Towards an International Consensus on Prognosis of Severely Traumatic or Non-Traumatic Brain-Injured Individuals with Prolonged Disorders of Consciousness

Presenters:

  • Joseph T. Giacino
  • Anna Estraneo
  • Andrea Soddu
  • Olivia Gosseries
  • Rita Formisano
  • Beth Slomine

Objectives:

  • Participants will be able to describe clinical evolution of patients with prolonged DoC
  • Participants will be able to identify factors that affect the long-term outcome of patients with prolonged DoC.
  • Participants will be able to comprehend the value of behavioral and neuroimaging assessment for monitoring clinical evolution of patients with prolonged DoC

Description:

Background: Long-term management of severely brain-injured patients with prolonged disorders of consciousness (DoC) has clinical, economic and ethical impact. In this context, to understand the evolution of these severe clinical conditions and to identify reliable prognostic markers would allow clinicians and patients’ family to make appropriate decisions concerning treatment and care. At the moment, research on prognosis has exploded in the last decade due to a number of research advances, including the development of electrophysiological and imaging techniques capable of detecting early signs of consciousness recovery. Recently, several American scientific societies conjointly issued care recommendations for patients with prolonged DoC but diagnostic and prognostic procedures for people with prolonged DoC vary across countries and might result in differences in patients’ management and outcome. In this context, the Special Interest Group on Disorders of Consciousness of International Brain Injury Association (IBIA – DoC-SIG) offers an international platform for professionals working on care and research on DoC to share assessment, prognostic and treatment procedures.

The proposed workshop aims to provide updates related to current evidence on prognosis of DoC and would attempt to promote an international consensus on prognostic procedures for individuals with DoC. We propose to involve international speakers with expertise in this area. Brief presentations will be grouped under specific themes, including long-term outcome and prognosis, and current prognostic procedures, as noted in the outline below.

1. Introduction and chairman: Joseph T Giacino (USA) and Anna Estraneo (Italy)
2.Joseph T Giacino (USA) – Natural history and prognosis in DoC (40 min)
3. Anna Estraneo (Italy)- Markers and clinical complications impacting evolution of patients with DoC (30 min)
4. Andrea Soddu (Canada) – Neuroimaging assessment in the prognostic process (30 min)
Coffee break (20 min)
5. Olivia Gosseries (Belgium) – Use of behavioral assessments in the prognostic process (30 min)
6. Rita Formisano (Italy) – Pain assessment by standard versus personalized painful stimulation as possible outcome predictor (30 min)
7. Beth Slomine (USA) – Assessment and prognosis in children with DoC (30 min)
II. General discussion (20 min)

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