van Ommen HJ, et al. - Authors attempted to examine if resistance to eye opening (REO) presented as a sign of consciousness or a reflex in severely brain-injured patients. for each individual, the clinical diagnosis of unresponsive wakefulness syndrome (UWS), minimally conscious state with (MCS+) or without (MCS-) preserved language processing was made with the aid of the Coma Recovery Scale-Revised (CRS-R). Yielded data pointed towards a voluntary basis for REO. A necessity arose for multiple serial assessments of REO in such patients, particularly as a majority of the subjects demonstrated fluctuating levels of consciousness.

Methods

• During a multimodal diagnostic analysis, REO was recorder in chronic patients with disorders of consciousness.
• In each patient, REO evaluations were conducted daily alongside clinical diagnosis of unresponsive wakefulness syndrome (UWS), minimally conscious state with (MCS+) or without (MCS-) preserved language processing via the Coma Recovery Scale-Revised (CRS-R).

Results

• The inclusion criteria was met by 79 patients among 150 consecutive patients.
• REO was seen in 19 patients (24.1%).
• A prominent association was reported between the presence of REO and the level of consciousness at the group level.
• A variation was also found in the repeatability of REO between patients in UWS, MCS- and MCS+.
• As per the outcomes, 6 illustrated REO out of 23 patients in UWS, in whom 5 exhibited atypical brain patterns activation.