Cognitive Motor Dissociation: Gap Analysis and Future Directions

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Jan Claassen
  • Kondziella, Daniel
  • Ayham Alkhachroum
  • Michael Diringer
  • Brian L. Edlow
  • Joseph J. Fins
  • Olivia Gosseries
  • Yousef Hannawi
  • Benjamin Rohaut
  • Caroline Schnakers
  • Robert D. Stevens
  • Aurore Thibaut
  • Martin Monti
  • the Curing Coma Campaign, and Its Contributing Collaborators

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.

OriginalsprogEngelsk
TidsskriftNeurocritical Care
Vol/bind40
Udgave nummer1
Sider (fra-til)81-98
Antal sider18
ISSN1541-6933
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
Funding sources included NINDS (R01NS106014, R03NS112760, R21NS128326) and James S. McDonnell Foundation (JC); Novo Nordisk Foundation (NNF21OC0067769), Lundbeck Foundation (R349-2020-658), and Offerfonden (19-610-00060, 21-610-00119) (DK); NIH BRAIN Initiative (RF1MH12378-01) (JJF); Miami CTSI NCATS (KL2 UL1TR002736), NINDS (K23NS126577, R21NS128326) (AA); Belgian National Funds for Scientific Research (FRS-FNRS), University and University Hospital of Liege, Fund Léon Fredericq, Fund Generet, King Baudouin Foundation, DOCMA project (EU-H2020-MSCA–RISE–778234), AstraZeneca Foundation, European Union’s Horizon 2020 Framework Programme for Research and Innovation (No. 945539 Human Brain Project SGA3), Mind Science Foundation and the European Commission, F.R.S-FNRS (OG, AT); NINDS, NIH Director’s Office, James S. McDonnell Foundation (BLE); NIH (R33AG071744), JHU Discovery, The Institute for Data Intensive Engineering and Science JHU (RDS); NIGMS (MM); none for BR, CS, and YH.

Publisher Copyright:
© 2023, Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.

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