Increased behavioural responsiveness with complex stimulation in VS and MCS: preliminary results.

Primary objective: Even in non-communicative disorders of consciousness such as vegetative and minimally conscious states, increasing the personal relevance and complexity of stimuli appears to enhance their activating effect in patients. It was hypothesized that enriched stimulation in an immersive environment could increase the number and/or the goal-directed quality of active movements.Methods, research design and procedures: Twelve patients with severe disorders of consciousness in the post-acute phase underwent an experimental protocol of sensory stimulation based on biographically meaningful objects. Enriched stimulation was compared to both a pattern of stimulation without augmented context and to standard interactions in a clinical setting. An A-B-C-B-A paradigm was applied to minimize the confounding effects of clinical changes during the protocol. The motor behaviours were recorded using the Wessex Head Injury Matrix (WHIM) and analysed with standard parametric statistics.Results and conclusions...