Disorders of Consciousness: Classification and Taxonomy

Katherine Golden; Yelena G Bodien; Joseph T Giacino

doi:10.1016/j.pmr.2023.06.011

Disorders of Consciousness: Classification and Taxonomy

Phys Med Rehabil Clin N Am. 2024 Feb;35(1):15-33. doi: 10.1016/j.pmr.2023.06.011. Epub 2023 Jul 27.

Authors

Katherine Golden¹, Yelena G Bodien², Joseph T Giacino³

Affiliations

¹ School of Health & Rehabilitation Sciences, MGH Institute of Health Professions, 36 1st Avenue, Boston, MA 02129, USA.
² Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Charlestown, MA, 02129, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA; Department of Physical Medicine and Rehabilitation, Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
³ Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, 300 1st Avenue, Charlestown, MA, 02129, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA. Electronic address: jgiacino@mgh.harvard.edu.

PMID: 37993185
DOI: 10.1016/j.pmr.2023.06.011

Abstract

In this article, we discuss the taxonomy associated with the four major disorders of consciousness (DoC): coma, vegetative state or unresponsive wakefulness syndrome, minimally conscious state, and post-traumatic confusional state. We briefly review the history of each disorder and then provide operational definitions and diagnostic criteria for each one. We rely heavily on recently released practice guidelines and, where appropriate, identify knowledge gaps and discuss future directions to advance DoC research and practice.

Keywords: Cognitive motor dissociation; Coma; Disorders of consciousness; Minimally conscious state; Post-traumatic confusional state; Unresponsive wakefulness syndrome; Vegetative state.

Publication types

Review

MeSH terms

Coma / diagnosis
Consciousness Disorders* / diagnosis
Consciousness*
Forecasting
Humans
Persistent Vegetative State / diagnosis