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DocumentSpasticity management in disorders of consciousness2017

Reference code: PT/FB
Entity holding: BIAL Foundation
Location: S. Mamede do Coronado
Title:
BIAL Foundation Archive
Start date: 1994
History:
The BIAL Foundation was created in 1994 by Laboratórios BIAL in conjunction with the Council of Rectors of Portuguese Universities. BIAL’s Foundation mission is to foster the scientific study of Man from both the physical and spiritual perspectives.
Along the years the BIAL Foundation has developed an important relationship with the scientific community, first in Portugal and after worldwide. Today it is an institution of reference which aims to stimulate new researches that may help people, promote more health and contribute to new milestones to gain access to knowledge.
Among its activities the BIAL Foundation manages the BIAL Award, created in 1984, one of the most important awards in the Health field in Europe. The BIAL Award rewards both the basic and the clinical research distinguishing works of major impact in medical research.
The BIAL Foundation also assigns Scientific Research Scholarships for the study of neurophysiological and mental health in people, arousing the interest of researchers in the areas of Psychophysiology and Parapsychology.
To date the BIAL Foundation has supported 461 projects, more than 1000 researchers, with research groups in twenty-seven countries, resulting, until April 2013, in about 600 full papers, out of which 172 published in indexed international journals with an average impact factor of 3.6 and a substantial number of citations (1665).
Since 1996 the BIAL Foundation organizes the Symposia entitled "Behind and Beyond the Brain", a Forum that gathers well renowned neurosciences speakers and the BIAL Foundation Fellows which are spread around the world.
Classified as an institution of public utility, the BIAL Foundation includes among its patrons the Portuguese President, the Portuguese Universities Rectors' Council and the Portuguese Medical Association.
URL: http://www.bial.com/pt/
Accessibility: By permission

Reference code: NDE
Location: Arquivo PCA - Pasta 1/Outros Apoios
Title:
Characterization of “Near-Death Experiences” through the comparison of experiencers and non-experiencers’ particularities: inter-individual differences in cognitive characteristics and susceptibility to false memories
Duration: 2016-03 - 2019-03
Researcher(s):
Steven Laureys, Charlotte Martial, Vanessa Charland-Verville, Héléna Cassol
Institution(s): Coma Science Group, University of Liège (Belgium)
Contents: Application
Research Funding Agreement
Progress report
Final report
Articles
Language: eng
Author:
Laureys, S.
Number of reproductions:
3
Keywords:
Parapsychology and Psychophysiology / Near-death experience / Functional magnetic resonance imaging (fMRI)

Reference code: NDE-06
Location: Arquivo PCA - Pasta 1/Outros Apoios
Title:
Spasticity management in disorders of consciousness
Publication year: 2017
URL:
http://www.mdpi.com/2076-3425/7/12/162/htm
Abstract/Results: ABSTRACT:
BACKGROUND:
Spasticity is a motor disorder frequently encountered after a lesion involving the central nervous system. It is hypothesized to arise from an anarchic reorganization of the pyramidal and parapyramidal fibers and leads to hypertonia and hyperreflexia of the affected muscular groups. While this symptom and its management is well-known in patients suffering from stroke, multiple sclerosis or spinal cord lesion, little is known regarding its appropriate management in patients presenting disorders of consciousness after brain damage.
OBJECTIVES:
Our aim was to review the occurrence of spasticity in patients with disorders of consciousness and the therapeutic interventions used to treat it. Methods: We conducted a systematic review using the PubMed online database. It returned 157 articles. After applying our inclusion criteria (i.e., studies about patients in coma, unresponsive wakefulness syndrome or minimally conscious state, with spasticity objectively reported as a primary or secondary outcome), 18 studies were fully reviewed.
RESULTS:
The prevalence of spasticity in patients with disorders of consciousness ranged from 59% to 89%. Current treatment options include intrathecal baclofen and soft splints. Several treatment options still need further investigation; including acupuncture, botulin toxin or cortical activation by thalamic stimulation.
CONCLUSION:
The small number of articles available in the current literature highlights that spasticity is poorly studied in patients with disorders of consciousness although it is one of the most common motor disorders. While treatments such as intrathecal baclofen and soft splints seem effective, large randomized controlled trials have to be done and new therapeutic options should be explored.
Accessibility: Document exists in file
Language:
eng
Author:
Martens, G.
Secondary author(s):
Laureys, S., Thibaut, A.
Document type:
Article
Number of reproductions:
3
Reference:
Martens, G., Laureys, S., & Thibaut, A. (2017). Spasticity management in disorders of consciousness. Brain Sciences, 7(12), 162. https://doi.org/10.3390/brainsci7120162
2-year Impact Factor: 2.786|2018
Impact factor notes: Impact factor computed since 2018
Times cited: 24|2025-09-16
Indexed document: Yes
Quartile: Q3
Keywords: Spasticity / Pain / Upper motor neuron syndrome / Disorders of consciousness / Brain injury / Treatment

Spasticity management in disorders of consciousness

Spasticity management in disorders of consciousness
DocumentClinical and electrophysiological investigation of spastic muscle overactivity in patients with disorders of consciousness following severe brain injury2019

Reference code: PT/FB
Entity holding: BIAL Foundation
Location: S. Mamede do Coronado
Title:
BIAL Foundation Archive
Start date: 1994
History:
The BIAL Foundation was created in 1994 by Laboratórios BIAL in conjunction with the Council of Rectors of Portuguese Universities. BIAL’s Foundation mission is to foster the scientific study of Man from both the physical and spiritual perspectives.
Along the years the BIAL Foundation has developed an important relationship with the scientific community, first in Portugal and after worldwide. Today it is an institution of reference which aims to stimulate new researches that may help people, promote more health and contribute to new milestones to gain access to knowledge.
Among its activities the BIAL Foundation manages the BIAL Award, created in 1984, one of the most important awards in the Health field in Europe. The BIAL Award rewards both the basic and the clinical research distinguishing works of major impact in medical research.
The BIAL Foundation also assigns Scientific Research Scholarships for the study of neurophysiological and mental health in people, arousing the interest of researchers in the areas of Psychophysiology and Parapsychology.
To date the BIAL Foundation has supported 461 projects, more than 1000 researchers, with research groups in twenty-seven countries, resulting, until April 2013, in about 600 full papers, out of which 172 published in indexed international journals with an average impact factor of 3.6 and a substantial number of citations (1665).
Since 1996 the BIAL Foundation organizes the Symposia entitled "Behind and Beyond the Brain", a Forum that gathers well renowned neurosciences speakers and the BIAL Foundation Fellows which are spread around the world.
Classified as an institution of public utility, the BIAL Foundation includes among its patrons the Portuguese President, the Portuguese Universities Rectors' Council and the Portuguese Medical Association.
URL: http://www.bial.com/pt/
Accessibility: By permission

Reference code: NDE
Location: Arquivo PCA - Pasta 1/Outros Apoios
Title:
Characterization of “Near-Death Experiences” through the comparison of experiencers and non-experiencers’ particularities: inter-individual differences in cognitive characteristics and susceptibility to false memories
Duration: 2016-03 - 2019-03
Researcher(s):
Steven Laureys, Charlotte Martial, Vanessa Charland-Verville, Héléna Cassol
Institution(s): Coma Science Group, University of Liège (Belgium)
Contents: Application
Research Funding Agreement
Progress report
Final report
Articles
Language: eng
Author:
Laureys, S.
Number of reproductions:
3
Keywords:
Parapsychology and Psychophysiology / Near-death experience / Functional magnetic resonance imaging (fMRI)

Reference code: NDE-36
Location: Arquivo PCA - Pasta 1/Outros Apoios
Title:
Clinical and electrophysiological investigation of spastic muscle overactivity in patients with disorders of consciousness following severe brain injury
Publication year: 2019
URL:
https://www.sciencedirect.com/science/article/pii/S1388245718313816?via%3Dihub
Abstract/Results: ABSTRACT
OBJECTIVE
The clinical and electrophysiological profile of spastic muscle overactivity (SMO) is poorly documented in patients with disorders of consciousness (DOC) following severe cortical and subcortical injury. We aim at investigating the link between the clinical observations of SMO and the electrophysiological spastic over-reactivity in patients with prolonged DOC.
METHODS
We prospectively enrolled adult patients with DOC at least 3?months post traumatic or non-traumatic brain injury. The spastic profile was investigated using the Modified Ashworth Scale and the Hmax/Mmax ratio. T1 MRI data and impact of medication were analyzed as well.
RESULTS
21 patients were included (mean age: 41?±?11?years; time since injury: 4?±?5?years; 9 women; 10 traumatic etiologies). Eighteen patients presented signs of SMO and 11 had an increased ratio. Eight patients presented signs of SMO but no increased ratio. We did not find any significant correlation between the ratio and the MAS score for each limb (all ps?>?0.05). The presence of medication was not significantly associated with a reduction in MAS scores or Hmax/Mmax ratios.
CONCLUSIONS
In this preliminary study, the Hmax/Mmax ratio does not seem to reflect the clinical MAS scores in patients with DOC. This supports the fact they do not only present spasticity but other forms of SMO and contracture.
SIGNIFICANCE
Patients with DOC are still in need of optimized tools to evaluate their spastic profile and therapeutic approaches should be adapted accordingly.
Accessibility: Document exists in file
Copyright/Reproduction:
By permission
Language:
eng
Author:
Martens, G.
Secondary author(s):
Deltombe, T., Foidart-Dessalle, M., Laureys, S., Thibaut, A.
Document type:
Article
Number of reproductions:
3
Reference:
Martens, G., Deltombe, T., Foidart-Dessalle, M., Laureys, S., & Thibaut, A. (2019). Clinical and electrophysiological investigation of spastic muscle overactivity in patients with disorders of consciousness following severe brain injury. Clinical Neurophysiology, 130(2), 207-213. https://doi.org/10.1016/j.clinph.2018.10.021
2-year Impact Factor: 3.214|2019
Times cited: 5|2025-09-17
Indexed document: Yes
Quartile: Q2
Keywords: Coma / H/M ratio / Minimally conscious state / Modified Ashworth Scale / Spasticity / Unresponsive wakefulness syndrome
DocumentEffect of multichannel transcranial direct current stimulation to reduce hypertonia in individuals with prolonged disorders of consciousness: A randomized controlled pilot study2019

Reference code: PT/FB
Entity holding: BIAL Foundation
Location: S. Mamede do Coronado
Title:
BIAL Foundation Archive
Start date: 1994
History:
The BIAL Foundation was created in 1994 by Laboratórios BIAL in conjunction with the Council of Rectors of Portuguese Universities. BIAL’s Foundation mission is to foster the scientific study of Man from both the physical and spiritual perspectives.
Along the years the BIAL Foundation has developed an important relationship with the scientific community, first in Portugal and after worldwide. Today it is an institution of reference which aims to stimulate new researches that may help people, promote more health and contribute to new milestones to gain access to knowledge.
Among its activities the BIAL Foundation manages the BIAL Award, created in 1984, one of the most important awards in the Health field in Europe. The BIAL Award rewards both the basic and the clinical research distinguishing works of major impact in medical research.
The BIAL Foundation also assigns Scientific Research Scholarships for the study of neurophysiological and mental health in people, arousing the interest of researchers in the areas of Psychophysiology and Parapsychology.
To date the BIAL Foundation has supported 461 projects, more than 1000 researchers, with research groups in twenty-seven countries, resulting, until April 2013, in about 600 full papers, out of which 172 published in indexed international journals with an average impact factor of 3.6 and a substantial number of citations (1665).
Since 1996 the BIAL Foundation organizes the Symposia entitled "Behind and Beyond the Brain", a Forum that gathers well renowned neurosciences speakers and the BIAL Foundation Fellows which are spread around the world.
Classified as an institution of public utility, the BIAL Foundation includes among its patrons the Portuguese President, the Portuguese Universities Rectors' Council and the Portuguese Medical Association.
URL: http://www.bial.com/pt/
Accessibility: By permission

Reference code: NDE
Location: Arquivo PCA - Pasta 1/Outros Apoios
Title:
Characterization of “Near-Death Experiences” through the comparison of experiencers and non-experiencers’ particularities: inter-individual differences in cognitive characteristics and susceptibility to false memories
Duration: 2016-03 - 2019-03
Researcher(s):
Steven Laureys, Charlotte Martial, Vanessa Charland-Verville, Héléna Cassol
Institution(s): Coma Science Group, University of Liège (Belgium)
Contents: Application
Research Funding Agreement
Progress report
Final report
Articles
Language: eng
Author:
Laureys, S.
Number of reproductions:
3
Keywords:
Parapsychology and Psychophysiology / Near-death experience / Functional magnetic resonance imaging (fMRI)

Reference code: NDE-73
Location: Arquivo PCA - Pasta 1/Outros Apoios
Title:
Effect of multichannel transcranial direct current stimulation to reduce hypertonia in individuals with prolonged disorders of consciousness: A randomized controlled pilot study
Publication year: 2019
URL:
https://www.sciencedirect.com/science/article/pii/S1877065719300934
Abstract/Results: ABSTRACT:
Background: Spasticity management in severely brain-injured patients with disorders of consciousness (DOC) is a major challenge because it leads to complications and severe pain that can seriously affect quality of life.
Objectives: We aimed to determine the feasibility of a single session of transcranial direct current stimulations (tDCS) to reduce spasticity in chronic patients with DOC.
Methods: We enrolled 14 patients in this double-blind, sham-controlled randomized crossover pilot study. Two cathodes were placed over the left and right primary motor cortex and 2 anodes over the left and right prefrontal cortex. Hypertonia of the upper limbs and level of consciousness were assessed by the Modified Ashworth Scale (MAS) and the Coma Recovery Scale-Revised (CRS-R). Resting state electroencephalography was also performed.
Results: At the group level, spasticity was reduced in only finger flexors. Four responders (29%) showed reduced hypertonicity in at least 2 joints after active but not sham stimulation. We found no behavioural changes by the CRS-R total score. At the group level, connectivity values in beta2 were higher with active versus sham stimulation. Relative power in the theta band and connectivity in the beta band were higher for responders than non-responders after the active stimulation.
Conclusion: This pilot study highlights the potential benefit of using tDCS for reducing upper-limb hypertonia in patients with chronic DOC. Large-sample clinical trials are needed to optimize and validate the technique.
Accessibility: Document exists in file
Language:
eng
Author:
Thibaut, A.
Secondary author(s):
Piarulli, A., Martens, G., Chatelle, C., Laureys, S.
Document type:
Article
Number of reproductions:
3
Reference:
Thibaut, A., Piarulli, A., Martens, G., Chatelle, C., & Laureys, S. (2019). Effect of multichannel transcranial direct current stimulation to reduce hypertonia in individuals with prolonged disorders of consciousness: A randomized controlled pilot study. Annals of Physical and Rehabilitation Medicine, 62(6), 418-425. https://doi.org/10.1016/j.rehab.2019.05.009
2-year Impact Factor: 3.657|2019
Times cited: 20|2025-09-17
Indexed document: Yes
Quartile: Q1
Keywords: Upper motor neuron syndrome / Spasticity / Hypertonia / Transcranial direct current stimulation / Minimally conscious state / Vegetative state

Effect of multichannel transcranial direct current stimulation to reduce hypertonia in individuals with prolonged disorders of consciousness: A randomized controlled pilot study

Effect of multichannel transcranial direct current stimulation to reduce hypertonia in individuals with prolonged disorders of consciousness: A randomized controlled pilot study
DocumentPhysical therapy in patients with disorders of consciousness: Impact on spasticity and muscle contracture2018

Reference code: PT/FB
Entity holding: BIAL Foundation
Location: S. Mamede do Coronado
Title:
BIAL Foundation Archive
Start date: 1994
History:
The BIAL Foundation was created in 1994 by Laboratórios BIAL in conjunction with the Council of Rectors of Portuguese Universities. BIAL’s Foundation mission is to foster the scientific study of Man from both the physical and spiritual perspectives.
Along the years the BIAL Foundation has developed an important relationship with the scientific community, first in Portugal and after worldwide. Today it is an institution of reference which aims to stimulate new researches that may help people, promote more health and contribute to new milestones to gain access to knowledge.
Among its activities the BIAL Foundation manages the BIAL Award, created in 1984, one of the most important awards in the Health field in Europe. The BIAL Award rewards both the basic and the clinical research distinguishing works of major impact in medical research.
The BIAL Foundation also assigns Scientific Research Scholarships for the study of neurophysiological and mental health in people, arousing the interest of researchers in the areas of Psychophysiology and Parapsychology.
To date the BIAL Foundation has supported 461 projects, more than 1000 researchers, with research groups in twenty-seven countries, resulting, until April 2013, in about 600 full papers, out of which 172 published in indexed international journals with an average impact factor of 3.6 and a substantial number of citations (1665).
Since 1996 the BIAL Foundation organizes the Symposia entitled "Behind and Beyond the Brain", a Forum that gathers well renowned neurosciences speakers and the BIAL Foundation Fellows which are spread around the world.
Classified as an institution of public utility, the BIAL Foundation includes among its patrons the Portuguese President, the Portuguese Universities Rectors' Council and the Portuguese Medical Association.
URL: http://www.bial.com/pt/
Accessibility: By permission

Reference code: NDE
Location: Arquivo PCA - Pasta 1/Outros Apoios
Title:
Characterization of “Near-Death Experiences” through the comparison of experiencers and non-experiencers’ particularities: inter-individual differences in cognitive characteristics and susceptibility to false memories
Duration: 2016-03 - 2019-03
Researcher(s):
Steven Laureys, Charlotte Martial, Vanessa Charland-Verville, Héléna Cassol
Institution(s): Coma Science Group, University of Liège (Belgium)
Contents: Application
Research Funding Agreement
Progress report
Final report
Articles
Language: eng
Author:
Laureys, S.
Number of reproductions:
3
Keywords:
Parapsychology and Psychophysiology / Near-death experience / Functional magnetic resonance imaging (fMRI)

Reference code: NDE-80
Location: BF-GMS
Title:
Physical therapy in patients with disorders of consciousness: Impact on spasticity and muscle contracture
Publication year: 2018
URL:
https://content.iospress.com/articles/neurorehabilitation/nre172229
Abstract/Results: ABSTRACT:
BACKGROUND: Spasticity is a frequent complication after severe brain injury, which may prevent the rehabilitation process and worsen the patients' quality of life.
OBJECTIVES: In this study, we investigated the correlation between spasticity, muscle contracture, and the frequency of physical therapy (PT) in subacute and chronic patients with disorders of consciousness (DOC).
METHODS: 109 patients with subacute and chronic disorders of consciousness (Vegetative state/Unresponsive wakefulness syndrome - VS/UWS; minimally conscious state - MCS and patients who emerged from MCS - EMCS) were included in the study (39 female; mean age: 40 +/- 13.5y; 60 with traumatic etiology; 35 VS/UWS, 68 MCS, 6 EMCS; time since insult: 38 +/- 42months). The number of PT sessions (i.e., 20 to 30 minutes of conventional stretching of the four limbs) was collected based on patients' medical record and varied between 0 to 6 times per week (low PT = 0-3 and high PT = 4-6 sessions per week). Spasticity was measured with the Modified Ashworth Scale (MAS) on every segment for both upper (UL) and lower limbs (LL). The presence of muscle contracture was assessed in every joint. We tested the relationship between spasticity and muscle contracture with the frequency of PT as well as other potential confounders such as time since injury or anti-spastic medication intake.
RESULTS: We identified a negative correlation between the frequency of PT and MAS scores as well as the presence of muscle contracture. We also identified that patients who received less than four sessions per week were more likely to be spastic and suffer from muscle contracture than patients receiving 4 sessions or more. When separating subacute (3 to 12 months post-insult) and chronic (>12months post-insult) patients, these negative correlations were only observed in chronic patients. A logit regression model showed that frequency of PT influenced spasticity, whereas neither time since insult nor medication had a significant impact on the presence of spasticity. On the other hand, PT, time since injury and medication seemed to be associated with the presence of muscle contracture.
CONCLUSION: Our results suggest that, in subacute and chronic patients with DOC, PT could have an impact on patients' spasticity and muscles contractures. Beside PT, other factors such as time since onset and medication seem to influence the development of muscle contractures. These findings support the need for frequent PT sessions and regular re-evaluation of the overall spastic treatment for patients with DOC.
Accessibility: Document does not exist in file
Language:
eng
Author:
Thibaut, A.
Secondary author(s):
Wannez, S., Deltombe, T., Martens, G., Laureys, S., Chatelle, C.
Document type:
Article
Number of reproductions:
3
Reference:
Thibaut, A., Wannez, S., Deltombe, T., Martens, G., Laureys, S., & Chatelle, C. (2018). Physical therapy in patients with disorders of consciousness: Impact on spasticity and muscle contracture. NeuroRehabilitation, 42(2), 199-205. https://doi.org/10.3233/NRE-172229
2-year Impact Factor: 1.197|2018
Times cited: 19|2025-09-17
Indexed document: Yes
Quartile: Q3
Keywords: Spasticity / Hypertonicity / Upper motor neuron / Muscle contracture / Disorders of consciousness / Minimally conscious state / Vegetative state/unresponsive wakefulness syndrome / Non-pharmacological treatment / Physical therapy