March 8, 2018 Journal article Open Access

Martens, Géraldine; Laureys, Steven; Thibaut, Aurore

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    "description": "<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>", 
    "license": {
      "id": "CC-BY-4.0"
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    "title": "SpasticityManagement in Disorders of Consciousness", 
    "journal": {
      "title": "Brain Sciences"
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        "title": "Studying, Measuring and Altering Consciousness through information theory in the electrical brain", 
        "acronym": "LUMINOUS", 
        "program": "H2020", 
        "funder": {
          "doi": "10.13039/501100000780", 
          "acronyms": [], 
          "name": "European Commission", 
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    "keywords": [
      "spasticity; pain; upper motor neuron syndrome; disorders of consciousness; brain injury; treatment"
    ], 
    "publication_date": "2018-03-08", 
    "creators": [
      {
        "affiliation": "Coma Science Group, GIGA Research (Interdisciplinary Cluster for Applied Genoproteomics)\u2013GIGA Consciousness & Neurology Department, University and University Hospital of Liege, 4000 Liege, Belgium", 
        "name": "Martens, G\u00e9raldine"
      }, 
      {
        "affiliation": "Coma Science Group, GIGA Research (Interdisciplinary Cluster for Applied Genoproteomics)\u2013GIGA Consciousness & Neurology Department, University and University Hospital of Liege, 4000 Liege, Belgium", 
        "name": "Laureys, Steven"
      }, 
      {
        "affiliation": "Coma Science Group, GIGA Research (Interdisciplinary Cluster for Applied Genoproteomics)\u2013GIGA Consciousness & Neurology Department, University and University Hospital of Liege, 4000 Liege, Belgium", 
        "name": "Thibaut, Aurore"
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