Application of an Intensive Rehabilitation Program After Very Late Recovery of Consciousness: A Single-Case Neurorehabilitation and Neuroimaging Study.

Late recovery of consciousness in vegetative state is considered as an exceptional outcome and has been reported prevalently in patients who suffered a traumatic brain injury. In these patients, the benefits of prolonging the rehabilitation, aimed at the recovery of autonomy in basic everyday activi...

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Published in:Journal of Central Nervous System Disease Vol. 11
Main Authors: Errante, Antonino, Saviola, Donatella, Fasano, Fabrizio, Basagni, Benedetta, Alinovi, Serena, Bosetti, Sara, Chiari, Margherita, Minardi, Rita, Pinardi, Chiara, Crisi, Girolamo, Fogassi, Leonardo, De Tanti, Antonio
Format: case study diagnostic images research tables/charts Journal Article
Published: Sage Publications Inc. 4/18/2019
Online Access:View this record in EBSCOhost
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      dt: 4/18/2019
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Application of an Intensive Rehabilitation Program After Very Late Recovery of Consciousness: A Single-Case Neurorehabilitation and Neuroimaging Study.
      aug:
        au:
          Errante, Antonino
          Saviola, Donatella
          Fasano, Fabrizio
          Basagni, Benedetta
          Alinovi, Serena
          Bosetti, Sara
          Chiari, Margherita
          Minardi, Rita
          Pinardi, Chiara
          Crisi, Girolamo
          Fogassi, Leonardo
          De Tanti, Antonio
        affil: Department of Medicine and Surgery, University of Parma, Parma, Italy
      sug:
        subj:
          Program Implementation
          Recovery
          Intracranial Hemorrhage Rehabilitation
          Consciousness Evaluation
          Diagnosis, Brain Methods
          Human
          Adult
          Female
          Persistent Vegetative State
          Severity of Illness
          Neuropsychological Tests
          Functional Assessment
          Magnetic Resonance Imaging Methods
          Probability
          Visual Acuity
          Visual Fields
          Dysarthria
          Activities of Daily Living
          Neural Networks (Computer)
          Task Performance and Analysis
          Neuroradiography Methods
          Adult: 19-44 years
          Female
      ab: Late recovery of consciousness in vegetative state is considered as an exceptional outcome and has been reported prevalently in patients who suffered a traumatic brain injury. In these patients, the benefits of prolonging the rehabilitation, aimed at the recovery of autonomy in basic everyday activities, has been demonstrated. Here, we describe the application of an intensive multi-professional rehabilitation program carried out on a young female patient, with exceptionally late recovery of consciousness, specifically, after 7 years of vegetative state due to severe brain hemorrhage. Neuropsychological and functional assessment was conducted before and after the end of the rehabilitation program. In addition, functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI)-based probabilistic tractography were performed. Two follow-up neuropsychological and functional assessments were also conducted 6 and 29 months after the conclusion of the program. Functional results showed an improvement, maintained over time, in walking with assistance, cognitive efficiency, visual acuity and visual field, dysarthria, and execution of activities of daily living. Moreover, functional and structural magnetic resonance imaging (MRI) data documented the existence of preserved neural networks involved in sensory, motor, and linguistic tasks, which in all likelihood support the recovery process. This report suggests the possibility of undertaking an intensive rehabilitation program in patients who remain for long periods in altered states of consciousness, in spite of early negative prognosis.
      pubtype: Academic Journal
      doctype:
        case study
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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