Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.
Centre du Cerveau, University Hospital of Liège, Liège, Belgium.
Semin Neurol. 2024 Jun;44(3):271-280. doi: 10.1055/s-0044-1785507. Epub 2024 Apr 11.
Cognitive motor dissociation (CMD) is characterized by a dissociation between volitional brain responses and motor control, detectable only through techniques such as electroencephalography (EEG) and functional magnetic resonance imaging. Hence, it has recently emerged as a major challenge in the assessment of patients with disorders of consciousness. Specifically, this review focuses on the prognostic implications of CMD detection during the acute stage of brain injury. CMD patients were identified in each diagnostic category (coma, unresponsive wakefulness syndrome/vegetative state, minimally conscious state minus) with a relatively similar prevalence of around 20%. Current knowledge tends to indicate that the diagnosis of CMD in the acute phase often predicts a more favorable clinical outcome compared with other unresponsive non-CMD patients. Nevertheless, the review underscores the limited research in this domain, probably at least partially explained by its nascent nature and the lack of uniformity in the nomenclature for CMD-related disorders, hindering the impact of the literature in the field.
认知运动分离（CMD）的特征是意志性脑反应与运动控制之间的分离，只有通过脑电图（EEG）和功能磁共振成像等技术才能检测到。因此，它最近成为意识障碍患者评估的一个主要挑战。具体来说，本综述重点关注在脑损伤的急性期检测到 CMD 对预后的影响。在每个诊断类别（昏迷、无反应觉醒综合征/植物状态、最小意识状态减）中都发现了 CMD 患者，其患病率相对相似，约为 20%。目前的知识倾向于表明，与其他无反应非 CMD 患者相比，急性阶段 CMD 的诊断通常预示着更有利的临床结局。然而，该综述强调了该领域研究的局限性，这可能至少部分归因于其新兴性质和与 CMD 相关障碍的命名法缺乏一致性，从而影响了该领域文献的影响力。
