As a newly described condition distinct from coma or the vegetative state, minimally conscious state (MCS) is characterised by a threshold level of consciousness, and diagnostic criteria have recently been proposed. 1 In MCS, cognitively mediated behaviour occurs inconsistently, but is reproducible or sustained enough to be differentiated from reflexive behaviour. It is clinically essential to ...

The minimally conscious state (MCS) is a clinical manifestation of severe brain injury. While there are no evidence-based criteria, diagnostic guidelines were reached in a series of consensus development workshops [1]. The differential diagnosis of the minimally conscious state is important and includes the vegetative state (transient, persistent and permanent), coma and the locked-in syndrome ...

We studied a patient in a minimally conscious state using PET and cognitive evoked potentials. Cerebral metabolism was below half of normal values. Auditory stimuli with emotional valence (infant cries and the patient's own name) induced a much more widespread activation than did meaningless noise; the activation pattern was comparable with that previously obtained in controls. Cognitive potent...

Neurostimulation to restore cognitive and physical functions is an innovative and promising technique for treating patients with severe brain injury that has resulted in a minimally conscious state (MCS). The technique may involve electrical stimulation of the central thalamus, which has extensive projections to the cerebral cortex. Yet it is unclear whether an improvement in neurological funct...

Editor’s note: Eight years ago an interdisciplinary group of scientists representing several institutions worked together to codify criteria for the minimally conscious state. Unlike vegetative patients, who have no conscious awareness, minimally conscious patients show signs of voluntary motor action and response. Technology, such as functional neuroimaging, is beginning to change the way medi...

Following a coma, some patients may "awaken" without voluntary interaction or communication with the environment. More than 40 years ago this condition was coined coma vigil or apallic syndrome and later became worldwide known as "persistent vegetative state". About 10 years ago it became clear that some of these patients who failed to recover verbal or non-verbal communication did show some de...

OBJECTIVE The aim of this study was to assess differences in brain activation in a large sample of Vegetative State (VS) and Minimally Conscious State (MCS) patients, using functional magnetic resonance imaging (fMRI). METHODS We studied 50 patients four to seven months after brain injury. By using international clinical criteria and validated behavioural scales such as the Glasgow Coma Scale...

BACKGROUND Detecting signs of consciousness in patients in a vegetative state/unresponsive wakefulness syndrome (UWS/VS) or minimally conscious state (MCS) is known to be very challenging. Plotkin et al. (2010) recently showed the possibility of using a breathing-controlled communication device in patients with locked in syndrome. We here aim to test a breathing-based "sniff controller" that co...