Citation

Dolce G, Lucca LF, Rogano S, Candelieri A, Pignolo L, Sannita WG. J. Neurotrauma 2011; 28(7): 1149-1154.

Affiliation

S.Anna Institute for neurorehabilitation, Scientific direction, via siris,11, Crotone, Italy, 88900, +39 962 23973, + 39 962 23973; giulianodolce@libero.it.

Copyright

(Copyright © 2011, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2010.1405

PMID

21175278

Abstract

Visual pursuit is a key descriptor of the minimally conscious state (above 80% of cases). It is also observable in about 20% of subjects in vegetative state, and its re-appearance after severe brain damage anticipates a favorable outcome, with recovery of consciousness in 73% of subjects (45% in the absence of it). We considered retrospectively 395 subjects in vegetative state because of traumatic (63%), massive acute vascular (30%) or diffuse anoxic-hypoxic (7%) brain damage consecutively admitted to one dedicated unit in the years 1998- 2008. Visual tracking was observed in 290 subjects (73.4%) and was already detectable within 50 days from brain injury in about 60% of posttraumatic or vascular subjects and 21% of anoxic-hypoxic patients. After 230 days of follow-up or more, it was observed in 89% and 88% of posttraumatic and vascular subjects and in 67% of anoxic-hypoxic patients. Rating at the Glasgow Outcome Scale (GOS) was better in those subjects with recovered visual tracking and inversely correlated with the time of re-appearance in posttraumatic and vascular subjects; also the subjects with late recovery of eye tracking (230 days or more) had better GOS outcome than those without it. The observation of visual tracking re-appearing in subjects in vegetative state would reflect recuperation of the brainstem-cortical interaction and overall brain functional organization that are thought to sustain consciousness and are interfered with by the "functional disconnection" resulting in the vegetative state.

Language: en