Article

The Nociception Coma Scale-Revised (NCS-R) was recently validated to
assess possible pain perception in patients with disorders of consciousness.
OBJECTIVE: To identify correlations between cerebral glucose metabolism and NCS-R
total scores. METHODS: [18F]-fluorodeoxyglucose positron emission tomography,
NCS-R, and Coma Recovery Scale-Revised assessments were performed in 49 patients
with disorders of consciousness. RESULTS: We identified a significant positive
correlation between NCS-R total scores and metabolism in the posterior part of
the anterior cingulate cortex, known to be involved in pain processing. No other
cluster reached significance. No significant effect of clinical diagnosis
(vegetative/unresponsive vs minimally conscious states), etiology or interval
since insult was observed. CONCLUSIONS: Our data support the hypothesis that the
NCS-R total scores are related to cortical processing of nociception and may
constitute an appropriate behavioral tool to assess, monitor, and treat possible
pain in brain-damaged noncommunicative patients with disorders of consciousness.
Future studies using event-related functional magnetic resonance imaging should
investigate the correlation between NCS-R scores and brain activation in response
to noxious stimulation at the single-subject level.

Langue : ANGLAIS