Haibo Di

Hangzhou Normal University | HNU · International vegetative state and consciousness science institute

Objectives We aim to investigate the ethical attitudes of the Chinese population toward withdrawal of life-sustaining treatment (WLST) in disorders of consciousness (DoC) patients. Methods A self-administered questionnaire concerning WLST was distributed to Chinese medical professionals and non-medical participants between February and July 2022....

Background The diagnosis of and life-sustaining treatment (LST) for patients with disorders of consciousness (DoC) and locked-in syndrome (LIS) have been the subject of intense debate. Objective We aim to investigate the application of diagnostic knowledge, opinions about the administration of LST, and ethical challenges related to DoC and LIS. D...

(1)Background: Patients with severe brain injuries who are bedridden for extended periods often exhibit diminished voluntary movements. This reduction can compromise the precision of CRS-R evaluations. The Arousal Facilitation Protocol (AFP)is designed to extend the duration of patient arousal through deep muscle pressure. Conversely, Neural Mobili...

Objectives Surrogate decision-making by family caregivers for patients with severe brain injury is influenced by the availability and understanding of relevant information and expectations for future rehabilitation. We aimed to compare the consistency of family caregivers’ perceptions with clinical diagnoses and to inform their expectation of progn...

Introduction In recent years, a growing number of near-death experience (NDE) testimonies have been collected worldwide due to an increasing interest in research on this phenomenon. China has many patients who survive life-threatening situations, leaving over much data on NDEs to be collected for research. In the historical context of Eastern civil...

Severe brain damage usually leads to disorders of consciousness (DOC), which include coma, unresponsive wakefulness syndrome (UWS) and a minimally conscious state (MCS). Visual stimulation is widely used, especially in the diagnosis and treatment and treatment of DOC. Researchers have indicated that tests based on visual stimulation including visua...

Objectives Long-term care of severe brain injury patients places a significant mental burden on family caregivers, yet few studies have reported the situation in China. We aimed to describe the mood states of family caregivers of patients with severe brain injury and examine the influencing factors that affect caregivers’ moods. Methods Cross-sect...

Background: The number of patients with disorders of consciousness (DoC) has increased dramatically with the advancement of intensive care and emergency medicine, which brings tremendous economic burdens and even ethical issues to families and society. Objective: To evaluate the effectiveness of neuromodulation therapy for patients with DoC. Me...

Background Transcutaneous auricular vagus nerve stimulation (taVNS) has recently been explored for the treatment of Disorders of consciousness (DoC) caused by traumatic brain injury. The evidence of taVNS during the consciousness recovery has been recently reported. However, the mechanism of taVNS in the recovery of consciousness is not clear. This...

Background The significant lack of rehabilitation prognostic data is the main reason that affects the treatment decision-making and ethical issues of patients with disorders of consciousness (DoC). Currently, the clinic's consciousness assessment tools cannot satisfy DoC patients' follow-up needs. Objective The purpose of this study is to construc...

In recent years, neuroimaging studies have remarkably demonstrated the presence of cognitive motor dissociation in patients with disorders of consciousness (DoC). These findings accelerated the development of brain–computer interfaces (BCIs) as clinical tools for behaviorally unresponsive patients. This article reviews the recent progress of BCIs i...

Objectives The aim of this study was to determine whether behavioral responses elicited by olfactory stimulation are a predictor of conscious behavioral response and prognosis of patients with disorders of consciousness (DOC). Methods Twenty-three DOC patients (8 unresponsive wakefulness syndrome [UWS]; 15 minimally conscious state [MCS]) were rec...

Background: This study aimed to examine and screen patients for potential biomarkers for the diagnosis of unresponsive wakefulness syndrome (UWS). Methods: Patients with UWS, patients who regained consciousness (RC; patients in a minimally conscious state), and patients who had emerged from the minimally conscious state were evaluated using the Com...

[This corrects the article DOI: 10.3389/fnint.2021.685627.].

Objective: The aim of this study was to develop a general method to estimate the minimal number of repeated examinations needed to detect patients with random responsiveness, given a limited rate of missed diagnosis. Methods: Basic statistical theory was applied to develop the method. As an application, 100 patients with disorders of consciousness...

Objective The aim of the study was to check on the reliability and validity of the translated version of Nociception Coma Scale–Revised. Design Prospective psychometric study. Setting Rehabilitation and neurology unit in hospital. Subjects Patients with prolonged disorders of consciousness. Interventions None. Main measures The original Englis...

Background: Previous studies have shown that a single Coma-Recovery Scale-Revision (CRS-R) assessment can identify high misdiagnosis rate for a clinical consensus. The aim of this study was to investigate the misdiagnosis rate of clinical consensus compared to repeated behavior scale assessments in patients with prolonged disorders of consciousness...

Background: Previous studies have shown that a single Coma-Recovery Scale-Revision (CRS-R) assessment can identify high misdiagnosis rate for a clinical consensus. The aim of this study was to investigate the misdiagnosis rate of clinical consensus compared to repeated behavior scale assessments in patients with prolonged disorders of consciousness...

Background: Previous studies have shown that a single Coma-Recovery Scale-Revision (CRS-R) assessment can identify high rates of misdiagnosis by clinical consensus. The aim of this study was to investigate the proportion of misdiagnosis by clinical consensus compared to repeated behavior-scale assessments in patients with prolonged disorders of con...

Background: Previous studies have shown that a single Coma-Recovery Scale-Revision (CRS-R) assessment can identify high rates of misdiagnosis by clinical consensus. The aim of this study was to investigate the proportion of misdiagnosis by clinical consensus compared to repeated behavior-scale assessments in patients with prolonged disorders of con...

Objective: To detect the initiation of swallowing in patients with disorders of consciousness (DOC) as well as the relationship between the initiation of swallowing and the prognosis of DOC patients. Methods: Nineteen DOC patients were included in this study, and a self-controlled trial compared five different stimuli. The five different stimuli we...

Background: Locked-in syndrome (LIS) characterizes individuals who have experienced pontine lesions, who have limited motor output but with preserved cognitive abilities. Despite their severe physical impairment, individuals with LIS self-profess a higher quality of life than generally expected. Such third-person expectations about LIS are shaped...

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 Recove...

Background The accurate assessment of patients with disorders of consciousness (DOC) is a challenge to most experienced clinicians. As a potential clinical tool, functional magnetic resonance imaging (fMRI) could detect residual awareness without the need for the patients’ actual motor responses. Methods We adopted a simple active fMRI motor parad...

Primary Objective: This study aims to validate the Chinese version of the Coma Recovery Scale-Revised (CRS-R). Methods: One hundred sixty-nine patients were assessed with both the CRS-R and the Glasgow Coma Scale (GCS), diagnosed as being in unresponsive wakefulness syndrome (UWS, formerly known as vegetative state), minimally conscious state (MCS)...

Objectives: Considering sensory stimulation programs (SSP) as a treatment for disorders of consciousness is still debated today. Previous studies investigating its efficacy were affected by various biases among which small sample size and spontaneous recovery. In this study, treatment-related changes were assessed using time-series design in patien...

Background: Behavioral assessment has been acted as the gold standard for the diagnosis of disorders of consciousness (DOC) patients. The item "Functional Object Use" in the motor function sub-scale in the Coma Recovery Scale-Revised (CRS-R) is a key item in differentiating between minimally conscious state (MCS) and emergence from MCS (EMCS). How...

Taking care of patients recovering from coma is challenging, with current therapeutic treatments being neither well developed nor well validated. Sensory stimulation is a long-established treatment developed for severely brain-injured patients. Numerous studies have investigated the use of sensory stimulation programs in patients with disorders of...

Corresponding author. International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, 18 Xuelin Road, Xiasha Higher Education Campus, Hangzhou, China.

Background: Misdiagnosis rate is high in patients with disorders of consciousness, potentially leading to an inappropriate clinical management of these patients. Sensitive standardised rating scales offer some protections from these diagnostic errors. In this context, the use of the Coma Recovery Scale-Revised (CRS-R) has strongly been recommended...

Previous studies have shown the prognostic value of stimulation elicited blood-oxygen-level-dependent (BOLD) signal in traumatic patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS). However, to the best of our knowledge, no studies have focused on the relevance of etiology and level of consciousness in patients with disorders of...

Background: Despite recent evidence suggesting that some severely brain-injured patients retain some capacity for top-down processing (covert cognition), the degree of sparing is unknown. Objective: Top-down attentional processing was assessed in patients in minimally conscious (MCS) and vegetative states (VS) using an active event-related poten...

Objective: The bedside detection of potential awareness in patients with disorders of consciousness (DOC) currently relies only on behavioral observations and tests; however, the misdiagnosis rates in this patient group are historically relatively high. In this study, we proposed a visual hybrid brain-computer interface (BCI) combining P300 and st...

Background Visual fixation plays a key role in the differentiation between vegetative state/unresponsive wakefulness (VS/UWS) syndrome and minimally conscious state (MCS). However, the use of different stimuli changes the frequency of visual fixation occured in patients, thereby possibly affecting the accuracy of the diagnosis. In order to establis...

Significant advances have been made in the behavioral assessment and clinical management of disorders of consciousness (DOC). In addition, functional neuroimaging paradigms are now available to help assess consciousness levels in this challenging patient population. The success of these neuroimaging approaches as diagnostic markers is, however, int...

Background At present, there is no consensus on how to clinically assess localisation to sound in patients recovering from coma. We here studied auditory localisation using the patient’s own name as compared to a meaningless sound (i.e., ringing bell). Methods Eighty-six post-comatose patients diagnosed with a vegetative state/unresponsive wakeful...

Taking care of patients recovering from coma is not easy, as current therapeutics are neither well developed nor well validated. Sensory stimulation programs are the most widely known treatment applied to severely brain-injured patients. In this chapter, we will introduce the theoretical principles underlying these programs and the studies assessin...

Recent advances in the study of spontaneous brain activity have demonstrated activity patterns that emerge with no task performance or sensory stimulation; these discoveries hold promise for the study of higher-order associative network functionality. Additionally, such advances are argued to be relevant in pathological states, such as disorders of...

Les progrès effectués au niveau des soins intensifs ont mené à une augmentation dans le nombre de patients qui survivent à une lésion cérébrale sévère. Bien que la plupart d’entre eux récupèrent au cours des premiers jours après le coma, certains restent en état de conscience altérée. Pour ces patients, les soins médicaux et infirmiers conventionne...

The aim of this study was to investigate the relationship between medial cortical activation and the presence of self and consciousness in healthy subjects and patients with vegetative state and minimally conscious state using functional magnetic resonance imaging (fMRI). We first conducted two fMRI experiments in healthy subjects to identify brain...

The vegetative state (VS) is a devastating clinical condition characterised by wakefulness without awareness. Functional neuroimaging permits to objectively measure brain responsiveness to external stimuli in VS. The literature on functional magnetic resonance imaging and positron emission tomography studies in these patients has been reviewed. Res...

Previous studies implicated potential value of mismatch negativity (MMN) in predicting recovery of consciousness in patients with disorders of consciousness (DOC). We have adopted a novel MMN evoked by subject's own name (SON), a self-referential stimulus thought to be powerful in evoking residual brain activity, and examined the correlation betwee...

A challenge in the management of severely brain-damaged patients with altered states of consciousness is the differential diagnosis between the vegetative state (VS) and the minimally conscious state (MCS), especially for the gray zone separating these clinical entities. To evaluate the differences in brain activation in response to presentation of...

Whether the cerebellum is involved in voluntary motor learning or motor performance is the subject of a new debate. Using functional magnetic resonance imaging (fMRI), we examined cerebellar activation in eight volunteers before and after an extended period of training. Activation volume on both sides of cerebellum after learning was significantly...