Recovery of Consciousness After Severe Brain Injury Phase II

Public awareness of the prognostic complexities for patients with severe brain injury is growing both from the sensationalized media attention given to “coma-recovery” cases and from popular depictions such as the book and recent film, The Diving Bell and the Butterfly featuring the true story of an individual with locked-in syndrome. Less attention, however, is paid to the lack of information presently available about the many factors influencing recovery from severe brain injury. Advances made in trauma care have increased the likelihood that an individual will survive a severe injury or insult to the brain. What is less certain is how successful medical science is, and can be, at assessing, predicting, or altering the degree to which an individual will recover conscious awareness after severe brain injury.

Patients with severe brain injury occupy a broad range of behaviorally defined states from vegetative (no evidence of self or environmental awareness) to minimally conscious (at least some evidence of awareness), and on to a variety of behaviorally defined conditions that can even include patients with “locked-in syndrome” (full consciousness with no motor control). Researchers and clinicians attempting to answer questions about a patient’s status, progress, and potential for recovery often depend on retrospective information, usually incomplete, obtained during the original assessments and from subsequent evaluations carried out in a fragmented health system. This collaborative research effort will advance the pace of translating current brain research into clinical practice while deepening neuroscientific models of consciousness with data from patient studies.