Can Salient Stimuli Enhance Responses in Disorders of Consciousness? A Systematic Review
Authors/Creators
- 1. Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100 Caserta, Italy
- 2. IRCCS Fondazione don Carlo Gnocchi ONLUS, Sant'Angelo dei Lombardi, Avellino, Italy
- 3. Department of Psychology, Universidad Loyola Andalucía, Seville, Spain
- 4. IRCCS Fondazione don Carlo Gnocchi ONLUS, Florence, Italy
Description
Purpose of Review Diagnostic classification of patients with disorders of consciousness (DoC) is based on clinician’s observation
of volitional behaviours. However, patients’ caregivers often report higher levels of responsiveness with respect to those observed
during the clinical assessment. Thus, increasing efforts have been aimed at comprehending the effects of self-referential and
emotional stimuli on patients’ responsiveness. Here we systematically reviewed the original experimental studies that compared
behavioural and electrophysiological responses with salient vs. neutral material in patients in vegetative state/unresponsive
wakefulness syndrome or in minimally conscious state.
Recent Findings Most of the reviewed studies showed that salient stimuli (i.e. patient’s own or familiar faces, patient’s own name,
and familiar voices) seem to elicit a higher amount of behavioural or electrophysiological responses with respect to neutral
pictures or sounds. Importantly, a quite high percentage of patients seem to respond to salient stimuli only.
Summary The present review could foster use of personally salient stimuli in assessing DoC. However, the low overall quality of
evidence and some limitations in the general reviewing process might induce caution in transferring these suggestions into
clinical practice.