The Gray Zone of Consciousness: Cognitive Motor Dissociation.

IF 7.4 2区医学 Q1 CLINICAL NEUROLOGY

Current Neurology and Neuroscience Reports Pub Date : 2025-07-18 DOI:10.1007/s11910-025-01438-2

Daniel Kondziella

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引用次数: 0

Abstract

Purpose of review: Covert consciousness, including cognitive motor dissociation (CMD), occurs in clinically unresponsive patients with brain injury who can willfully modulate their brain activity to comply with motor imagery commands as revealed by functional magnetic resonance imaging, EEG or other technologies. In 2024, the Curing Coma Campaign conducted a gap analysis of the field of covert consciousness and CMD. This article discusses the achievements that have been made in the field since then.

Recent findings: Three major recent achievements include epidemiological data that CMD occurs in up to 25% of unresponsive brain injury patients, the development of convenient tools for detecting CMD at the bedside, and CMD as a biomarker of cerebral reserves that may possibly be exploited pharmacologically for prognostication and rehabilitation. Although many questions remain, recent findings have paved the way for the implementation of CMD screening in clinical routine, also in resource-poor settings, for better prognostication after brain injury and possibly for therapeutic purposes.

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意识的灰色地带：认知运动分离。

综述目的：脑损伤临床无反应患者存在隐性意识，包括认知运动分离（CMD），这些患者可以通过功能磁共振成像、脑电图或其他技术显示有意调节其脑活动以服从运动图像命令。2024年，“治愈昏迷运动”对隐蔽意识和CMD领域进行了差距分析。本文讨论了自那时以来在该领域取得的成就。最近的发现：最近的三个主要成就包括流行病学数据表明，高达25%的无反应性脑损伤患者发生CMD，在床边检测CMD的便捷工具的开发，以及CMD作为脑储备的生物标志物，可能在药理学上用于预测和康复。尽管仍存在许多问题，但最近的研究结果为在临床常规中以及在资源贫乏的环境中实施CMD筛查铺平了道路，以便更好地预测脑损伤后的预后，并可能用于治疗目的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Neurology and Neuroscience Reports 医学-临床神经学

CiteScore

9.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Neurology and Neuroscience Reports provides in-depth review articles contributed by international experts on the most significant developments in the field. By presenting clear, insightful, balanced reviews that emphasize recently published papers of major importance, the journal elucidates current and emerging approaches to the diagnosis, treatment, management, and prevention of neurological disease and disorders. Presents the views of experts on current advances in neurology and neuroscience Gathers and synthesizes important recent papers on the topic Includes reviews of recently published clinical trials, valuable web sites, and commentaries from well-known figures in the field.