DOC States

Question 1

Coma

Answer 1

• State 1
• Persists btw 1h to 5 weeks before dvlp into another state of DOC
  1. Abs of sleep-wake cycle
  2. Abs of verbal communication
  3. Abs of reaction on command
  4. Diminished respiratory & thermo-regulatory functions

Question 2

UWS

= Unresponsive wakefulness syndrome

Answer 2

• as soon as eye opening is observed
• still = vegetative state
• Sleep wake cycle ✅
• Most BSRS & autonomic functions ✅

There is 2 states : persistent (>1 month) & permanent (sympt >3 months)

Question 3

MCS

= Minimal consciousness state

Answer 3

• inconsistent sings off awarness (might be able to communicate verbally or thr mvt) ✅
• Emotional state ✅
• Eyes following objects/persons ✅
• Thalamo-cortical & cortico-cortical synapses restores ✅

This state can be temporary or permanent

Question 4

Locked-in syndrome

Answer 4

• complete plegia exepct for eyes mvts & index for some (no sensory deficit)
• no mvt
• no verbal interactions

Follow a brainsem lesion

Question 5

Which networks are decreased in DOC?

Answer 5

1. DMN = Default Mode Network => self-related functions related to perspective taking of desires , beliefs, memory, planning..
2. SN = Salience Network => Involved in conscious perception of stimuli, creating contex to be interpreted as a base for decision-making processes

Both decreased, will increased as the level of consicousness increases

Question 6

What are the levels of SN & DMN in the differents states of DOC?

Answer 6

• SN : no thalamic activity in 2 first stages, incr. in MCS => Show better perception of stimuli
• DMN : connection inside DMN improve => improvement in neurobehavioral sum can be observed