Journal article Open Access

SpasticityManagement in Disorders of Consciousness

Martens, Géraldine; Laureys, Steven; Thibaut, Aurore


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  <identifier identifierType="DOI">10.5281/zenodo.1194506</identifier>
  <creators>
    <creator>
      <creatorName>Martens, Géraldine</creatorName>
      <givenName>Géraldine</givenName>
      <familyName>Martens</familyName>
      <affiliation>Coma Science Group, GIGA Research (Interdisciplinary Cluster for Applied Genoproteomics)–GIGA Consciousness &amp; Neurology Department, University and University Hospital of Liege, 4000 Liege, Belgium</affiliation>
    </creator>
    <creator>
      <creatorName>Laureys, Steven</creatorName>
      <givenName>Steven</givenName>
      <familyName>Laureys</familyName>
      <affiliation>Coma Science Group, GIGA Research (Interdisciplinary Cluster for Applied Genoproteomics)–GIGA Consciousness &amp; Neurology Department, University and University Hospital of Liege, 4000 Liege, Belgium</affiliation>
    </creator>
    <creator>
      <creatorName>Thibaut, Aurore</creatorName>
      <givenName>Aurore</givenName>
      <familyName>Thibaut</familyName>
      <affiliation>Coma Science Group, GIGA Research (Interdisciplinary Cluster for Applied Genoproteomics)–GIGA Consciousness &amp; Neurology Department, University and University Hospital of Liege, 4000 Liege, Belgium</affiliation>
    </creator>
  </creators>
  <titles>
    <title>SpasticityManagement in Disorders of Consciousness</title>
  </titles>
  <publisher>Zenodo</publisher>
  <publicationYear>2018</publicationYear>
  <subjects>
    <subject>spasticity; pain; upper motor neuron syndrome; disorders of consciousness; brain injury; treatment</subject>
  </subjects>
  <dates>
    <date dateType="Issued">2018-03-08</date>
  </dates>
  <resourceType resourceTypeGeneral="Text">Journal article</resourceType>
  <alternateIdentifiers>
    <alternateIdentifier alternateIdentifierType="url">https://zenodo.org/record/1194506</alternateIdentifier>
  </alternateIdentifiers>
  <relatedIdentifiers>
    <relatedIdentifier relatedIdentifierType="DOI" relationType="IsVersionOf">10.5281/zenodo.1194505</relatedIdentifier>
  </relatedIdentifiers>
  <rightsList>
    <rights rightsURI="https://creativecommons.org/licenses/by/4.0/legalcode">Creative Commons Attribution 4.0 International</rights>
    <rights rightsURI="info:eu-repo/semantics/openAccess">Open Access</rights>
  </rightsList>
  <descriptions>
    <description descriptionType="Abstract">&lt;p&gt;Background: Spasticity is a motor disorder frequently encountered after a lesion involving&lt;br&gt;
the central nervous system. It is hypothesized to arise from an anarchic reorganization of the&lt;br&gt;
pyramidal and parapyramidal fibers and leads to hypertonia and hyperreflexia of the affected&lt;br&gt;
muscular groups. While this symptom and its management is well-known in patients suffering from&lt;br&gt;
stroke, multiple sclerosis or spinal cord lesion, little is known regarding its appropriate management&lt;br&gt;
in patients presenting disorders of consciousness after brain damage. Objectives: Our aim was to&lt;br&gt;
review the occurrence of spasticity in patients with disorders of consciousness and the therapeutic&lt;br&gt;
interventions used to treat it. Methods: We conducted a systematic review using the PubMed online&lt;br&gt;
database. It returned 157 articles. After applying our inclusion criteria (i.e., studies about patients in&lt;br&gt;
coma, unresponsive wakefulness syndrome or minimally conscious state, with spasticity objectively&lt;br&gt;
reported as a primary or secondary outcome), 18 studies were fully reviewed. Results: The prevalence&lt;br&gt;
of spasticity in patients with disorders of consciousness ranged from 59% to 89%. Current treatment&lt;br&gt;
options include intrathecal baclofen and soft splints. Several treatment options still need further&lt;br&gt;
investigation; including acupuncture, botulin toxin or cortical activation by thalamic stimulation.&lt;br&gt;
Conclusion: The small number of articles available in the current literature highlights that spasticity&lt;br&gt;
is poorly studied in patients with disorders of consciousness although it is one of the most common&lt;br&gt;
motor disorders. While treatments such as intrathecal baclofen and soft splints seem effective,&lt;br&gt;
large randomized controlled trials have to be done and new therapeutic options should be explored.&lt;/p&gt;</description>
  </descriptions>
  <fundingReferences>
    <fundingReference>
      <funderName>European Commission</funderName>
      <funderIdentifier funderIdentifierType="Crossref Funder ID">10.13039/501100000780</funderIdentifier>
      <awardNumber awardURI="info:eu-repo/grantAgreement/EC/H2020/686764/">686764</awardNumber>
      <awardTitle>Studying, Measuring and Altering Consciousness through information theory in the electrical brain</awardTitle>
    </fundingReference>
  </fundingReferences>
</resource>
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