Covert Cognition in Disorders of Consciousness: A Meta-Analysis

Covert cognition in patients with disorders of consciousness represents a real diagnostic conundrum for clinicians. In this meta-analysis, our main objective was to identify clinical and demographic variables that are more likely to be associated with responding to an active paradigm. Among 2018 cit...

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Bibliographic Details
Published in:Brain sciences 2020-12, Vol.10 (12), p.930
Main Authors: Schnakers, Caroline, Hirsch, Michaela, Noé, Enrique, Llorens, Roberto, Lejeune, Nicolas, Veeramuthu, Vigneswaran, De Marco, Sabrina, Demertzi, Athena, Duclos, Catherine, Morrissey, Ann-Marie, Chatelle, Camille, Estraneo, Anna
Format: Article
Language:English
Subjects:
Accuracy
Behavior
Bias
Cognition
Cognition & reasoning
cognitive motor dissociation
Coma
Communication
Consciousness
covert cognition
Electrophysiology
Human health sciences
Human subjects
Medical imaging
Meta-analysis
minimally conscious state
Neuroimaging
Neurologie
Neurology
Paradigms
Patients
Sciences de la santé humaine
severe brain injury
Statistical analysis
Structure-function relationships
Traumatic brain injury
vegetative state
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Summary:Covert cognition in patients with disorders of consciousness represents a real diagnostic conundrum for clinicians. In this meta-analysis, our main objective was to identify clinical and demographic variables that are more likely to be associated with responding to an active paradigm. Among 2018 citations found on PubMed, 60 observational studies were found relevant. Based on the QUADAS-2, 49 studies were considered. Data from 25 publications were extracted and included in the meta-analysis. Most of these studies used electrophysiology as well as counting tasks or mental imagery. According to our statistical analysis, patients clinically diagnosed as being in a vegetative state and in a minimally conscious state minus (MCS-) show similar likelihood in responding to active paradigm and responders are most likely suffering from a traumatic brain injury. In the future, multi-centric studies should be performed in order to increase sample size, with similar methodologies and include structural and functional neuroimaging in order to identify cerebral markers related to such a challenging diagnosis.
ISSN:2076-3425
2076-3425
DOI:10.3390/brainsci10120930