PsycINFO (1967–2013). Database searches were completed between October 2012 and March 2013. Prior to that, a pre-search for sensitizing relevant key words was performed independently by two assistants. The PubMed search was developed by one author (NI), checked by a second author (AF), and translated for use in other databases. The PubMed search string can be viewed in Additional file 1. All database search strings contained both controlled vocabulary and free text words representing the concept of VSED at the end of life. An additional search was performed in the internet using Google Scholar. Furthermore, we checked all reference lists of the included articles for additional published research.
Research articles were included if they report on VSED and adults with decision-making capacity at the end of life, as well as family members and healthcare professionals who have experience with VSED. Furthermore, articles met the inclusion criteria if they described the physiological process during VSED and supporting interventions by healthcare professionals. As VSED is an ethically controversial issue, discussion contribution papers were also included. Articles were excluded if they focused on VSED indirectly, referred to patients in vegetative states or patients with an inability to eat and drink because of disease, patients with artificial nutrition, and when VSED was politically motivated (e.g. hunger strikes). Newspaper articles and commentary letters to the editor of journals were also excluded, because they were regarded as information not contributing to our research questions.
Two authors (NI and AF) independently screened the titles and abstracts for eligibility. Full reports were obtained if the abstracts met our inclusion criteria or when no abstract was available. The full-text of relevant articles were read independently by two authors (NI and AF) to check for inclusion. Disagreements were resolved by discussion. Data were primarily extracted by one author (NI) and checked by the second author (AF) using a data extraction sheet classified with respect to design, objective, sample, measures, analysis and results/case description.
Because the included articles used a wide variety of descriptive and quantitative methods, we evaluated them according to general criteria for quantitative research as described by Coughlan et al. [37 (link)]. There was no uniform rating scale and the articles were coded according to two criteria proposed by Whittemore [38 (link)] when using diverse empirical sources: methodological rigour and data relevance on a 2-point scale (1 = low; 2 = high). Based on the data, evaluation articles with low rigour or relevance were not excluded, but rather considered as trends.
Data synthesis was performed in narrative form typically used for ‘a systematic search and review design’ [35 (link)].

Ivanović N., Büche D, & Fringer A. (2014). Voluntary stopping of eating and drinking at the end of life – a ‘systematic search and review’ giving insight into an option of hastening death in capacitated adults at the end of life. BMC Palliative Care, 13, 1.

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Publication 2014

Adult Anabolism Eligibility Determination Family Member Health Care Professionals Muscle Rigidity Patients Physiological Processes prisma Vegetative State

Functional Recovery Outcomes in Traumatic Brain Injury

The primary outcome was functional recovery as determined with the use of the Extended Glasgow Outcome Scale^{9 (link),10 (link)} (GOS-E) at 6 months (±30 days) after randomization. A GOS-E score of 1 indicates death, 2 indicates a vegetative state, 3 or 4 indicates severe disability, 5 or 6 indicates moderate disability, and 7 or 8 indicates good recovery. Consistent scoring was ensured by means of rigorous training and quality assessment.
A favorable outcome was defined with the use of a stratified dichotomy of the GOS-E scores in which the definition of favorable depended on the severity of the initial injury. The index GCS score, the highest reliable GCS score documented before randomization, determined the initial injury severity. (If the patient was intubated, the index GCS motor score was used to assess severity; scores on the motor component of the GCS range from 1 to 6, with lower scores indicating a lower level of consciousness.) Patients with a less severe initial injury had to have a better recovery than those with a more severe injury in order to have a favorable outcome. Patients with a severe initial injury (an index GCS score of 4 to 5 or, if the patient was intubated, an index GCS motor score of 2 to 3) were considered to have a favorable outcome if the 6-month GOS-E score was 3 or higher. Patients with a moderate-to-severe initial injury (an index GCS score of 6 to 8 or, if the patient was intubated, an index GCS motor score of 4 to 5) were considered to have a favorable outcome if the 6-month GOS-E score was 5 or higher, and those with a moderate initial injury (an index GCS score of 9 to 12) were considered to have a favorable outcome if the 6-month GOS-E score was 7 or higher.
Secondary outcome measures included mortality, the Disability Rating Scale score,^{11 (link)} the rates of nine prespecified adverse events that were considered to be potentially associated with treatment, and the rates of all reported adverse events and serious adverse events. Data on cognitive, psychological, and neurologic outcomes were also collected but are not reported here.

Wright D.W., Yeatts S.D., Silbergleit R., Palesch Y.Y., Hertzberg V.S., Frankel M., Goldstein F.C., Caveney A.F., Howlett-Smith H., Bengelink E.M., Manley G.T., Merck L.H., Janis L.S, & Barsan W.G. (2014). Very Early Administration of Progesterone for Acute Traumatic Brain Injury. The New England journal of medicine, 371(26), 2457-2466.

Publication 2014

Cognition Consciousness Disabled Persons Injuries Muscle Rigidity Patients Range of Motion, Articular Recovery of Function Systems, Nervous Vegetative State

In-Hospital OHCA Patient Data Collection

In‐hospital data on OHCA patients after hospital arrival were prospectively collected using an original report form. The cause of arrest was defined as having cardiac (acute coronary syndrome, other heart disease, presumed cardiac cause) or non‐cardiac (cerebrovascular diseases, respiratory diseases, malignant tumors, external causes including traffic injury, fall, hanging, drowning, asphyxia, drug overdose, or any other external cause, and sudden infant death syndrome [only for children]) causes. The presumed cardiac cause category was a diagnosis by exclusion (i.e., the diagnosis was made when no evidence of a non‐cardiac cause was found). Diagnoses of cardiac or non‐cardiac origin were clinically made by the physician in charge. Other baseline information are as follows: departure of ambulance or helicopter with physicians (yes, no), body temperature upon hospital arrival (°C), ROSC status (ROSC after hospital arrival, ROSC before hospital arrival, no ROSC), and first documented rhythm upon hospital arrival (ventricular fibrillation/pulseless, ventricular tachycardia, pulseless electrical activity, asystole, and presence of pulse).
The reporting form also required actual detailed treatments for OHCA patients (i.e., defibrillation, tracheal intubation, ECPR, intra‐aortic balloon pumping, coronary angiography, PCI, TTM, drug administration during cardiopulmonary arrest [adrenalin, amiodarone, nifekalant, lidocaine, atropine, magnesium, and vasopressin]), and arterial blood gases measured initially on hospital arrival (pH, PaCO₂ [mmHg], PaO₂ [mmHg], HCO₃ [mEq/L], base excess [mEq/L], lactate [mmol/L], and glucose [mg/dL]) before and after the first ROSC.
Outcome data were also prospectively collected and included the following: condition after hospital arrival (admitted to ICU/ward or death at the emergency department); and neurological status 1 month after OHCA occurrence using the Glasgow–Pittsburgh CPC scale (category 1, good cerebral performance; 2, moderate cerebral disability; 3, severe cerebral disability; 4, coma or vegetative state; and 5, death/brain death) or pediatric CPC scale (category 1, normal cerebral performance; 2, mild cerebral disability; 3, moderate cerebral disability; 4, severe cerebral disability; 5, coma or vegetative state; and 6, death/brain death) in patients aged ≤17 years. The neurological status of the survivors was evaluated by the medical staff in each institution 1 month after the event. Favorable neurological outcome was defined as a CPC of 1 or 2.9

Kitamura T., Iwami T., Atsumi T., Endo T., Kanna T., Kuroda Y., Sakurai A., Tasaki O., Tahara Y., Tsuruta R., Tomio J., Nakata K., Nachi S., Hase M., Hayakawa M., Hiruma T., Hiasa K., Muguruma T., Yano T., Shimazu T, & Morimura N. (2018). The profile of Japanese Association for Acute Medicine – out‐of‐hospital cardiac arrest registry in 2014–2015. Acute Medicine & Surgery, 5(3), 249-258.

Publication 2018

Acute Coronary Syndrome Ambulances Amiodarone Arteries Asphyxia Atropine Bicarbonates Blood Gas Analysis Body Temperature Brain Death Cardiac Arrest Cardiopulmonary Arrest Cerebrovascular Disorders Comatose Coronary Angiography Diagnosis Disabled Persons Drug Overdose Electric Countershock Electricity Epinephrine Glucose Heart Heart Diseases Hormone, Antidiuretic Injuries Inpatient Intubation, Intratracheal Lactate Lidocaine Magnesium Malignant Neoplasms Medical Staff nifekalant Only Child Patients Physicians Pulse Rate Respiration Disorders Sudden Infant Death Syndrome Survivors Tachycardia, Ventricular Vegetative State

Most recents protocols related to «Vegetative State»

Glasgow Outcome Scale Evaluation

The patients were followed up by telephone at 6 months after discharge. The therapeutic effect was evaluated by Glasgow Outcome Scale,^{[11 ]} including grade I (death), grade II (vegetative state), grade III (severe disability requiring care), grade IV (mild disability, independent life) and grade V (good recovery, normal life and work). Among them, grade I and grade II were judged as poor curative effect. Grade III was judged as moderate, and grade IV and V were judged as good. The moderate curative effect and good curative effect were regarded as good prognosis. The proportion of patients with good prognosis in the group was calculated and compared with each other.

Wang Y., Huang C., Tian R, & Yang X. (2023). Target temperature management and therapeutic hypothermia in sever neuroprotection for traumatic brain injury: Clinic value and effect on oxidative stress. Medicine, 102(10), e32921.

Publication 2023

Disabled Persons Patient Discharge Patients Prognosis Therapeutic Effect Vegetative State

Neurobehavioral Evaluation of Consciousness Disorders

As a part of routine clinical evaluation, patients were repeatedly evaluated with various neurobehavioural tests during their stay in the acute neurorehabilitation unit. In our analyses we used the total CRS-R score (0 = absence of any response, 23 = cognitively mediated behaviors) and the Disability rating scale (DRS) (Williams and Smith, 2017 (link)) scores (0 = no disability, 29 = extreme vegetative state) at discharge. The items in this scale correspond to the three original World Health Organization categories of impairment, disability, and handicap, and track a patient's functional and cognitive progress from coma to the community. In addition, the patients were also assessed with the Motor Behavior Tool – revised (MBT-r) (Jöhr et al., 2020 , Pincherle et al., 2019 (link)), a clinical evaluation tool for detecting subtle motor behavior that might reflect residual cognition in unresponsive patients. The patients with detected signs of motor behaviour are identified as patients with clinical cognitive motor dissociation. Experienced clinicians or neuropsychologists carried out the neurobehavioral evaluations. Patients’ demographic and clinical data are presented in Table 1.Table 1

Demographic and clinical data.

Subject	Sex	Age (years)	Interval Injury to MRI (days)	Interval MRI to discharge (days)	Etiology	CRS-R intitial	DRS at disch. (days)	CRS-R at disch. (days)
1	f	67	14	34	CVA	VS/UWS	5	23
2	m	24	8	45	CVA	VS/UWS	22	13
3	m	64	45	28	CVA	VS/UWS	22	4
4	f	57	9	11	CVA	MCS	17	15
5	f	72	101	28	CVA	MCS	25	5
6	m	73	16	41	CVA	VS/UWS	19	16
7	f	67	4	20	TBI	VS/UWS	9	23
8	m	37	1	42	ANOX	COMA	27	4
9	f	35	33	33	TBI	VS/UWS	21	7
10	m	60	21	10	TBI	VS/UWS	9	23
11	m	63	19	63	CVA	MCS	4	22
12	m	55	19	41	CVA	MCS	15	11
13	m	42	31	14	TBI	COMA	15	20
14	f	65	43	8	ANOX	COMA	7	23
15	m	27	287	16	TBI	VS/UWS	20	11
16	m	28	42	8	TBI	MCS	2	23
17	f	37	30	60	TBI	COMA	23	9
18	m	47	16	44	TBI	VS/UWS	7	22
19	f	66	30	28	TBI	COMA	11	23
20	f	39	34	20	CVA	COMA	11	21
21	f	52	23	27	CVA	MCS	15	21
22	m	61	35	27	CVA	COMA	14	18
23	m	61	34	34	CVA	COMA	11	23
24	m	78	50	41	ENC	COMA	15	13
25	m	44	28	26	TBI	COMA	11	21
26	f	60	26	49	CVA	COMA	22	11
27	f	69	41	59	ENC	MCS	18	11
28	f	54	30	25	TBI	VS/UWS	26	5
29	m	50	9	63	ANOX	MCS	8	22
30	f	84	26	14	TBI	COMA	21	13
31	m	16	20	12	TBI	MCS	6	23
32	m	35	19	25	LEUCO	VS/UWS	18	13
33	m	49	29	15	CVA	MCS-	6	21
34	m	72	22	13	CVA	MCS-	7	22
35	m	55	41	47	CVA	COMA	29	22
36	f	58	63	−5	CVA	VS/UWS	9	20
37	f	25	38	7	TBI	VS/UWS	11	11
38	m	73	20	37	TBI	VS/UWS	7	22
39	m	60	38	20	CVA	VS/UWS	11	22
40	m	59	43	3	ANOX	VS/UWS	23	8

CVA = cardiovascular accident, TBI = traumatic brain injury, ANOX = anoxia, ENC = encephalopathy, LEUCO = leucoencephalopathy, VS/UWS = vegetative state or unresponsive wakefulness syndrome, MCS = minimally conscious state, DRS = Disability Rating Scale, CRS-R = Coma Recovery Scale – Revised.

Pozeg P., Alemán-Goméz Y., Jöhr J., Muresanu D., Pincherle A., Ryvlin P., Hagmann P., Diserens K, & Dunet V. (2023). Structural connectivity in recovery after coma: Connectome atlas approach. NeuroImage : Clinical, 37, 103358.

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Publication 2023

Accidents Anoxia Cardiovascular System Cognition Comatose Disabled Persons Encephalopathies Injuries Leukoencephalopathy Minimally Conscious State Neurological Rehabilitation Patient Discharge Patients Syndrome Traumatic Brain Injury Vegetative State Wakefulness

Neuroimaging of Disorders of Consciousness

As previously reported (Luppi et al., 2019 (link)), 71 DOC patients were recruited from specialised long-term care centres from January 2010 to December 2015. Ethical approval for this study was provided by the National Research Ethics Service (National Health Service, UK; LREC reference 99/391). Patients were eligible to be recruited in the study if they had a diagnosis of chronic disorder of consciousness, provided that written informed consent to participation was provided by their legal representative, and provided that the patients could be transported to Addenbrooke's Hospital (Cambridge, UK). The exclusion criteria included any medical condition that made it unsafe for the patient to participate, according to clinical personnel blinded to the specific aims of the study; or any reason that made a patient unsuitable to enter the MRI scanner environment (e.g., non-MRI-safe implants). Patients were also excluded based on significant pre-existing mental health problems, or insufficient fluency in the English language prior to their injury. After admission to Addenbrooke's Hospital, each patient underwent clinical and neuroimaging testing, spending a total of five days in the hospital (including arrival and departure days). Neuroimaging scanning took place at the Wolfson Brain Imaging Centre (Addenbrooke's Hospital, Cambridge, UK), and medication prescribed to each patient was maintained during scanning.
For each day of admission, Coma Recovery Scale-Revised (CRS-R) assessments were recorded at least daily. Patients whose behavioural responses were not indicative of awareness at any time, were classified as UWS. In contrast, patients were classified as being in a minimally conscious state (MCS) if they provided behavioural evidence of simple automatic motor reactions (e.g., scratching, pulling the bed sheet), visual fixation and pursuit, or localisation to noxious stimulation. Since this study focused on whole-brain properties, coverage of most of the brain was required, and we followed the same criteria as in our previous studies (Luppi et al., 2019 (link), 2022b (link)): before analysis took place, patients were systematically excluded if an expert neuroanatomist blinded to diagnosis judged that they displayed excessive focal brain damage (over one third of one hemisphere), or if brain damage led to suboptimal segmentation and normalisation, or due to excessive head motion in the MRI scanner (exceeding 3 mm translation or 3° rotation). A total of 22 adults (14 males; 17–70 years; mean time post injury: 13 months) meeting diagnostic criteria for unresponsive wakefulness syndrome/vegetative state (UWS; N = 10) or minimally conscious state (MCS; N = 12) due to brain injury were included in this study (Table 1). One patient only had functional data due to incomplete DWI acquisition.Table 1

Demographic information for patients with Disorders of Consciousness.

Table 1

Sex	Age	Aetiology	Diagnosis	CRS-R Score	Scan
M	46	TBI	UWS	6	12 dir
M	57	TBI	MCS	12	12 dir
M	46	TBI	MCS	10	Not available
M	35	Anoxic	UWS	8	12 dir
M	17	Anoxic	UWS	8	12 dir
F	31	Anoxic	MCS	10	12 dir
F	38	TBI	MCS	11	12 dir
M	29	TBI	MCS	10	63 dir
M	23	TBI	MCS	7	63 dir
F	70	Cerebral bleed	MCS	9	63 dir
F	30	Anoxic	MCS	9	63 dir
F	36	Anoxic	UWS	8	63 dir
M	22	Anoxic	UWS	7	63 dir
M	40	Anoxic	UWS	7	63 dir
F	62	Anoxic	UWS	7	63 dir
M	46	Anoxic	UWS	5	63 dir
M	21	TBI	MCS	11	63 dir
M	67	TBI	MCS	11	63 dir
F	55	Hypoxia	UWS	7	63 dir
M	28	TBI	MCS	8	63 dir
M	22	TBI	MCS	10	63 dir
F	28	ADEM	UWS	6	63 dir

CRS-R, Coma Recovery Scale-Revised; UWS, Unresponsive Wakefulness Syndrome; MCS, Minimally Conscious State; TBI, Traumatic Brain Injury.

Luppi A.I., Mediano P.A., Rosas F.E., Allanson J., Pickard J.D., Williams G.B., Craig M.M., Finoia P., Peattie A.R., Coppola P., Menon D.K., Bor D, & Stamatakis E.A. (2023). Reduced emergent character of neural dynamics in patients with a disrupted connectome. Neuroimage, 269, 119926.

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Publication 2023

Adult Awareness Brain Brain Injuries Brain Injuries, Focal Comatose Consciousness Disorders Diagnosis Fixation, Ocular Head Health Services, National Injuries Long-Term Care Males Mental Health Minimally Conscious State Patients Pharmaceutical Preparations Syndrome Traumatic Brain Injury Vegetative State Wakefulness

Prospective Trauma Data Collection in Rwanda

Following patient enrollment, trained research personnel collected data continuously using structured case reporting forms on an hourly basis during the first 6 h of ED care. Variables prospectively collected included patient demographics, mechanism of injury, time from injury to presentation, injury acuity, acute interventions during the first 6 h of care, imaging findings, and disposition. Injury severity was quantified by the Glasgow Coma Scale (GCS) and Kampala Trauma Score (KTS). The KTS is a previously validated trauma prognostication score designed specifically for use in LMIC and ranges continuously from 5 to 16, with lower scores denoting higher acuity.^{26–28 (link)} Following earlier studies, the shock index was calculated as the quotient of heart rate over systolic blood pressure on ED arrival and dichotomized at a threshold of ≥0.9 to indicate hemodynamic instability.^{29 (link)}To identify additional clinical variables of interest not captured by standardized screening forms, a retrospective chart review was conducted to record symptoms on presentation, serial neurological examinations, neurological intensive care unit (neuro-ICU) admission and length of stay (LOS), pharmacological agents administered, overall LOS, and extended Glasgow Outcome Scale (GOSE) score at discharge, reflecting functional status.^{30 (link),31 (link)} GCS score (mild = 13–15, moderate = 9–12, severe = 3–8) and GOSE score (7–8 = good recovery vs. 1–6 = death, vegetative state, or disability) were categorized following earlier methods.^{28 (link),32 (link)} The outcome of neurological decline was defined as a composite variable encapsulating GCS score decline of ≥2 points, new-onset unconsciousness, or new-onset sensorimotor deficit documented on serial exams.^{33 (link),34 (link)}Study enrollment and standardized data collection were performed by a team of seven research personnel who remained constant through the study period, all native to Rwanda, fluent in the three local languages (Kinyarwanda, French, and English), and with experience in clinical research and health care provision. Research personnel were trained in operating procedures by via didactic sessions and interactive role playing over a 2-day seminar. Data were collected on standardized hard-copy case reporting forms and entered daily into a password-protected online database. Data were checked weekly by the study team for validation and any data collection personnel having >5% missingness in their data were given focused assistance and retraining to improve data capture.

Tang O.Y., Uwamahoro C., González Marqués C., Beeman A., Odoom E., Ndebwanimana V., Uwamahoro D., Niyonsaba M., Nzabahimana A., Munyanziza S., Nshuti S., Jarmale S., Stephen A.H, & Aluisio A.R. (2023). Trends in Neurotrauma Epidemiology, Management, and Outcomes during the COVID-19 Pandemic in Kigali, Rwanda. Journal of Neurotrauma, 40(5-6), 536-546.

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Publication 2023

Disabled Persons Hemodynamics Injuries Neurologic Examination Patient Discharge Patients Rate, Heart Shock Systolic Pressure Vegetative State Wounds and Injuries

Meningitis, Encephalitis, and Lyme Neuroborreliosis Patients

Adult (≥ 18 years) patients admitted to the University Hospital North Zealand, in Copenhagen, Department of Infectious diseases between June 2016 and August 2019 clinically suspected of having meningitis, encephalitis, or Lyme neuroborreliosis were included. Nordsjællands Hospital services a population of 320.000 individuals. Patients were included prospectively in an observational study and samples were analyzed retrospectively.
CSF- and blood biochemistry results were obtained from the laboratory database LABKA II (Dedalus Healthcare ApS, Denmark). Blood biochemistry data obtained on the same day as lumbar puncture was performed were included. Data on microbiology was retrieved from databases for the individual departments.
Clinical data were collected from patient medical records including clinical datasheets, nurse registration files, and discharge records.
Outcome at discharge was categorized using the Glasgow Outcome Scale (GOS): (1) death; (2) vegetative state; (3) severe sequelae and dependency upon others in daily life; (4) moderate sequelae but with the ability to live independently; and (5) no or mild sequelae. An unfavorable outcome was defined as a GOS score of 1–4.
The included meningitis, encephalitis, or Lyme neuroborreliosis patients were ≥ 18 years of age and had a clinical appearance suggestive of CNS infection (any combination of neck stiffness, fever, headache or altered mental status or neurological symptoms) with ≥10 x 10⁶ cells/L in the CSF in combination with specific criteria as described below.
The control group was patients ≥ 18 years of age admitted under suspicion of CNS infection but with normal CSF biochemistry (CSF white blood cell count under 5 x 10⁶ cells/L, lactate under 2,4 mmol/L and protein < 0,8 g/L with no sign of blood contamination in the CSF) and with clinical improvement without specific meningitis treatment.

Thomsen M.M., Munthe-Fog L., Trier Petersen P., Hillig T., Friis-Hansen L.J., Roed C., Harboe Z.B, & Brandt C.T. (2023). Pentraxin 3 in the cerebrospinal fluid during central nervous system infections: A retrospective cohort study. PLOS ONE, 18(3), e0282004.

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Publication 2023

Adult BLOOD Cells Central Nervous System Infection Communicable Diseases Encephalitis Fever Headache Lactate L Cells Leukocyte Count Lyme Neuroborreliosis Meningitis Neck Neurologic Symptoms Nurses Patient Discharge Patients Proteins Punctures, Lumbar Respiratory Diaphragm sequels Vegetative State

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What is a Vegetative State?

A Vegetative State is a clinical condition characterized by complete loss of higher cortical functions. Patients in this state appear awake, with their eyes open, but they lack any purposeful response to stimuli and are unable to interact with their environment. This state typically arises from severe brain injury, such as traumatic brain injury, stroke, or hypoxic-ischemic encephalopathy.

How can I accurately assess and diagnose Vegetative State?

Accurate assessment and diagnosis of Vegetative State is crucial for prognosis and treatment planning. Clinicians should perform a thorough neurological examination, along with specialized tests and imaging, to rule out other conditions and confirm the presence of a Vegetative State. Consulting with expert healthcare providers can also help ensure an accurate diagnosis.

What are the different types or variations of Vegetative State?

While Vegetative State is the most common term, there are some variations that are important to understand. Minimally Conscious State is a related condition where the patient shows minimal but definite behavioral evidence of self-awareness or environmental awareness. Brain Death is a separate and irreversible condition where there is complete and permanent cessation of all brain function. Recognizing these distinctions is key for appropriate treatment and management.

How can PubCompare.ai assist with Vegetative State research?

PubCompare.ai's AI-driven platform can enhance reproducibility and accuracy in Vegetative State research. The platform allows you to screen protocol literature more efficiently, and leverage AI to pinpoint critical insights. This helps researchers identify the most effective protocols related to Vegetative State for their specific research goals. The platform's AI-driven analysis can highlight key differences in protocol effectiveness, enabling you to choose the best option for reproducibility and accuracy in your studies.

What are some common challenges in using Vegetative State protocols?

One of the main challenges in using Vegetative State protocols is ensuring reproducibility. Slight variations in patient assessment, diagnostic criteria, or data analysis can lead to inconsistent results across studies. Additionally, the complex nature of Vegetative State, with its potential for gradual improvement or fluctuations, can make it difficult to standardize protocols. Careful attention to detail and the use of AI-driven comparisons, as offered by PubCompare.ai, can help overcome these hurdles.

More about "Vegetative State"

Vegetative state (VS) is a clinical condition characterized by complete loss of higher cortical brain functions, with the patient exhibiting only reflex and autonomic activities.
Patients in a VS may appear awake, with their eyes open, but they lack any purposeful response to stimuli and are unable to interact with their environment.
This state typically arises from severe brain injury, such as traumatic brain injury, stroke, or hypoxic-ischemic encephalopathy.
Accurate assessment and diagnosis of VS is crucial for prognosis and treatment planning.
Researchers studying VS can utilize PubComapre.ai's AI-driven platform to enhance reproducibility and accuracy in their research.
The platform can help researchers locate relevant protocols from literature, preprints, and patents, and use AI-driven comparisons to identify the best protocols and products for their studies.
Some key subtopics related to VS research include: - Neurological evaluation and assessment tools (e.g., Glasgow Coma Scale, Coma Recovery Scale-Revised) - Neuroimaging techniques (e.g., MRI, fMRI, PET) - Electrophysiological measures (e.g., EEG, evoked potentials) - Pharmacological interventions (e.g., amantadine, zolpidem) - Rehabilitation and therapy approaches (e.g., sensory stimulation, music therapy) Researchers may also leverage various analytical tools and kits to support their VS studies, such as the DNeasy Plant Mini Kit for DNA extraction, STATA version 11 or R version 4.0.2 for statistical analysis, the TempliPhi DNA amplification kit for DNA amplification, DMEM for cell culture, and Strata SI-1 Silica columns for sample purification.
Additionally, they may use microplate readers for quantitative measurements and SPSS Statistics for data analysis and visualization.
By incorporating these insights and resources, researchers can enhance the reproducibility and accuracy of their VS studies, ultimately advancing our understanding of this complex and challenging clinical condition.