意识障碍：分类与分类学。
Disorders of Consciousness: Classification and Taxonomy.
机构信息
School of Health & Rehabilitation Sciences, MGH Institute of Health Professions, 36 1st Avenue, Boston, MA 02129, USA.
Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Charlestown, MA, 02129, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
出版信息
Phys Med Rehabil Clin N Am. 2024 Feb;35(1):15-33. doi: 10.1016/j.pmr.2023.06.011. Epub 2023 Jul 27.
Abstract
In this article, we discuss the taxonomy associated with the four major disorders of consciousness (DoC): coma, vegetative state or unresponsive wakefulness syndrome, minimally conscious state, and post-traumatic confusional state. We briefly review the history of each disorder and then provide operational definitions and diagnostic criteria for each one. We rely heavily on recently released practice guidelines and, where appropriate, identify knowledge gaps and discuss future directions to advance DoC research and practice.
摘要
在这篇文章中，我们讨论了与四大意识障碍（DoC）相关的分类法：昏迷、植物状态或无反应觉醒综合征、最小意识状态和创伤后意识混乱状态。我们简要回顾了每种疾病的历史，然后提供了每种疾病的操作定义和诊断标准。我们主要依赖于最近发布的实践指南，并在适当的情况下，确定知识空白并讨论未来的方向，以推进 DoC 的研究和实践。
相似文献
1
Disorders of Consciousness: Classification and Taxonomy.意识障碍：分类与分类学。
Phys Med Rehabil Clin N Am. 2024 Feb;35(1):15-33. doi: 10.1016/j.pmr.2023.06.011. Epub 2023 Jul 27.
2
Intrinsic functional connectivity differentiates minimally conscious from unresponsive patients.内源性功能连接可区分最小意识和无反应患者。
Brain. 2015 Sep;138(Pt 9):2619-31. doi: 10.1093/brain/awv169. Epub 2015 Jun 27.
3
Definitions, diagnostic criteria, and clinical assessment scales in disorders of consciousness.意识障碍的定义、诊断标准及临床评估量表
Handb Clin Neurol. 2025;207:1-13. doi: 10.1016/B978-0-443-13408-1.00011-7.
4
Coma and vegetative states: state of the art and proposal of a novel approach combining existing coma scales.昏迷与植物状态：现有昏迷量表相结合的新方法的最新进展与建议
Ann Ist Super Sanita. 2014;50(3):241-8. doi: 10.4415/ANN_14_03_07.
5
6
Disorders of consciousness terminology: history, evolution and future directions.意识障碍术语：历史、演变与未来方向
Brain Inj. 2019;33(13-14):1684-1689. doi: 10.1080/02699052.2019.1656821. Epub 2019 Sep 9.
7
[Consciousness disorders: vegetative state and minimally conscious state].意识障碍：植物状态和微意识状态
Przegl Lek. 2013;70(8):595-600.
8
Neuropsychological assessment through Coma Recovery Scale-Revised and Coma/Near Coma Scale in a sample of pediatric patients with disorder of consciousness.采用昏迷恢复量表修订版和昏迷/接近昏迷量表对一组意识障碍的儿科患者进行神经心理学评估。
J Neurol. 2023 Feb;270(2):1019-1029. doi: 10.1007/s00415-022-11456-6. Epub 2022 Nov 5.
9
The misdiagnosis of prolonged disorders of consciousness by a clinical consensus compared with repeated coma-recovery scale-revised assessment.临床共识与反复昏迷恢复量表修订评估相比，对迁延性意识障碍的误诊。
BMC Neurol. 2020 Sep 12;20(1):343. doi: 10.1186/s12883-020-01924-9.
10
Assessing consciousness in coma and related states using transcranial magnetic stimulation combined with electroencephalography.使用经颅磁刺激联合脑电图评估昏迷及相关状态下的意识水平。
Ann Fr Anesth Reanim. 2014 Feb;33(2):65-71. doi: 10.1016/j.annfar.2013.11.002. Epub 2014 Jan 6.
引用本文的文献
1
Parietal rTMS Induced Changes in Cortical Excitability in Patients With Minimally Conscious State Using TMS-EEG.使用经颅磁刺激-脑电图（TMS-EEG）研究顶叶重复经颅磁刺激对最小意识状态患者皮质兴奋性的影响
CNS Neurosci Ther. 2025 Sep;31(9):e70583. doi: 10.1111/cns.70583.
2
[Brain-computer interface technology and its applications for patients with disorders of consciousness].[脑机接口技术及其在意识障碍患者中的应用]
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2025 Jun 25;42(3):438-446. doi: 10.7507/1001-5515.202410061.
3
Unilateral anterior choroidal artery infarction presenting with a temporary stupor.单侧脉络膜前动脉梗死伴短暂昏迷。
J Int Med Res. 2025 Jun;53(6):3000605251345965. doi: 10.1177/03000605251345965. Epub 2025 Jun 10.
4
The Neural Correlates of Consciousness: A Spectral Exponent Approach to Diagnosing Disorders of Consciousness.意识的神经关联：一种用于诊断意识障碍的频谱指数方法。
Brain Sci. 2025 Apr 4;15(4):377. doi: 10.3390/brainsci15040377.
5
Swallowing Assessment in Post-Comatose Patients: A Feasibility Study on the SWADOC Tool.昏迷后患者的吞咽评估：关于SWADOC工具的可行性研究
J Clin Med. 2024 May 31;13(11):3268. doi: 10.3390/jcm13113268.
6
Covert cortical processing: a diagnosis in search of a definition.隐匿性皮质处理：寻求定义的一种诊断。
Neurosci Conscious. 2024 Feb 7;2024(1):niad026. doi: 10.1093/nc/niad026. eCollection 2024.
本文引用的文献
1
Incidence and prevalence of coma in the UK and the USA.英国和美国昏迷的发病率与患病率。
Brain Commun. 2022 Sep 1;4(5):fcac188. doi: 10.1093/braincomms/fcac188. eCollection 2022.
2
Cognitive-motor dissociation and time to functional recovery in patients with acute brain injury in the USA: a prospective observational cohort study.美国急性脑损伤患者认知-运动分离与功能恢复时间：一项前瞻性观察队列研究。
Lancet Neurol. 2022 Aug;21(8):704-713. doi: 10.1016/S1474-4422(22)00212-5.
3
Determining the Hierarchy of Coma Recovery Scale-Revised Rating Scale Categories and Alignment with Aspen Consensus Criteria for Patients with Brain Injury: A Rasch Analysis.基于 Rasch 分析探讨昏迷恢复量表修订版分级与脑损伤患者的 Aspen 共识标准的一致性。
J Neurotrauma. 2022 Oct;39(19-20):1417-1428. doi: 10.1089/neu.2022.0095. Epub 2022 Jun 16.
4
Prolonged disorders of consciousness: A response to a "critical evaluation of the new UK guidelines.".持续性意识障碍：对“英国新指南的批判性评价”的回应。
Clin Rehabil. 2022 Sep;36(9):1267-1275. doi: 10.1177/02692155221099704. Epub 2022 May 12.
5
Should Consistent Command-Following Be Added to the Criteria for Emergence From the Minimally Conscious State?是否应该将一致的遵从命令纳入最低意识状态的判定标准中？
Arch Phys Med Rehabil. 2022 Sep;103(9):1870-1873. doi: 10.1016/j.apmr.2022.03.010. Epub 2022 Apr 6.
6
The Curing Coma Campaign International Survey on Coma Epidemiology, Evaluation, and Therapy (COME TOGETHER).《昏迷促醒国际调研（COME TOGETHER）》——昏迷流行病学、评估与治疗调查
Neurocrit Care. 2022 Aug;37(1):47-59. doi: 10.1007/s12028-021-01425-8. Epub 2022 Feb 9.
7
The neuroethics of disorders of consciousness: a brief history of evolving ideas.意识障碍的神经伦理学：观念演变简史。
Brain. 2021 Dec 16;144(11):3291-3310. doi: 10.1093/brain/awab290.
8
Proceedings of the First Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness.第一届治愈昏迷运动 NIH 研讨会会议记录：挑战昏迷和意识障碍研究的未来。
Neurocrit Care. 2021 Jul;35(Suppl 1):4-23. doi: 10.1007/s12028-021-01260-x. Epub 2021 Jul 8.
9
The Curing Coma Campaign: Challenging the Paradigm for Disorders of Consciousness.治愈昏迷运动：挑战意识障碍范式
Neurocrit Care. 2021 Jul;35(Suppl 1):1-3. doi: 10.1007/s12028-021-01290-5. Epub 2021 Jul 8.
10
Empiricism and Rights Justify the Allocation of Health Care Resources to Persons with Disorders of Consciousness.经验主义和权利证明了将医疗保健资源分配给意识障碍患者的合理性。
AJOB Neurosci. 2021 Apr-Sep;12(2-3):169-171. doi: 10.1080/21507740.2021.1904055.
Zotero 插件