An fMRI region-based investigation of cognitive processes involved in the item-method directed forgetting
Bastin, Christine ; Feyers, Dorothée ; Salmon, Eric et al
Conference (2010)Detailed reference viewed: 8 (2 ULg)
Assessment and detection of pain in noncommunicative severely brain-injured patients.
Schnakers, Caroline ; Chatelle, Camille ; Majerus, Steve et al
in Expert Review of Neurotherapeutics (2010), 10(11), 1725-31
Detecting pain in severely brain-injured patients recovering from coma represents a real challenge. Patients with disorders of consciousness are unable to consistently or reliably communicate their ... [more ▼]
Detecting pain in severely brain-injured patients recovering from coma represents a real challenge. Patients with disorders of consciousness are unable to consistently or reliably communicate their feelings and potential perception of pain. However, recent studies suggest that patients in a minimally conscious state can experience pain to some extent. Pain monitoring in these patients is hence of medical and ethical importance. In this article, we will focus on the possible use of behavioral scales for the assessment and detection of pain in noncommunicative patients. [less ▲]Detailed reference viewed: 21 (3 ULg)
The commonality of neural networks for verbal and visual short-term memory.
Majerus, Steve ; D'Argembeau, Arnaud ; Martinez Perez, Trecy et al
in Journal of Cognitive Neuroscience (2010), 22(11), 2570-2593
Although many neuroimaging studies have considered verbal and visual short-term memory (STM) as relying on neurally segregated short-term buffer systems, the present study explored the existence of shared ... [more ▼]
Although many neuroimaging studies have considered verbal and visual short-term memory (STM) as relying on neurally segregated short-term buffer systems, the present study explored the existence of shared neural correlates supporting verbal and visual STM. We hypothesized that networks involved in attentional and executive processes, as well as networks involved in serial order processing, underlie STM for both verbal and visual list information, with neural specificity restricted to sensory areas involved in processing the specific items to be retained. Participants were presented sequences of nonwords or unfamiliar faces, and were instructed to maintain and recognize order or item information. For encoding and retrieval phases, null conjunction analysis revealed an identical fronto-parieto-cerebellar network comprising the left intraparietal sulcus, bilateral dorsolateral prefrontal cortex, and the bilateral cerebellum, irrespective of information type and modality. A network centered around the right intraparietal sulcus supported STM for order information, in both verbal and visual modalities. Modality-specific effects were observed in left superior temporal and mid-fusiform areas associated with phonological and orthographic processing during the verbal STM tasks, and in right hippocampal and fusiform face processing areas during the visual STM tasks, wherein these modality effects were most pronounced when storing item information. The present results suggest that STM emerges from the deployment of modality-independent attentional and serial ordering processes toward sensory networks underlying the processing and storage of modality-specific item information. [less ▲]Detailed reference viewed: 197 (68 ULg)
Neural networks involved in self-judgement in young and elderly adults
Feyers, Dorothée ; Collette, Fabienne ; D'Argembeau, Arnaud et al
in NeuroImage (2010)
Recent studies have shown that both young and elderly subjects activate the ventromedial prefrontal cortex (VMPFC) when they make self-referential judgements. However, the VMPFC might interact with ... [more ▼]
Recent studies have shown that both young and elderly subjects activate the ventromedial prefrontal cortex (VMPFC) when they make self-referential judgements. However, the VMPFC might interact with different brain regions during self-referencing in the two groups. In this study, based on data from Ruby et al (2009), we have explored this issue using psychophysiological interaction analyses. Young and elderly participants had to judge adjectives describing personality traits in reference to the self versus a close friend or relative (the other), taking either a first-person or a third-person perspective. The physiological factor was the VMPFC activity observed in all participants during self judgement, and the psychological factor was the self versus other referential process. The main effect of first-person perspective in both groups revealed that the VMPFC was coactivated with the left parahippocampal gyrus and the precuneus for self versus other judgments. The main effect of age showed a stronger correlation between activity in the VMPFC and the lingual gyrus in young compared to elderly subjects. Finally, in the interaction, the VMPFC was specifically co-activated with the orbitofrontal gyrus and the precentral gyrus when elderly subjects took a first-person perspective for self judgements. No significant result was observed for the interaction in young subjects. These findings show that, although the VMPFC is engaged by both young and older adults when making self-referential judgements, this brain structure interacts differently with other brain regions as a function of age and perspective. These differences might reflect a tendency by older people to engage in more emotional/social processing than younger adults when making self-referential judgements with a first-person perspective [less ▲]Detailed reference viewed: 48 (15 ULg)
Visual fixation in the vegetative state: an observational case series PET study.
Bruno, Marie-Aurélie ; Vanhaudenhuyse, Audrey ; Schnakers, Caroline et al
in BMC Neurology (2010), 10
BACKGROUND: Assessment of visual fixation is commonly used in the clinical examination of patients with disorders of consciousness. However, different international guidelines seem to disagree whether ... [more ▼]
BACKGROUND: Assessment of visual fixation is commonly used in the clinical examination of patients with disorders of consciousness. However, different international guidelines seem to disagree whether fixation is compatible with the diagnosis of the vegetative state (i.e., represents "automatic" subcortical processing) or is a sufficient sign of consciousness and higher order cortical processing. METHODS: We here studied cerebral metabolism in ten patients with chronic post-anoxic encephalopathy and 39 age-matched healthy controls. Five patients were in a vegetative state (without fixation) and five presented visual fixation but otherwise showed all criteria typical of the vegetative state. Patients were matched for age, etiology and time since insult and were followed by repeated Coma Recovery Scale-Revised (CRS-R) assessments for at least 1 year. Sustained visual fixation was considered as present when the eyes refixated a moving target for more than 2 seconds as defined by CRS-R criteria. RESULTS: Patients without fixation showed metabolic dysfunction in a widespread fronto-parietal cortical network (with only sparing of the brainstem and cerebellum) which was not different from the brain function seen in patients with visual fixation. Cortico-cortical functional connectivity with visual cortex showed no difference between both patient groups. Recovery rates did not differ between patients without or with fixation (none of the patients showed good outcome). CONCLUSIONS: Our findings suggest that sustained visual fixation in (non-traumatic) disorders of consciousness does not necessarily reflect consciousness and higher order cortical brain function. [less ▲]Detailed reference viewed: 26 (4 ULg)
Modulation of medial prefrontal and inferior parietal cortices when thinking about past, present, and future selves.
D'Argembeau, Arnaud ; Stawarczyk, David ; Majerus, Steve et al
in Social Neuroscience (2010), 5
Recent functional neuroimaging studies have shown that reflecting on representations of the present self versus temporally distant selves is associated with higher activity in the medial prefrontal cortex ... [more ▼]
Recent functional neuroimaging studies have shown that reflecting on representations of the present self versus temporally distant selves is associated with higher activity in the medial prefrontal cortex (MPFC). In the current fMRI study, we investigated whether this effect of temporal perspective is symmetrical between the past and future. The main results revealed that the MPFC showed higher activity when reflecting on the present self than when reflecting on past and future selves, with no difference between past and future selves. Temporal perspective also modulated activity in the right inferior parietal cortex but in the opposite direction, activity in this brain region being higher when reflecting on past and future selves relative to the present self (with again no difference between past and future selves). These findings show that differences in brain activity when thinking about current versus temporally distant selves are symmetrical between the past and the future. It is suggested that by processing degrees of self-relatedness, the MPFC might sustain the process of identifying oneself with current representations of the self, whereas the right inferior parietal cortex might be involved in distinguishing the present self from temporally distant selves. [less ▲]Detailed reference viewed: 193 (15 ULg)
The neural basis of personal goal processing when envisioning future events
D'Argembeau, Arnaud ; Stawarczyk, David ; Majerus, Steve et al
in Journal of Cognitive Neuroscience (2010), 22
Abstract Episodic future thinking allows humans to mentally simulate virtually infinite future possibilities, yet this device is fundamentally goal-directed and should not be equated with fantasizing or ... [more ▼]
Abstract Episodic future thinking allows humans to mentally simulate virtually infinite future possibilities, yet this device is fundamentally goal-directed and should not be equated with fantasizing or wishful thinking. The purpose of this functional magnetic resonance imaging study was to investigate the neural basis of such goal-directed processing during future-event simulation. Participants were scanned while they imagined future events that were related to their personal goals (personal future events) and future events that were plausible but unrelated to their personal goals (nonpersonal future events). Results showed that imaging personal future events elicited stronger activation in ventral medial prefrontal cortex (MPFC) and posterior cingulate cortex (PCC) compared to imaging nonpersonal future events. Moreover, these brain activations overlapped with activations elicited by a second task that assessed semantic self-knowledge (i.e., making judgments on one's own personality traits), suggesting that ventral MPFC and PCC mediate self-referential processing across different functional domains. It is suggested that these brain regions may support a collection of processes that evaluate, code, and contextualize the relevance of mental representations with regard to personal goals. The implications of these findings for the understanding of the function instantiated by the default network of the brain are also discussed. [less ▲]Detailed reference viewed: 162 (19 ULg)
The relationship between serial order STM and vocabulary development: a longitudinal study.
Leclercq, Anne-Lise ; Majerus, Steve
in Developmental Psychology (2010), 46(2), 417-427Detailed reference viewed: 160 (40 ULg)
The nociception coma scale: A new tool to assess nociception in disorders of consciousness.
Schnakers, Caroline ; Chatelle, Camille ; Vanhaudenhuyse, Audrey et al
in Pain (2010), 148
Assessing behavioral responses to nociception is difficult in severely brain-injured patients recovering from coma. We here propose a new scale developed for assessing nociception in vegetative (VS) and ... [more ▼]
Assessing behavioral responses to nociception is difficult in severely brain-injured patients recovering from coma. We here propose a new scale developed for assessing nociception in vegetative (VS) and minimally conscious (MCS) coma survivors, the Nociception Coma Scale (NCS), and explore its concurrent validity, inter-rater agreement and sensitivity. Concurrent validity was assessed by analyzing behavioral responses of 48 post-comatose patients to a noxious stimulation (pressure applied to the fingernail) (28 VS and 20 MCS; age range 20-82years; 17 of traumatic etiology). Patients' were assessed using the NCS and four other scales employed in non-communicative patients: the 'Neonatal Infant Pain Scale' (NIPS) and the 'Faces, Legs, Activity, Cry, Consolability' (FLACC) used in newborns; and the 'Pain Assessment In Advanced Dementia Scale' (PAINAD) and the 'Checklist of Non-verbal Pain Indicators' (CNPI) used in dementia. For the establishment of inter-rater agreement, fifteen patients were concurrently assessed by two examiners. Concurrent validity, assessed by Spearman rank order correlations between the NCS and the four other validated scales, was good. Cohen's kappa analyses revealed a good to excellent inter-rater agreement for the NCS total and subscore measures, indicating that the scale yields reproducible findings across examiners. Finally, a significant difference between NCS total scores was observed as a function of diagnosis (i.e., VS or MCS). The NCS constitutes a sensitive clinical tool for assessing nociception in severely brain-injured patients. This scale constitutes the first step to a better management of patients recovering from coma. [less ▲]Detailed reference viewed: 76 (8 ULg)
Das verbale Kurzzeitgedächtnis als Produkt der Interaktionen zwischen Aufmerksamkeitskapazitäten, Sequenzverarbeitung und Aktivierung des Sprachsystems.
in Psychologische Rundschau : Ueberblick Uber die Fortschritte der Psychologie in Deutschland, Oesterreich, und der Schweiz (2010), 61Detailed reference viewed: 34 (3 ULg)
Les multiples determinants de la mémoire à court terme verbale : implications théoriques et évaluatives
in Développements (2010), 4Detailed reference viewed: 125 (23 ULg)
Rétention de l’ordre sériel en mémoire verbale à court-terme chez des adultes dyslexiques
Martinez Perez, Trecy ; Poncelet, Martine ; Majerus, Steve
Poster (2009, December 04)
Les difficultés en mémoire verbale à court terme (MCTV) chez les dyslexiques sont interprétées comme le reflet de représentations phonologiques déficitaires (voir Snowling, 2000). Cependant, leurs ... [more ▼]
Les difficultés en mémoire verbale à court terme (MCTV) chez les dyslexiques sont interprétées comme le reflet de représentations phonologiques déficitaires (voir Snowling, 2000). Cependant, leurs capacités en MCTV sont généralement évaluées au moyen de tâches classiques (tâches d'empan) qui ne permettent pas de dissocier le stockage de l'information relative à l'identité des items (information « item ») du stockage de l'information concernant l'ordre de présentation de ces items (information « ordre sériel ») (Majerus et al., 2006). Or, ces deux aspects de la MCTV pourraient être différentiellement liés à l'apprentissage du langage écrit et être tous deux déficitaires dans la dyslexie. L’objectif de cette étude est de déterminer si les dyslexiques présentent des difficultés en MCTV non seulement pour l'information « item » mais également pour l'ordre sériel. [less ▲]Detailed reference viewed: 216 (33 ULg)
Répétition de non-mots et rappel sériel immédiat : Des mesures équivalentes de la mémoire à court terme verbale?
Leclercq, Anne-Lise ; Majerus, Steve
Poster (2009, December 04)
En psychologie expérimentale et en neuropsychologie, les mesures classiques pour évaluer la mémoire à court terme verbale (MCTV) sont des tâches de rappel sériel immédiat (empan de chiffres ou de mots ... [more ▼]
En psychologie expérimentale et en neuropsychologie, les mesures classiques pour évaluer la mémoire à court terme verbale (MCTV) sont des tâches de rappel sériel immédiat (empan de chiffres ou de mots). Il a été démontré que cette même MCTV prédit les capacités de développement lexical, mais sur base d’une estimation de la MCTV à partir de tâches de répétition de non-mots. Même si ces deux procédures (répétition de non-mots, rappel sériel immédiat) sont censées mesurer la MCTV de façon équivalente, la répétition de non-mots recrute davantage de processus linguistiques tels que la segmentation phonologique et la coarticulation (Gathercole, 2006; Majerus, Van der Linden, Mulder, Meulemans, & Peters, 2004). Le but de cette étude est de déterminer dans quelle mesure ces deux types d’estimation de la MCTV sont des prédicteurs équivalents du développement lexical. Des tâches de rappel de syllabes présentées soit de manière sérielle (chaque syllabe étant séparée par une pause), soit de manière agglutinée (= répétition de non-mots) ont été administrées à des enfants de 4, 5, 6 et 8 ans (N=30 dans chaque groupe). Le niveau de vocabulaire a été évalué par le test EVIP (Dunn, Thériault-Whalen, & Dunn, 1993). Une analyse de variance sur les performances aux tâches de MCTV a montré un effet de l’âge (F(3,116)=26.87, p<.001) et un effet du type de tâche, avec de meilleures performances pour les syllabes présentées de façon agglutinée (F(1,116)=390.85, p<.001). Une analyse de régression sur le niveau de vocabulaire a indiqué qu’à la fois la répétition de non-mots et le rappel de séries de syllabes sont des prédicteurs significatifs, après contrôle de l’âge et du niveau intellectuel non-verbal. En outre, la répétition de non-mots reste un prédicteur significatif du niveau de vocabulaire après contrôle du rappel sériel de syllabes (Δ R²=.016). La relation inverse n’est pas significative. Cette étude montre que la répétition de non-mots et le rappel sériel immédiat ne reflètent pas des mesures identiques de la MCTV, et que la prédiction la plus robuste du niveau de vocabulaire est observée pour les tâches de MCTV recrutant un maximum de processus linguistiques. [less ▲]Detailed reference viewed: 386 (24 ULg)
Phonological impairment as a decay-based impairment : New evidence from a single case study
Martinez Perez, Trecy ; Poncelet, Martine ; Boniver, Celine et al
Poster (2009, October 19)
Computational models of language processing such as the Martin and Saffran (1992) model assume two properties underlying language processing: decay rate of activated representations and strength of ... [more ▼]
Computational models of language processing such as the Martin and Saffran (1992) model assume two properties underlying language processing: decay rate of activated representations and strength of activation spread between phonological, lexical and semantic levels of representation. Despite the theoretical and epistemological advantages of these models, as opposed to box-and-arrow type models, empirical evidence for these models is currently based on a very limited number of case studies (e.g., patient NC, Martin & Saffran, 1992; patient CO, Majerus et al., 2001). We present here a new single case study providing further support for the existence of decay rate impairments as an underlying cause of language impairment. [less ▲]Detailed reference viewed: 72 (16 ULg)
A theoretically motivated approach of receptive language assessment based on an interactive spreading activation account of language processing
Martinez Perez, Trecy ; Majerus, Steve ; Delvenne, Marie-Anne et al
Poster (2009, June 03)
In French language, existing tests do not provide a sensitive assessment of auditory comprehension impairments in aphasic patients. These tests don’t detect slight deficits because their a limited number ... [more ▼]
In French language, existing tests do not provide a sensitive assessment of auditory comprehension impairments in aphasic patients. These tests don’t detect slight deficits because their a limited number of tasks and items. Our aim was to construct a series of more sensible tasks to assess auditory perception. Our battery consists on of phonological, lexical, semantic and verbal short-term memory tasks with a high number of items for each test. The computerization of tasks allows to measure correct answers and time latency and allows a standardized assessment. Our poster will focus on our assessment tasks of auditory comprehension, performances pattern of our aphasic patient and underlying theoretical models. [less ▲]Detailed reference viewed: 76 (26 ULg)
The neural correlates of verbal short-term memory in Alzheimer's disease: an fMRI study.
; Collette, Fabienne ; Degueldre, Christian et al
in Brain : A Journal of Neurology (2009), 132(7), 1833-1846
Although many studies have shown diminished performance in verbal short-term memory tasks in Alzheimer's disease, few studies have explored the neural correlates of impaired verbal short-term memory in ... [more ▼]
Although many studies have shown diminished performance in verbal short-term memory tasks in Alzheimer's disease, few studies have explored the neural correlates of impaired verbal short-term memory in Alzheimer's disease patients. In this fMRI study, we examined alterations in brain activation patterns during a verbal short-term memory recognition task, by differentiating encoding and retrieval phases. Sixteen mild Alzheimer's disease patients and 16 elderly controls were presented with lists of four words followed, after a few seconds, by a probe word. Participants had to judge whether the probe matched one of the items of the memory list. In both groups, the short-term memory task elicited a distributed fronto-parieto-temporal activation that encompassed bilateral inferior frontal, insular, supplementary motor, precentral and postcentral areas, consistent with previous studies of verbal short-term memory in young subjects. Most notably, Alzheimer's disease patients showed reduced activation in several regions during the encoding phase, including the bilateral middle frontal and the left inferior frontal gyri (associated with executive control processes) as well as the transverse temporal gyri (associated with phonological processing). During the recognition phase, we found decreased activation in the left supramarginal gyrus and the right middle frontal gyrus in Alzheimer's disease patients compared with healthy seniors, possibly related to deficits in manipulation and decision processes for phonological information. At the same time, Alzheimer's disease patients showed increased activation in several brain areas, including the left parahippocampus and hippocampus, suggesting that Alzheimer's disease patients may recruit alternative recognition mechanisms when performing a short-term memory task. Overall, our results indicate that Alzheimer's disease patients show differences in the functional networks underlying memory over short delays, mostly in brain areas known to support phonological processing or executive functioning. [less ▲]Detailed reference viewed: 45 (10 ULg)
Detecting consciousness in a total Locked-in syndrome: an active event related paradigm
Schnakers, Caroline ; ; et al
in Neurocase : Case Studies in Neuropsychology, Neuropsychiatry & Behavioural Neurology (2009), 25
Total locked-in syndrome is characterized by tetraplegia, anarthria and paralysis of eye motility. In this study, consciousness was detected in a 21-year-old woman who presented a total locked-in syndrome ... [more ▼]
Total locked-in syndrome is characterized by tetraplegia, anarthria and paralysis of eye motility. In this study, consciousness was detected in a 21-year-old woman who presented a total locked-in syndrome after a basilar artery thrombosis (49 days post-injury) using an active event-related paradigm. The patient was presented sequences of names containing the patient's own name and other names. The patient was instructed to count her own name or to count another target name. Similar to 4 age- and gender-matched healthy controls, the P3 response recorded for the voluntarily counted own name was larger than while passively listening. This P3 response was observed 14 days before the first behavioral signs of consciousness. This study shows that our active event-related paradigm allowed to identify voluntary brain activity in a patient who would behaviorally be diagnosed as comatose. [less ▲]Detailed reference viewed: 63 (9 ULg)
Impaired semantic knowledge underlies the reduced verbal short-term storage capacity in Alzheimer's disease.
; Majerus, Steve ; et al
in Neuropsychologia (2009), 47(14), 3067-73
A decrease in verbal short-term memory (STM) capacity is consistently observed in patients with Alzheimer's disease (AD). Although this impairment has been mainly attributed to attentional deficits during ... [more ▼]
A decrease in verbal short-term memory (STM) capacity is consistently observed in patients with Alzheimer's disease (AD). Although this impairment has been mainly attributed to attentional deficits during encoding and maintenance, the progressive deterioration of semantic knowledge in early stages of AD may also be an important determinant of poor STM performance. The aim of this study was to examine the influence of semantic knowledge on verbal short-term memory storage capacity in normal aging and in AD by exploring the impact of word imageability on STM performance. Sixteen patients suffering from mild AD, 16 healthy elderly subjects and 16 young subjects performed an immediate serial recall task using word lists containing high or low imageability words. All participant groups recalled more high imageability words than low imageability words, but the effect of word imageability on verbal STM was greater in AD patients than in both the young and the elderly control groups. More precisely, AD patients showed a marked decrease in STM performance when presented with lists of low imageability words, whereas recall of high imageability words was relatively well preserved. Furthermore, AD patients displayed an abnormal proportion of phonological errors in the low imageability condition. Overall, these results indicate that the support of semantic knowledge on STM performance was impaired for lists of low imageability words in AD patients. More generally, these findings suggest that the deterioration of semantic knowledge is partly responsible for the poor verbal short-term storage capacity observed in AD. [less ▲]Detailed reference viewed: 63 (20 ULg)
Neural substrates of phonological and lexicosemantic representations in Alzheimer's disease.
; Majerus, Steve ; Collette, Fabienne et al
in Human Brain Mapping (2009), 30(1), 185-99
The language profile of patients suffering from Alzheimer's disease (AD) is characterized not only by lexicosemantic impairments but also by phonological deficits, as shown by an increasing number of ... [more ▼]
The language profile of patients suffering from Alzheimer's disease (AD) is characterized not only by lexicosemantic impairments but also by phonological deficits, as shown by an increasing number of neuropsychological studies. This study explored the functional neural correlates underlying phonological and lexicosemantic processing in AD. Using H(215)O PET functional brain imaging, a group of mild to moderate AD patients and a group of age-matched controls were asked to repeat four types of verbal stimuli: words, wordlike nonwords (WL+), non-wordlike nonwords (WL-) and simple vowels. The comparison between the different conditions allowed us to determine brain activation preferentially associated with lexicosemantic or phonological levels of language representations. When repeating words, AD patients showed decreased activity in the left temporo-parietal and inferior frontal regions relative to controls, consistent with distorted lexicosemantic representations. Brain activity was abnormally increased in the right superior temporal area during word repetition, a region more commonly associated with perceptual-phonological processing. During repetition of WL+ and WL- nonwords, AD patients showed decreased activity in the middle part of the superior temporal gyrus, presumably associated with sublexical phonological information; at the same time, AD patients showed larger activation than controls in the inferior temporal gyrus, typically associated with lexicosemantic levels of representation. Overall, the results suggest that AD patients use altered pathways to process phonological and lexicosemantic information, possibly related to a progressive loss of specialization of phonological and lexicosemantic neural networks. [less ▲]Detailed reference viewed: 110 (19 ULg)
Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment.
Schnakers, Caroline ; Vanhaudenhuyse, Audrey ; et al
in BMC Neurology (2009), 9
BACKGROUND: Previously published studies have reported that up to 43% of patients with disorders of consciousness are erroneously assigned a diagnosis of vegetative state (VS). However, no recent studies ... [more ▼]
BACKGROUND: Previously published studies have reported that up to 43% of patients with disorders of consciousness are erroneously assigned a diagnosis of vegetative state (VS). However, no recent studies have investigated the accuracy of this grave clinical diagnosis. In this study, we compared consensus-based diagnoses of VS and MCS to those based on a well-established standardized neurobehavioral rating scale, the JFK Coma Recovery Scale-Revised (CRS-R). METHODS: We prospectively followed 103 patients (55 +/- 19 years) with mixed etiologies and compared the clinical consensus diagnosis provided by the physician on the basis of the medical staff's daily observations to diagnoses derived from CRS-R assessments performed by research staff. All patients were assigned a diagnosis of 'VS', 'MCS' or 'uncertain diagnosis.' RESULTS: Of the 44 patients diagnosed with VS based on the clinical consensus of the medical team, 18 (41%) were found to be in MCS following standardized assessment with the CRS-R. In the 41 patients with a consensus diagnosis of MCS, 4 (10%) had emerged from MCS, according to the CRS-R. We also found that the majority of patients assigned an uncertain diagnosis by clinical consensus (89%) were in MCS based on CRS-R findings. CONCLUSION: Despite the importance of diagnostic accuracy, the rate of misdiagnosis of VS has not substantially changed in the past 15 years. Standardized neurobehavioral assessment is a more sensitive means of establishing differential diagnosis in patients with disorders of consciousness when compared to diagnoses determined by clinical consensus. [less ▲]Detailed reference viewed: 36 (4 ULg)