Abstract
Due to the complex situation of disorder of consciousness (DOC) patients, the assessment of conscious states of these patients has become a huge challenge for a long time (Laureys et al., 2010). At present, the main clinical diagnostic method to assess the conscious state of a DOC patient is the use of a relevant behavior scale like the Coma Recovery Scale-Revised (CRS-R). In this article, we will focus on auditory stimulation and select some representative auditory stimulus, like calling names and music stimulation, to discuss the function and application of the auditory stimulus in patients with DOC and provide guidance for future research.
Highlights
Disorders of consciousness (DOC) are commonly caused by severe brain damage, and include minimally conscious state (MCS) and unresponsive wakefulness syndrome (UWS)(Laureys et al, 2010)
An EEG study ran by Kempny et al (2018) using s Own Name (SON) and others’ name on 16 patients (5 UWS; 11 MCS) indicated that there seemed to be no significant difference between disorder of consciousness (DOC) patients’ response to SON and others’ name at the group level, but 4 of 15 patients showed significantly different responses between hearing their own name and others’ names at a single subject and two of these patients had similar responses as controls (Kempny et al, 2018), while another fMRI study applying the patient’s mother’s voice and a stranger’s voice to read the same story reported by Bekinschtein et al (2004) showed that, compared to the unfamiliar voice, the brain activation is stronger under a familiar sound condition
The results indicated that, compared to meaningless sound, brain activation is easier to be observed during MS (Okumura et al, 2014)
Summary
Disorders of consciousness (DOC) are commonly caused by severe brain damage, and include minimally conscious state (MCS) and unresponsive wakefulness syndrome (UWS)(Laureys et al, 2010). While there is arousal but no awareness in UWS, MCS shows fluctuating but reproducible signs of consciousness but an absence of reliable communication (Giacino et al, 2002). The CRS-R is a widely used behavioral assessment scale for DOC recommended by a review of the American Congress of Rehabilitation Medicine with 6 subscales designed to assess visual, auditory, motor, and verbal, communication and arousal (American Congress of Rehabilitation Medicine et al, 2010; Gerrard et al, 2014). The CRS-R has become a standardized measure of consciousness that has been widely used for diagnostic assessment in studies involving persons with DOC (Gerrard et al, 2014)
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