Annals of Rehabilitation Medicine

"Minimally conscious state"

Original Article

Validation of Korean Version of Coma Recovery Scale-Revised (K-CRSR): Hee Jun Han, Ee Jin Kim, Hae Jin Lee, Sung Bom Pyun, Kyung Lim Joa, Han Young Jung; Ann Rehabil Med 2018;42(4):536-541. Published online August 31, 2018; DOI: https://doi.org/10.5535/arm.2018.42.4.536; Correction in: Ann Rehabil Med 2021;45(6):471

Abstract
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Objective
To determine the validity and reliability of the Korean version of the Coma Recovery Scale-Revised (K-CRSR) for evaluation of patients with a severe brain lesion.
Methods
With permission from Giacino, the developer of the Coma Recovery Scale Revised (CRSR), the scale was translated into Korean and back-translated into English by a Korean physiatrist highly proficient in English, and then verified by the original developer. Adult patients with a severe brain lesion following traumatic brain injury, stroke, or hypoxic brain injury were examined. To assess the inter-rater reliability, all patients were tested with K-CRSR by two physiatrists individually. To determine intra-rater reliability, the same test was re-administered by the same physiatrists after three days.
Results
Inter-rater reliability (k=0.929, p<0.01) and intra-rater reliability (k=0.938, p<0.01) were both high for total K-CRSR scores. Inter- and intra-rater agreement rates were very high (94.9% and 97.4%, respectively). The total K-CRSR score was significantly correlated with K-GCS (r=0.894, p<0.01), demonstrating sufficient concurrent validity.
Conclusion
K-CRSR is a reliable and valid instrument for the assessment of patients with brain injury by trained physiatrists. This scale is useful in differentiating patients in minimally conscious state from those in vegetative state.

Citations

Citations to this article as recorded by

Reliability and validation of the Japanese version of the coma recovery scale-revised (CRS-R)
Takayuki Kitano, Joseph T. Giacino, Yelena Bodien, Abigail Waters, Daichi Hioki, Junko Shinya, Teiji Nakayama, Shohei Ohgi
Brain Injury.2024; 38(4): 249. CrossRef
Cerebrolysin Concentrate: Therapeutic Potential for Severe Oral Apraxia After Stroke: A Case Report
Hyeonwoo Jeon, Doo Young Kim
Brain & Neurorehabilitation.2024;[Epub] CrossRef
Safety and therapeutic effects of personalized transcranial direct current stimulation based on electrical field simulation for prolonged disorders of consciousness: study protocol for a multi-center, double-blind, randomized controlled trial
Mi-Jeong Yoon, Hyun Mi Oh, TaeYeong Kim, Soo-Jin Choi, Woo Hee Choi, Hong Soo Jung, Sung Chul Lim, Yeun Jie Yoo, Hye Jung Park, Bo Young Hong, Geun-Young Park, Donghyeon Kim, Tae-Woo Kim, Sun Im, Seong Hoon Lim
Frontiers in Neurology.2023;[Epub] CrossRef
Behavioral Assessment of Patients with Disorders of Consciousness
Yelena G. Bodien, Douglas I. Katz, Nicholas D. Schiff, Joseph T. Giacino
Seminars in Neurology.2022; 42(03): 249. CrossRef
Prolonged Disorders of Consciousness
Daeyoung Kim
Journal of the Korean Neurological Association.2020; 38(1): 9. CrossRef
Neurobehavioral recovery in patients who emerged from prolonged disorder of consciousness: a retrospective study
Hoo Young Lee, Jung Hyun Park, Ae Ryoung Kim, Misun Park, Tae-Woo Kim
BMC Neurology.2020;[Epub] CrossRef

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Case Report

A Learning Set Up for Detecting Minimally Conscious State (MCS): Eun Joo Kim, Jeong Mi Park, Wan Ho Kim, Kwang Lai Lee, Han Na Kim, Ko Eun Lee, Jeong Joon Park, Kwang Ok Ahn; Ann Rehabil Med 2012;36(3):428-431. Published online June 30, 2012; DOI: https://doi.org/10.5535/arm.2012.36.3.428

Abstract
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Detecting signs of learning in persons diagnosed to be in a post-coma vegetative state and minimally conscious state (MCS) may modify their diagnosis. We report the case of a 65-year-old female in a vegetative state. We used microswitch-based technology that is based on patient response to eye-blinking. We followed an ABABCB design, in which A represented baseline periods, B intervention periods with stimuli contingent on the responses, and C a control condition with stimuli presented non-contingently. We observed the level of response during the B phases was higher than the level of A and C phases. This indicated the patient showed signs of learning. This state was confirmed by an evaluation through the Coma Recovery Scale-Revised (CRSR) score, and after completion of this study her CRSR score changed from 4 to 10. We believe microswitch technology may be useful to make a diagnosis of MCS and offer new opportunities for education to MCS patients.

Citations

Citations to this article as recorded by

Exploring the clinical diagnostic value of linguistic learning ability in patients with disorders of consciousness using electrooculography
Xiangyue Xiao, Junhua Ding, Mingyan Yu, Zhicai Dong, Sara Cruz, Nai Ding, Charlène Aubinet, Steven Laureys, Haibo Di, Yan Chen
NeuroImage.2024; 297: 120753. CrossRef
An assistive technology program for enabling five adolescents emerging from a minimally conscious state to engage in communication, occupation, and leisure opportunities
Fabrizio Stasolla, Alessandro O. Caffò, Sara Bottiroli, Donatella Ciarmoli
Developmental Neurorehabilitation.2022; 25(3): 193. CrossRef
The Integration of Assistive Technology and Virtual Reality for Assessment and Recovery of Post-coma Patients With Disorders of Consciousness: A New Hypothesis
Fabrizio Stasolla, Leonarda Anna Vinci, Maria Cusano
Frontiers in Psychology.2022;[Epub] CrossRef
A Behavioral Approach to Treatment and Assessment of People with Disorders of Consciousness: The Response-contingent Stimulation Strategy
Giulio E. Lancioni, Marta Olivetti Belardinelli, Nirbhay N. Singh, Mark F. O’Reilly, Jeff Sigafoos, Gloria Alberti, Lorenzo Desideri
Journal of Integrative Neuroscience.2022;[Epub] CrossRef
Assessment and Intervention with Patients with Severe Disorders of Consciousness
Giulio E. Lancioni, Andrea Bosco, Mark F. O’Reilly, Jeff Sigafoos, Marta Olivetti Belardinelli
Advances in Neurodevelopmental Disorders.2017; 1(3): 196. CrossRef
Evidence of trace conditioning in comatose patients revealed by the reactivation of EEG responses to alerting sounds
Elsa Juan, Nathalie Ata Nguepnjo Nguissi, Athina Tzovara, Dragana Viceic, Marco Rusca, Mauro Oddo, Andrea O. Rossetti, Marzia De Lucia
NeuroImage.2016; 141: 530. CrossRef
Microswitch-aided programs with contingent stimulation versus general stimulation programs for post-coma persons with multiple disabilities
Giulio E. Lancioni, Nirbhay N. Singh, Mark F. O’Reilly, Vanessa A. Green, Francesca Buonocunto, Valentina Sacco, Jorge Navarro, Crocifissa Lanzilotti, Marta Olivetti Belardinelli
Developmental Neurorehabilitation.2014; 17(4): 251. CrossRef