• Anna Estraneo, Pasquale Moretta, Viviana Cardinale, Antonio De Tanti, Giordano Gatta, Joseph T Giacino, and Luigi Trojano.
• Lab. for the study of Disorders of Consciousness, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Italy anna.estraneo@fsm.it.
• Clin Rehabil. 2015 Aug 1; 29 (8): 803-8.

ObjectiveTo investigate which conscious behaviour is most frequently detected using the Coma Recovery Scale-Revised in patients with minimally conscious state.DesignMulticentre, cross-sectional study.SettingOne intensive care unit, 8 post-acute rehabilitation centres and 2 long-term facilities.SubjectsFifty-two patients with established diagnosis of minimally conscious state of different aetiology.Main MeasuresAll patients were assessed by the Coma Recovery Scale-Revised.ResultsIn most patients (34/52) non-reflexive responses were identified by two or more subscales of the Coma Recovery Scale-Revised, whereas in 14 patients only the visual subscale could identify cortically-mediated behaviours, and in the remaining 4 patients only the motor subscale did so.The clinical signs of intentional behaviour were most often detected by the visual subscale (43/52 patients) and by the motor subscale (31/52), and least frequently by the oromotor/verbal subscale (3/52) of the Coma Recovery Scale-Revised. This clinical pattern was observed independently from time post-onset and aetiology.ConclusionsNon-reflexive visual behaviour, identified by the visual subscale of Coma Recovery Scale-Revised, is the most frequently detected intentional sign consistent with the diagnosis of minimally conscious state, independently from aetiology and time post-onset.© The Author(s) 2014.

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