The DOI matches its Crossref record; 33 of the 34 references it cites were found in a registry or an index.
The minimally conscious state: Definition and diagnostic criteria
Open accessAbstract
OBJECTIVE: To establish consensus recommendations among health care specialties for defining and establishing diagnostic criteria for the minimally conscious state (MCS). BACKGROUND: There is a subgroup of patients with severe alteration in consciousness who do not meet diagnostic criteria for coma or the vegetative state (VS). These patients demonstrate inconsistent but discernible evidence of consciousness. It is important to distinguish patients in MCS from those in coma and VS because preliminary findings suggest that there are meaningful differences in outcome. METHODS: An evidence-based literature review of disorders of consciousness was completed to define MCS, develop diagnostic criteria for entry into MCS, and identify markers for emergence to higher levels of cognitive function. RESULTS: There were insufficient data to establish evidence-based guidelines for diagnosis, prognosis, and management of MCS. Therefore, a consensus-based case definition with behaviorally referenced diagnostic criteria was formulated to facilitate future empirical investigation. CONCLUSIONS: MCS is characterized by inconsistent but clearly discernible behavioral evidence of consciousness and can be distinguished from coma and VS by documenting the presence of specific behavioral features not found in either of these conditions. Patients may evolve to MCS from coma or VS after acute brain injury. MCS may also result from degenerative or congenital nervous system disorders. This condition is often transient but may also exist as a permanent outcome. Defining MCS should promote further research on its epidemiology, neuropathology, natural history, and management.
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“An example of a C-test with high speci fi city (in humans) is the command-following test [32], which is assumed to be a reliable indicator of consciousness in many clinical contexts -an embedded assumption in the diagnostic criteria for the minimally conscious state [52].”
From Tests for consciousness in humans and beyond (2024) · cites this paper as [52]
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“Patients can be placed along a scale where normal, alert waking consciousness is at the top, deep coma at the bottom, and various intermediate conditions, such as the minimally conscious state, in between (Giacino et al., 2002).”
Background
Metadata
- Authors
- Giacino, J. T., Ashwal, S., Childs, N., Cranford, R., Jennett, B., Katz, D. I., Kelly, J. P., Rosenberg, J. H., Whyte, J., Zafonte, R. D., & Zasler, N. D.
- Affiliations
- Loma Linda University Medical Center (US)
- Venue
- Neurology
- Published
- 2002-02-12
- Volume
- 58
- Issue
- 3
- Pages
- 349-353
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2168575964
- Cited by
- 2,422
- References
- 34
- Citations by year
- 2026: 83 · 2025: 123 · 2024: 150 · 2023: 144 · 2022: 129 · 2021: 132 · 2020: 151 · 2019: 113 · 2018: 137 · 2017: 132 · 2016: 106 · 2015: 119 · 2014: 123 · 2013: 126 · 2012: 117
- FWCI
- 27.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Funders
- JFK Medical Center Foundation
- School of Medicine, Boston University
- University of Pittsburgh
- Hennepin County Medical Center
- Loma Linda University
- American Academy of Physical Medicine and Rehabilitation
- University of Glasgow
- Topics
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Social Sciences › Arts and Humanities › Philosophy › Philosophy and Theoretical Science
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- minimally conscious state, disorders of consciousness, diagnostic criteria, coma, vegetative state, case definition, prognosis, acute brain injury, degenerative neurological disorders, emergence of consciousness
- MeSH terms
- Humans, Neurologic Examination, Persistent Vegetative State
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