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Journal of Neurorestoratology  2021, Vol. 9 Issue (1): 50-59    doi: 10.26599/JNR.2021.9040006
Special Reports     
Clinical diagnosis guidelines and neurorestorative treatment for chronic disorders of consciousness (2021 China version)
Yusheng Li1,(✉)(),Jianghong He2,Bo Yang1,Hui Zhang3,Zhonghua Yang2,Jianhui Fu4,Lian Huang5,Hong Chen6,Xiaofeng Yang7,Yijun Bao8,On behalf of Chinese Association of Neurorestoratology (Preparatory) and China Committee of International Association of Neurorestoratology
1The 1st Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China
2Tiantan Hospital, Capital Medical University, Beijing 100070, China
3Zhengzhou Central Hospital, Zhengzhou 450007, Henan, China
4Shanghai Huashan Hospital, Shanghai 200040, China
5The First Affiliated Hospital of Ji’nan University, Guangzhou 510630, Guangdong, China
6Tongji Hospital of Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
7The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang, China
8The Fourth Hospital of China Medical University, Shenyang 110084, Liaoning, China
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Abstract  

Chronic disorders of consciousness (DOC) include the vegetative state and the minimally consciousness state. The DOC diagnosis mainly relies on the evaluation of clinical behavioral scales, electrophysiological testing, and neuroimaging examinations. No specifically effective neurorestorative methods for chronic DOC currently exist. Any valuable exploration therapies of being able to repair functions and/or structures in the consciousness loop (e.g., drugs, hyperbaric medicines, noninvasive neurostimulation, sensory and environmental stimulation, invasive neuromodulation therapy, and cell transplantation) may become effective neurorestorative strategies for chronic DOC. In the viewpoint of Neurorestoratology, this guideline proposes the diagnostic and neurorestorative therapeutic suggestions and future exploration direction for this disease following the review of the existing treatment exploration achievements for chronic DOC.



Key wordschronic disorders of consciousness      neurorestoration      clinical guideline     
Received: 30 October 2020      Published: 17 June 2021
Corresponding Authors: Yusheng Li     E-mail: yushengli1970@163.com
Cite this article:

Yusheng Li, Jianghong He, Bo Yang, Hui Zhang, Zhonghua Yang, Jianhui Fu, Lian Huang, Hong Chen, Xiaofeng Yang, Yijun Bao. Clinical diagnosis guidelines and neurorestorative treatment for chronic disorders of consciousness (2021 China version). Journal of Neurorestoratology, 2021, 9: 50-59.

URL:

http://jnr.tsinghuajournals.com/10.26599/JNR.2021.9040006     OR     http://jnr.tsinghuajournals.com/Y2021/V9/I1/50

ScoreTest
Auditory function scale
4Consistent movement to command
3Reproducible movement to command
2Localization to sound
1Auditory startle
0None
Visual function scale
5Object recognition
4Object localization: reaching
3Visual pursuit
2Fixation
1Visual startle
0None
Motor function scale
6Function object use
5Automatic motor response
4Object manipulation
3Localization to noxious stimulation
2Flexion withdrawal
1Abnormal posturing
0None/flaccid
Oral motor/verbal function scale
3Intelligible verbalization
2Vocalization/oral movement
1Oral reflexive movement
0None
Communication scale
2Functional: accurate
1Nonfunctional: intentional
0None
Arousal scale
3Attention
2Eye opening without stimulation
1Eye opening with stimulation
0Unarousable
Table 1Coma Recovery Scale-Revised.
Fig. 1Consciousness disorder treatment process.
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