First reliable measure of neurobehavioral functioning during coma from severe brain injury

A Northwestern University researcher has developed the first truly reliable measure of neurobehavioral functioning during coma from severe brain injury that predicts recovery of consciousness up to one year after injury, with up to 86 percent certainty.

Theresa Louise-Bender Pape, assistant research professor of physical medicine and rehabilitation at Northwestern University Feinberg School of Medicine, and her colleagues described the measure, called Disorders of Consciousness Scale© (DOCS) in a two-part series in the January/February 2005 issue of the Journal of Rehabilitation Research & Development.

Using the DOCS, the researchers evaluated military veterans and civilians over age 18 years who were unconscious after a severe brain injury. The test stimuli were organized into eight subscales, including social knowledge; taste and swallowing; olfactory; proprioceptive (perception of one's body in space) and vestibular (balance); auditory; visual; tactile; and testing-readiness. The investigators found that DOCS accurately detected improvements, declines and plateaus in neurobehavioral functioning in unconscious patients.

The study also showed how repeated measures using DOCS improved medical and rehabilitation management during coma recovery. The investigators found previously undetected secondary medical complications, which were successfully treated.

Pape is also researcher at the Edward Hines, Jr., Veterans Administration Hospital, Hines, Ill., and at Marianjoy Rehabilitation Hospital, Wheaton, Ill. Investigators from the Rehabilitation Institute of Chicago collaborated on the research.

The study was based on work supported by grants from the Department of Veterans Affairs, Veterans Health Administration; the Midwest Center for Health Services and Policy Research; and the National Institute on Disability and Rehabilitation Research.

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