March 8, 2018 Journal article Open Access

Martens, Géraldine; Laureys, Steven; Thibaut, Aurore

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{
  "publisher": "Zenodo", 
  "DOI": "10.5281/zenodo.1194506", 
  "container_title": "Brain Sciences", 
  "title": "SpasticityManagement in Disorders of Consciousness", 
  "issued": {
    "date-parts": [
      [
        2018, 
        3, 
        8
      ]
    ]
  }, 
  "abstract": "<p>Background: Spasticity is a motor disorder frequently encountered after a lesion involving<br>\nthe central nervous system. It is hypothesized to arise from an anarchic reorganization of the<br>\npyramidal and parapyramidal fibers and leads to hypertonia and hyperreflexia of the affected<br>\nmuscular groups. While this symptom and its management is well-known in patients suffering from<br>\nstroke, multiple sclerosis or spinal cord lesion, little is known regarding its appropriate management<br>\nin patients presenting disorders of consciousness after brain damage. Objectives: Our aim was to<br>\nreview the occurrence of spasticity in patients with disorders of consciousness and the therapeutic<br>\ninterventions used to treat it. Methods: We conducted a systematic review using the PubMed online<br>\ndatabase. It returned 157 articles. After applying our inclusion criteria (i.e., studies about patients in<br>\ncoma, unresponsive wakefulness syndrome or minimally conscious state, with spasticity objectively<br>\nreported as a primary or secondary outcome), 18 studies were fully reviewed. Results: The prevalence<br>\nof spasticity in patients with disorders of consciousness ranged from 59% to 89%. Current treatment<br>\noptions include intrathecal baclofen and soft splints. Several treatment options still need further<br>\ninvestigation; including acupuncture, botulin toxin or cortical activation by thalamic stimulation.<br>\nConclusion: The small number of articles available in the current literature highlights that spasticity<br>\nis poorly studied in patients with disorders of consciousness although it is one of the most common<br>\nmotor disorders. While treatments such as intrathecal baclofen and soft splints seem effective,<br>\nlarge randomized controlled trials have to be done and new therapeutic options should be explored.</p>", 
  "author": [
    {
      "family": "Martens, G\u00e9raldine"
    }, 
    {
      "family": "Laureys, Steven"
    }, 
    {
      "family": "Thibaut, Aurore"
    }
  ], 
  "type": "article-journal", 
  "id": "1194506"
}