• Haibo Di, Yunzhi Nie, Xiaohua Hu, Yong Tong, Lizette Heine, Sarah Wannez, Wangshan Huang, Dan Yu, Minhui He, Aurore Thibaut, Caroline Schnakers, and Steven Laureys.
• International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, 310036 Hangzhou, China. dihaibo19@aliyun.com.
• Bmc Neurol. 2014 Jan 1; 14: 147.

BackgroundVisual fixation plays a key role in the differentiation between vegetative state/unresponsive wakefulness (VS/UWS) syndrome and minimally conscious state (MCS). However, the use of different stimuli changes the frequency of visual fixation occured in patients, thereby possibly affecting the accuracy of the diagnosis. In order to establish a standardized assessment of visual fixation in patients in disorders of consciousness (DOC), we compared the frequency of visual fixation elicited by mirror,a ball and a light.MethodVisual fixation was assessed in eighty-one post-comatose patients diagnosed with a MCS or VS/UWS. Occurrence of fixation to different stimuli was analysis used Chi-square testing.Result40 (49%) out of the 81 patients showed fixation to visual stimuli. Among those, significantly more patients (39, 48%) had visual fixation elicited by mirror compared to a ball (23, 28%) and mirror compared to a light (20, 25%).ConclusionThe use of a mirror during the assessment of visual fixation showed higher positive response rate, compared to other stimuli in eliciting a visual fixating response. Therefore, fixation elicited by a mirror can be a very sensitive and accurate test to differentiate the two disorders of consciousness.

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