References of "Schnakers, Caroline"
     in
Bookmark and Share    
See detailDisorders of consciousness: new advances in neuroimaging techniques
Soddu, Andrea ULg; Bruno, Marie-Aurélie ULg; VANHAUDENHUYSE, Audrey ULg et al

in Zanotti, Bruno (Ed.) Vegetative State (in press)

Detailed reference viewed: 119 (11 ULg)
Full Text
Peer Reviewed
See detail2 Years outcome of patients in unresponsive wakefulness syndrome/vegetative state and minimally conscious state
Cassol, Helena ULg; LEDOUX, Didier ULg; Thibaut, Aurore ULg et al

Poster (2017, March)

INTRODUCTION: Following severe acute brain damage, patients typically evolve from coma to an unresponsive wakefulness syndrome/vegetative state (UWS/VS; wakefulness without awareness) and later to a ... [more ▼]

INTRODUCTION: Following severe acute brain damage, patients typically evolve from coma to an unresponsive wakefulness syndrome/vegetative state (UWS/VS; wakefulness without awareness) and later to a minimally conscious state (MCS; fluctuating but consistent nonreflex behaviors). MCS is subcategorized in MCS+ (i.e., command following) and MCS- (i.e., visual pursuit, localization of noxious stimulation or contingent behaviours). Reliable and consistent interactive communication and/or functional use of objects indicate the next boundary – emergence from MCS (EMCS). To date, there is still no reliable predictive model of recovery from the UWS/VS and the MCS. A better understanding of patients' outcome would help in decisions regarding patients’ care and rehabilitation, as well as end-of-life decisions. METHODS: We collected demographic information, acute care history and longitudinal follow-up of patients in UWS/VS and MCS admitted in 15 expert centers in Belgium (via the Belgian Federal Public Service Health). Patients were evaluated at 1, 3, 6, 12 and 24 months post injury with the Coma Recovery Scale-Revised and the diagnosis was based on internationally accepted criteria of UWS/VS, MCS or EMCS. Results were considered significant at p<0.001. RESULTS: 24 months follow-up was available for 476 patients including 261 diagnosed in UWS/VS (88 traumatic, 173 non-traumatic) and 215 diagnosed in MCS (80 traumatic, 135 non-traumatic) one month after the injury. Patients who were in MCS one month after the insult were more likely to recover functional communication or object use after 24 months than patients in UWS/VS. Moreover, functional recovery occurred more often in MCS+ (79%) as compared to MCS- (29%), and mortality rate was more important in MCS- patients (68%) as compared to MCS+ (21%). Comparisons within UWS/VS and MCS groups based on etiology showed that traumatic patients had a better outcome at 24 months than non-traumatic patients. Among non-traumatic patients, no difference was found between anoxic patients and patients with other etiologies regarding functional recovery. CONCLUSION: Our study highlights that the outcome is significantly better for patients who are in MCS one month post-injury as compared to patients who remain in UWS/VS at that time. Concerning MCS patients, the outcome is significantly better for patients who are MCS+ one month post-injury as compared to patients who are MCS- at that time. This study also confirms that patients with traumatic etiology have better prognosis than patients with non-traumatic causes. [less ▲]

Detailed reference viewed: 71 (4 ULg)
Full Text
Peer Reviewed
See detailPrevalence of coma-recovery scale-revised signs of consciousness in patients in minimally conscious state
Wannez, Sarah ULg; Gosseries, Olivia ULg; Azzolini, Deborah et al

in Neuropsychological Rehabilitation (2017)

Detailed reference viewed: 39 (11 ULg)
Peer Reviewed
See detailRepeated Behavioral Assessments in Patients with Disorders of Consciousness
Wannez, Sarah ULg; Annen, Jitka ULg; Aubinet, Charlène ULg et al

Conference (2016, March 04)

The Coma Recovery Scale Revised (CRS-R) is considered as the most sensitive scale to assess patients with disorders of consciousness (DOC). Guidelines recommend repeated assessments because patients might ... [more ▼]

The Coma Recovery Scale Revised (CRS-R) is considered as the most sensitive scale to assess patients with disorders of consciousness (DOC). Guidelines recommend repeated assessments because patients might suffer from consciousness fluctuations, but it is not specified how many assessments are needed. The present study included 131 patients with DOC. They have been assessed at least 6 times during a 14-days period with the CRS-R. Results show that 5 CRS-R assessments are needed to reach a reliable diagnosis, and that all the CRS-R subscales are influenced by consciousness fluctuations. We here showed that consciousness fluctuations influence the behavioral diagnosis, and that 5 assessments within a short period of time are needed to get a reliable clinical diagnosis. [less ▲]

Detailed reference viewed: 128 (30 ULg)
Full Text
Peer Reviewed
See detailIs the Nociception Coma Scale-Revised a Useful Clinical Tool for Managing Pain in Patients with Disorders of Consciousness?
Chatelle, Camille ULg; De Val, Marie Daniele; Catano, Antonio et al

in The Clinical journal of pain (2016)

OBJECTIVES: Our objective was to assess the clinical interest of the Nociception Coma Scale Revised (NCS-R) in pain management of patients with disorders of consciousness. METHODS: Thirty-nine patients ... [more ▼]

OBJECTIVES: Our objective was to assess the clinical interest of the Nociception Coma Scale Revised (NCS-R) in pain management of patients with disorders of consciousness. METHODS: Thirty-nine patients with potential painful conditions (e.g., due to fractures, decubitus ulcers or spasticity) were assessed during nursing cares before and after the administration of an analgesic treatment tailored to each patient's clinical status. In addition to the NCS-R, the Glasgow Coma Scale (GCS) was used before and during treatment in order to observe fluctuations in consciousness. Twenty-three of them had no analgesic treatment prior to the assessment whereas the analgesic treatment has been adapted in the other 16 patients. We performed non-parametric Wilcoxon tests to investigate the difference in the NCS-R and GCS total scores but also in the NCS-R subscores before versus during treatment. The effect of the level of consciousness and the etiology were assessed using a U Mann Whitney. RESULTS: NCS-R total scores were statistically lower during treatment when compared to the scores obtained before treatment. We also found that the motor, verbal and facial expression subscores were lower during treatment than before treatment. On the other hand, we found no difference between the GCS total scores obtained before versus during treatment. DISCUSSION: Our results suggest that the NCS-R is an interesting clinical tool for pain management. Besides, this tool seems useful when a balance is needed between reduced pain and preserved level of consciousness in patients with disorders of consciousness. [less ▲]

Detailed reference viewed: 35 (5 ULg)
See detailThe Minimally Conscious State: Clinical Features, Pathophysiology and Therapeutic Implications
Giacino, Joseph T; Edlow, Brian; Chatelle, Camille ULg et al

in LAUREYS, Steven; Giulio, Tononi; Gosseries, Olivia (Eds.) The Neurology of Consciousness 2nd Edition (2015)

Detailed reference viewed: 20 (1 ULg)
Full Text
Peer Reviewed
See detailSpasticity in disorders of consciousness: a behavioral study
Thibaut, Aurore ULg; Chatelle, Camille ULg; Wannez, Sarah ULg et al

in European Journal of Physical Medicine & Rehabilitation (2015)

Background: Spasticity is a frequent complication after severe brain injury, which may impede the rehabilitation process and diminish the patients’ quality of life. Aim: We here investigate the presence ... [more ▼]

Background: Spasticity is a frequent complication after severe brain injury, which may impede the rehabilitation process and diminish the patients’ quality of life. Aim: We here investigate the presence of spasticity in a population of non-communicative patients with disorders of consciousness. We also evaluate the correlation between spasticity and potential factors of co-morbidity, frequency of physical therapy, time since insult presence of pain, presence of tendon retraction, etiology and diagnosis. Design: Cross sectional study. Setting: University Hospital of Liège, Belgium. Population: 65 patients with chronic (>3 months post insult) disorders of consciousness were included (22 women; mean age: 44±14y; 40 with traumatic etiology; 40 in a minimally conscious state; time since insult: 39±37months). Methods: Spasticity was measured with the Modified Ashworth Scale (MAS) and pain was assessed using the Nociception Coma Scale-Revised (NCS-R). Results: Out of 65 patients, 58 demonstrated signs of spasticity (89%; MAS ≥ 1), including 39 who showed severe spasticity (60%; MAS ≥ 3). Patients with spasticity receiving anti-spastic medication were more spastic than unmedicated patients. A negative correlation was observed between the severity of spasticity and the frequency of physical therapy. MAS scores correlated positively with time since injury and NCS-R scores. We did not observe a difference of spasticity between the diagnostic. Conclusion: A large proportion of patients with disorders of consciousness develop severe spasticity, possibly affecting their functional recovery and their quality of life. The observed correlation between degrees of spasticity and pain scores highlights the importance of pain management in these patients with altered states of consciousness. Finally, the relationship between spasticity and treatment (i.e., pharmacological and physical therapy) should be further investigated in order to improve clinical care. Clinical Rehabilitation Impact: Managing spasticity at first signs could improve rehabilitation of patients with disorders of consciousness and maximize their chances of recovery. In addition, decreasing this trouble could allow a better quality of life for these non-communicative patients. [less ▲]

Detailed reference viewed: 117 (16 ULg)
Peer Reviewed
See detailSymposium on pain assessment in patients with disorders of consciousness
Chatelle, Camille ULg; Whyte, John; Schnakers, Caroline

Conference (2014)

Detailed reference viewed: 14 (0 ULg)
See detailPreserved Covert Cognition in Noncommunicative Patients With Severe Brain Injury?
schnakers, caroline; Giacino, Joseph T; Løvstad, Marianne et al

in Neurorehabilitation and Neural Repair (2014)

Detailed reference viewed: 40 (11 ULg)
Full Text
Peer Reviewed
See detailAssessment of visual fixatio in vegetative and minimally conscious states
Di, Haibo; Nie, Yunzhi; Hu, Xiaohu et al

in BMC Neurology (2014), 14(147),

Background: Visual fixation plays a key role in the differentiation between vegetative state/unresponsive wakefulness (VS/UWS) syndrome and minimally conscious state (MCS). However, the use of different ... [more ▼]

Background: Visual fixation plays a key role in the differentiation between vegetative state/unresponsive wakefulness (VS/UWS) syndrome and minimally conscious state (MCS). However, the use of different stimuli changes the frequency of visual fixation occured in patients, thereby possibly affecting the accuracy of the diagnosis. In order to establish a standardized assessment of visual fixation in patients in disorders of consciousness (DOC), we compared the frequency of visual fixation elicited by mirror,a ball and a light. Method: Visual fixation was assessed in eighty-one post-comatose patients diagnosed with a MCS or VS/UWS. Occurrence of fixation to different stimuli was analysis used Chi-square testing. Result: 40 (49%) out of the 81 patients showed fixation to visual stimuli. Among those, significantly more patients (39, 48%) had visual fixation elicited by mirror compared to a ball (23, 28%) and mirror compared to a light (20, 25%).Conclusion: The use of a mirror during the assessment of visual fixation showed higher positive response rate, compared to other stimuli in eliciting a visual fixating response. Therefore, fixation elicited by a mirror can be a very sensitive and accurate test to differentiate the two disorders of consciousness. [less ▲]

Detailed reference viewed: 25 (10 ULg)
Full Text
Peer Reviewed
See detailPain issues in disorders of consciousness
Chatelle, Camille ULg; Thibaut, Aurore ULg; Wythe, John et al

in Brain Injury (2014), 28(9), 1202-1208

Background: The assessment of pain and nociception in non-communicative patients with disorders of consciousness (DOC) is a real challenge for clinicians. It is, therefore, important to develop sensitive ... [more ▼]

Background: The assessment of pain and nociception in non-communicative patients with disorders of consciousness (DOC) is a real challenge for clinicians. It is, therefore, important to develop sensitive standardized tools usable at the bedside. Objectives: This review aims to provide an overview of the current knowledge about pain processing and assessment in patients with DOC. Methods: A search was performed on PubMed using MeSH terms including vegetative state, unresponsive wakefulness syndrome, minimally conscious state, consciousness disorders, pain, nociception, neuroimaging and pain assessment. Results: Neuroimaging studies investigating pain processing in patients with DOC and their implication for clinicians are reviewed. Current works on the development of standardized and sensitive tools for assessing nociception are described. Conclusion: The suggested pain perception capacity highlighted by neuroimaging studies in patients in a MCS and in some patients in a VS/UWS supports the idea that these patients need analgesic treatment and monitoring. The first tool which has been developed to assess nociception and pain in patients with DOC is the NCS. Its revised version represents a rapid, standardized and sensitive scale which can be easily implemented in a clinical setting. Complementary pain assessments are also under validation in order to offer more options to clinicians. [less ▲]

Detailed reference viewed: 115 (6 ULg)
Peer Reviewed
See detailLocalisation to auditory stimulation in coma.
Charland-Verville, Vanessa ULg; Gosseries, Olivia ULg; Schnakers, Caroline et al

Conference (2012, June)

Detailed reference viewed: 4 (0 ULg)
Full Text
Peer Reviewed
See detailWhat about pain in disorders of consciousness?
Schnakers, Caroline; Chatelle, Camille ULg; Demertzi, Athina ULg et al

in AAPS Journal (2012), 14

Detailed reference viewed: 10 (0 ULg)
See detailEvaluation de la douleur chez le patient récupérant du coma: la Nociception Coma Scale
Chatelle, Camille ULg; Schnakers, Caroline

Scientific conference (2011)

Detailed reference viewed: 7 (0 ULg)
See detailThe Nociception Coma Scale to assess nociception in disorders of consciousness
Chatelle, Camille ULg; Schnakers, Caroline; VANHAUDENHUYSE, Audrey ULg et al

Poster (2010)

Detailed reference viewed: 10 (0 ULg)
Full Text
Peer Reviewed
See detailCognitive function in locked-in syndrome
Schnakers, Caroline; Majerus, Steve ULg; Goldman, Serge et al

in Journal of Neurology (2008), 255

Detailed reference viewed: 10 (1 ULg)