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September 04, 2018; 91 (10) Special Article

Comprehensive systematic review update summary: Disorders of consciousness

Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology; the American Congress of Rehabilitation Medicine; and the National Institute on Disability, Independent Living, and Rehabilitation Research

Joseph T. Giacino, Douglas I. Katz, Nicholas D. Schiff, John Whyte, Eric J. Ashman, Stephen Ashwal, Richard Barbano, Flora M. Hammond, Steven Laureys, Geoffrey S.F. Ling, Risa Nakase-Richardson, Ronald T. Seel, Stuart Yablon, Thomas S.D. Getchius, Gary S. Gronseth, Melissa J. Armstrong
First published August 8, 2018, DOI: https://doi.org/10.1212/WNL.0000000000005928
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Article Information

vol. 91 no. 10 461-470
DOI: 
https://doi.org/10.1212/WNL.0000000000005928
PubMed: 
30089617
Published By: 
Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology
Print ISSN: 
0028-3878
Online ISSN: 
1526-632X
History: 
  • Received December 12, 2017
  • Accepted in final form May 22, 2018
  • First Published August 8, 2018.

Article Versions

Author Disclosures

    1. Joseph T. Giacino, PhD,
    2. Douglas I. Katz, MD,
    3. Nicholas D. Schiff, MD,
    4. John Whyte, MD, PhD,
    5. Eric J. Ashman, MD,
    6. Stephen Ashwal, MD,
    7. Richard Barbano, MD, PhD,
    8. Flora M. Hammond, MD,
    9. Steven Laureys, MD, PhD,
    10. Geoffrey S.F. Ling, MD,
    11. Risa Nakase-Richardson, PhD,
    12. Ronald T. Seel, PhD,
    13. Stuart Yablon, MD,
    14. Thomas S.D. Getchius,
    15. Gary S. Gronseth, MD and
    16. Melissa J. Armstrong, MD, MSc
  1. Joseph T. Giacino, PhD,
    2. Scientific Advisory Boards:

    1. Traumatic Brain Injury Model Systems National Data and Statistical Center (federal agency)

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Journal of Head Trauma Rehabilitation, Editorial Board, 2002-Present

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical procedures or imaging studies:

    1. Director, Spaulding Rehabilitation Network Disorders of Consciousness Program, 15% effort

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. 1) U.S. Department of Defense, Co-Investigator, W81XWH-11- 2-0210, 2011-2013 (NCE 2014-2017), Co-Investigator; W81XWH- 08-2-0159, 2011-2014, Co-Investigator; W81XWH-14-2-0176, 2014-2019, Co-PI) 2) National Institute on Disability and Rehabilitation Research, H133A120085, PI, 2012-2017; 90DP0060, Site PI, 2013-2018; 90DPTB0011, 2017-2022, PI 4) National Institutes of Health, 1U01NS086090-01, Co-PI, 2013-2018; UH3NS095554, 2015-2020, Co-PI

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. 1) James S. McDonnell Foundation 2) The Barbara Epstein Foundation, Inc

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. 1) DeCorato Cohen Sheehan & Federico, expert witness, 2018

  2. Douglas I. Katz, MD,
    3. Scientific Advisory Boards:

    1. (1) Chair, External Scientific Advisory Board, VA Rehabilitation Research and Development TBI Center of Excellence, Boston; MA (2) Data Safety Monitoring Board Multicenter Evaluation of Memory Remediation After TBI With Donepazil (MEMRI-TBI-D) NIDILRR Grant Number: H133A130047

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. (1) travel support for talks and conferences on DoC from organizations: World Federation of Neurorehabilitation, International Brain Injury Association, Moody Foundation/ Galveston Brain Injury Conference

    Editorial Boards:

    1. (1) Journal of Head Trauma Rehabilitation, Editorial Board, 1994-present (2) Neurorehabilitation and Neural Repair, Assoc. Editor, 2002-present (3) Frontiers in Neurotrauma, editorial board, 2010-present (4) Journal of Neurotrauma, eidtorial board, 2013-present

    Patents:

    1. NONE

    Publishing Royalties:

    1. (1) Brain Injury Medicine, Principles and Practice, Demos, 2013 (2) Lash Publications, Post-traumatic seizures, 2009

    Employment, Commercial Entity:

    1. (1) HealthSouth, (stipend) Medical Director of the Acquired Brain Injury Program at Braintree Rehab. Hosp., 2015-present

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other activities:

    1. (1) HealthSouth / Encompass Health Medical Directors? Conference, Honorarium, Keynote address (2) Harvard Longwood Neurology, Providence VA Hospital, Tufts Medical Center, Baystate Medical Center, University of Massachusetts Medical Center, Honoraria for Grand Rounds on DoC and brain injury

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. (1) NIH (NINDS) 50202423 PI: Ann McKee MD, CTE and Posttraumatic Neurodegeneration: Neuropathology and Ex Vivo Imaging, Co-investigator, 2014-2018 (2) NIH (NINDS) 1U01NS093334-01 PI: Robert Stern PhD, Chronic Traumatic Encephalopathy: Detection, Diagnosis, Course, and Risk Factors, Co-investigator, 2016-2022 (3) NIH (NICHD) 5R21HD089088-02 PI: Rhoda Au, PhD, Impact of Traumatic Brain Injury on Brain Aging and Dementia, Co- investigator, 2016-2018

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. (1) expert testimony in several legal cases involving patients with DoC after brain injury

  3. Nicholas D. Schiff, MD,
    4. Scientific Advisory Boards:

    1. EnspireDBS, Inc, Cleveland, Ohio. Commercial, early stage University Start-Up company.

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. All patents owned by Cornell University. Listed as Inventor on the following active or pending patents (expired patents omitted). Victor, JD, Schiff, ND, and Repucci, M. (2000) Method and System for Analyzing Multi-variate Data Using Canonical Decomposition. Cornell Research Foundation CRF-2577. US Patent #7,171,339 (Issued 1/30/07), US Patent and Trademarks Office. Data analysis algorithm for multivariate time series Schiff, ND, Purpura, K.P. and Kalik, S.F. (1999) Feedback mechanism for deep brain stimulation. Cornell Research Foundation CRF-D2495 European Patent No. 1191972 (Granted: 8/31/05, Licensed to IntElect Medical, Inc 2/2005-3/2012) Deep brain stimulation closed-loop control system Victor, JD, Schiff, ND, and Repucci, M. (2004) Method and System for Analyzing Multi-variate Data Using Canonical Decomposition. Cornell Research Foundation CRF-2577), US Patent and Trademarks Office. US Patent #7,409,321 Data analysis algorithm for multivariate time series Schiff, ND (2008) Patient controlled brain repair system. Cornell Center for Technology Enterprise and Commercialization Reference D4286 US Patent #8,694,087 Combination deep brain stimulation/brain computer interface system Schiff, ND, Purpura, K.P. and Kalik, S.F. (2002) Feedback mechanism for deep brain stimulation with detection of generalized efference copy signals Cornell Center for Technology Enterprise and Commercialization Reference D- 2495-07 US Patent #8,150,523. Deep brain stimulation closed-loop control system Schiff, ND, Purpura, K.P. and Kalik, S.F. (1999) Feedback mechanism for deep brain stimulation. Cornell Research Foundation CRF-D2495 European Patent No. 5075990.1 (division of European Patent No. 00939701.9) European Patent Allowed. Licensed to IntElect Medical, Inc. 2/2005-3/2012 Deep brain stimulation closed-loop control system Schiff, ND, Purpura, KP, Baker, J, Ryu, JW. (2013) Systems and methods allowing complete control of thalamic pathways via DBS. 61/755,842 (US) Cornell Center for Technology Enterprise and Commercialization Reference D-5617. US Patent #9,592,383B2. Issued March 14, 2017. Deep brain stimulation closed-loop control system Szeto, H, Schiff, ND (2013) Methods and compositions for treating and preventing cognitive dysfunction. No. 61/916,647 (US), Cornell Center for Technology Enterprise and Commercialization Reference D-6556 Mitochrondrial function modulation in neurological disorders Schiff, ND (2014) Patient controlled brain repair system. Cornell Center for Technology Enterprise and Commercialization. US Patent #9,215,298 Combination deep brain stimulation/brain computer interface system Schiff, ND and Braiman, C (2016). An envelope responsive brain computer interface and an envelope responsive measure for the assessment of brain function in severely brain- injured patients with covert cognition. Cornell Technology Licensing# 7472-01. US Provisional 62/235,565 System and method for evaluation of language processing in the brain Purpura, K, Baker, J, Schiff, ND, DEEP BRAIN STIMULATION THROUGH TRIPOLAR ELECTRICAL FIELD SHAPING for U.S. Provisional Application No. 62/373,475, filed August 11, 2016; Deep brain stimulation closed-loop control system Braiman, C, Braiman, C, Schiff, ND, A SENSORY EVOKED RESPONSE ATTENTION INDEX application for Letters Patent in the United States was filed as U.S. Serial No. 62/468,004 on March 7, 2017; System and method for evaluation of sensory information processing in the brain

    Publishing Royalties:

    1. Posner, J, Saper C., Schiff, N. and Plum, F. (2007) Plum and Posner?s Diagnosis of Stupor and Coma 4th Edition. Oxford University Press

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. Mechanisms of recovery following severe brain injury PI: Schiff, ND. NIH-NICHD/NCMRR R01 HD051912-02 4/3/08-3/31/13

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. James S. McDonnell Foundation Principal Investigator 7/09-6/12 ]Collaborative study of recovery of consciousness after severe brain injury: Phase II PI: Schiff, ND, James S. McDonnell Foundation, 8/1/2013-4/30/18

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  4. John Whyte, MD, PhD,
    5. Scientific Advisory Boards:

    1. InTrust Data Safety Monitoring Board

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. Travel expenses covered and honoraria paid (but endorsed over to MossRehab) for multiple professional and academic lectures, sponsored by professional associations and individual University departments.

    Editorial Boards:

    1. American Journal of Physical Medicine and Rehabilitation (Associate editor, 2002 - present) Journal of Head Trauma Rehabilitation (Editorial Board, 1995 - present) Journal of Neuortrauma (Editorial Board, 2010 - present)

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. University of Southern California - Consultant to NIH- funded T32 career development grant

    Speakers' Bureaus:

    1. NONE

    Other activities:

    1. Expert testimony (both sides) pertaining to individuals with severe disorders of consciousness (1 - 3 cases/year, payment endorsed over to MossRehab).

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NIH: 2 K12 HD001097-20 Medical Rehabilitation Scientist Development Program Boninger (PD) 03/01/2012 - 2/28/2017 Role: Co-Program Director PCORI ME-1403-14083 Whyte (PI) Better rehabilitation through better characterization of treatments. 1/01/2015 - 1/31/2018 NIDILRR: H133A120037 Hart (PI) 10/01/2017-09/30/20122 The Moss Traumatic Brain Injury Model System Role: Co-Investigator NNIH: 1T32HD071844 Whyte (PI) 5/01/2018-4/30/2023 Postdoctoral Training in Translational Neurorehabilitation Research PCORI R-1511-33005 Nakase-Richardson (PI) 10/1/2016 - 9/30/2019 Comparative effectiveness of sleep assessment strategies to maximize TBI rehabilitation outcome. Role: Site PI NIDILRR H133A130047/90DP0060 Arciniegas (PI) 10/01/2013 - 9/30/2018 Muulticenter evaluation of memory remediation after TBI with donepezil. Role: Co-investigator DoD W81XWH-14-2-0176 Manley (PI) 9/30/2014 - 9/29-2019 TBI Endpoints development Role: Co-investigator

    Research Support, Academic Entities:

    1. See #3

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. Review and provision of expert opinion in a DoC legal settlement case (Lewis Brisbois Bisgaard & Smith LLP)

  5. Eric J. Ashman, MD,
    6. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other activities:

    1. Member of Guideline Development Subcommittee of the AAN until May 2017, and current ex officio member. Editorial Board of Neurology Clinical Practice.

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  6. Stephen Ashwal, MD,
    7. Scientific Advisory Boards:

    1. SPIN trial DSMB member

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. PEDIATRIC NEUROLOGY

    Patents:

    1. NONE

    Publishing Royalties:

    1. PEDIATRIAC NEUROLOGY:PRINICPLES AND PRACTICE---COEDITOR

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. Ongoing Research Support (OSR# 56232) S. Ashwal (PI)2006- 2011 NIH-04-298 NINDS--R01 NS054001-01 Pediatric TBI and DAI: Normal Appearing Brain is not Normal This prospective 5-yr study will use SWI, MRI and MRS in 90 pediatric TBI and 90 controls to determine which specific imaging variables will predict outcome. Role: Principal Investigator

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  7. Richard Barbano, MD, PhD,
    8. Scientific Advisory Boards:

    1. Allergan, compensation for speaking engagement Scientific Ad Board for Merz, Ipsen, Revance

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. Neurotoxin Association, non-commercial entity: I received travel expenses for workshop presentation. Jagellonian University, Poland: academic institution: I received travel honoraria for lectures/participation in conference

    Editorial Boards:

    1. Neurology Clinical Practice, Associate editor, 2011- present

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical procedures or imaging studies:

    1. University of Rochester, botulinum toxin injections, 30% effort, since 1994

    Research Support, Commercial Entities:

    1. 1. Vaccinex 2. Biotie 3. Allergan

    Research Support, Government Entities:

    1. NIH, NINDS, ORDR: Dystonia Coalition Projects, Site PI Stock/Stock Options, Medical Equipment & Materials: I receive stock options from Visual Dx as Neurology Section Editor, VisualDx, 2014-present

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. Expert witness in legal proceedings including malpractice, but NOT involving commercial entities

  8. Flora M. Hammond, MD,
    9. Scientific Advisory Boards:

    1. (1) Avanir Prism II Study Steering Committee (2) Avanir Scientific Advisory Committee

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Journal of Head Trauma Rehabilitation, editorial board member, 2003 - present

    Patents:

    1. NONE

    Publishing Royalties:

    1. 1) Tip Cards, Lash Publishing Inc, 2003 - present 2) Handbook for Clinical Research: Design, Statistics, and Implementation, by Flora M. Hammond, James F. Malec, Todd G. Nick, and Ralph M. Buschbacher. Demos Publishing 2016

    Employment, Commercial Entity:

    1. 1) Indiana University School of Medicine, Professor and Chair, Physical Medicine and Rehabilitation

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. (1) NIDILRR, PI, 2012 - 2012; 90DP0036 (2) NIDILRR, PI, 2017 - 2022; 90DRTB0002 Stock/Stock Options, Medical Equipment & Materials: ABBVIE INC SHS ($8,515 market value) AMGEN INC COM ($24153) ASTRAZENECA PLC SPND ADR ($39,672) EDWARDS LIFESCIENCES CRP ($8, 925) GW PHARMACEUTICALS PLC ADR ($7,736) INTUITIVE SURGICAL INC NEW ($9,482) KONINKL PHIL NV SH NEW ($8,849) MERCK AND CO INC SHS ($22,490) PFIZER INC($29,808) SANOFI ($6,969) THERMO FISCHER SCIENTIFIC INC ($8,427) UNITED HEALTH GROUP (8,371) ZOETIS INC ($15,272)

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  9. Steven Laureys, MD, PhD,
    10. Scientific Advisory Boards:

    1. Non-profit: FONDAZIONE EUROPEA DI RICERCA BIOMEDICA FERB ONLUS, Italy (volunteer Organization) Commercial: CEFALY Technology SPRL, Belgium (electrical stimulation therapy for headache) g.tec medical engineering GmbH, Austria (real-time biosignal amplifiers & EEG processing) Neurosteer Ltd, Israel (real-time wearable brain sensing and control for medical and lifestyle applications) Rinbeat Srl, Italy (real-time monitoring and analysis of biometric and environmental parameters) Neuroelectrics Barcelona SL, Spain (neuro-modulation and EEG medical applications); Mind Science Tech SPRL, Belgium (brain-monitoring technology)

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. The Neurology of Consciousness 2nd Edition, Laureys S, Gosseries O and Tononi G (Eds), Academic Press, 2015, 488 pages, ISBN-13: 978-0128009482 Clinical Neurophysiology in Disorders of Consciousness: Brain Function Monitoring in the ICU and Beyond, Rossetti A, Laureys S (Eds) Springer 2015, 161 pages, ISBN-13: 978-3709116333 Un si brillant cerveau, Laureys S, Editions Odile Jacob, 2015, 293 pages, ISBN-13: 978-2738131768 Assessing Pain and Communication in Disorders of Consciousness (Neuropsychological Rehabilitation: A Modular Handbook), Chatelle C and Laureys S (Eds), Psychology Press, 2015, 174 pages, Paperback ISBN-13: 978-1138814820, Hardcover ISBN-13: 978- 1138814806 Coma Science, clinical and ethical implications, Laureys S, Schiff S, Owen A (Eds), Elsevier Science, 2013, 444 pages, ISBN-13: 978- 0444562098 Evolution de l??tat de conscience lors de stimulations transcraniennes, Thibaut A and Laureys S, ?ditions universitaires europ?ennes, 2013, 120 pages, ISBN-13: 978-3841783967 Neuroimaging of Consciousness, Cavanna AE, Nani A, Blumenfeld H, Laureys S (Eds) Springer, 2013, 261 pages, Paperback ISBN-13: 978-3642440571, ISBN 978-3-642-37580-4 Hardcover ISBN-13: 978-3642375798 Ons briljante brein, Laureys S, Borgerhoff & Lamberigts, 2013, 238 pages, ISBN-13: 978-9089313584 Coma and disorders of Consciousness, Schnakers C and Laureys S (Eds), Springer, London, 2012, 172 pages, Paperback ISBN-13: 978-1447161233, Hardcover ISBN-13: 978-1447124399 Coma et ?tats de conscience alt?r?e, Schnakers C and Laureys S (Eds), Springer, 2011, 170 pages, ISBN-13: 978-2817801261

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical procedures or imaging studies:

    1. Coma Science Group, Dept of Neurology, University Hospital of Li?ge, Sart Tilman B35, Avenue de l'H?pital n?1, 4000 Li?ge Clinical MRI, PET, EEG, TMS, tDCS assessment & treatment of patients with disorders of consciousness 20%

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. Belgian Funds for Scientific Research (FRS), European Commission H2020 Luminous project, Center-TBI, Human Brain Project, McDonnell Foundation, European Space Agency, Belspo, "Fondazione Europea di Ricerca Biomedica", BIAL Foundation, Mind Science Foundation Stock/Stock Options, Medical Equipment & Materials: Imagilys SPRL, Belgium (brain advanced MRI services, software and hardware and neurosurgical planning) 2015

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  10. Geoffrey S.F. Ling, MD,
    11. Scientific Advisory Boards:

    1. (1) Biogen (commercial) (2) NFL Health Foundation (not for profit) (3) NFLPA Mackey White Committee (commercial) (4) NIH NCATS Advisory Council (government) (5) VA National Research Advisory Council (government) (6) Boy Scouts of America STEM Advisory Council (not for profit) (7) Brain Scope, Inc (commercial) (8) QDTI (commercial) (9) NED Biosystems (commercial)

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. Medtronic (speaking honorarium)

    Editorial Boards:

    1. NONE

    Patents:

    1. Patent, wearable monitor for blood pressure, oximetry, heart rate

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. (1) On Demand Pharmaceuticals, Chief Operating Officer, 2 years (2) Kno Limits, Co-Founder and partner, 2 years (3) Mind-X, Co-Founder and Board of Directors, 1 year (4) Host Response, Co-Founder, 2 years (5) SunQ, Co-Founder and CEO, 2 years (6) DrsGSLing, LLC, CEO, 2 years (7) Ling and Associates, CEO, 1 year (8) COLGLingMD, LLC, sole proprietor, 1 year (9) Johns Hopkins Hospital (not for profit), 2 years

    Consultancies:

    1. (1) Inova Fairfax Medical Center, not for profit (2) Caivis Fund, commercial (3) Heritage Fund, commercial (4) Camden Partners, commercial Stock/Stock Options, Medical Equipment & Materials: (1) On Demand Pharmaceuticals, 2 years (2) Host Response, 2 years (3) NED Biosystems, 1 year

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  11. Risa Nakase-Richardson, PhD,
    12. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. University of Pittsburgh, Pittsburgh, PA; The Learning Center, Galveston, TX; Center for Neuroscience and Regenerative Medicine, Bethesda, MD; Craig Hospital, Denver, CO; Western Michigan Brain Injury Network, Grand Rapids, MI.

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. I have had the following research support over the past two years: (1) Patient Centered Outcomes Research Institute, PCORI R- 1511-33005, Principal Investigator, 10/2016 -09/2019. (2) Department of Veterans Affairs, Rehabilitation Research and Development,VA RR&D; 1 I21 RX001923-01A1, Co- Investigator, 10/2016-09/2018. (3) General Dynamics Information Technology Subcontract with Defense and Veterans Brain Injury Center, Defense Health Agency, DOD, DVBIC-W91YTZ-13-C-0015, Principal Investigator,05/2015-09/2025. (4) Department of Veterans Affairs, Health Services Research and Development, VA HSRD; 1 I50 HX001233-01, Investigator, 04/2013- 05/2018. (5) Department of Defense and Veterans Affairs Clinical Research and Development, W81XWH-13-2-0095, Site Principal Investigator, 10/2013-10/2019. (6) National Institute of Health, 5R01NR013658-03, Site Investigator, 10/2016-6/2017.

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  12. Ronald T. Seel, PhD,
    13. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Journal of Head Trauma Rehabilitation, Editorial Board Member, 2012-present

    Patents:

    1. NONE

    Publishing Royalties:

    1. Neurobehavioral Functioning Inventory, The Psychological Corporation, 2000-present

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. HHS-ACL-NIDILRR, Knowledge Translation Center Grant, 90DP0098 Consultant, 9/30/16-9/29/19 NIH?NICHD/NCMRR, R21, HD089110-01, Co-I, 7/21/16-6/30/18 HHS-ACL-NIDILRR, RERC 90RE5023-01-00, Co-I, 10/1/15-9/30/20

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. Commonwealth of Virginia Neurotrauma Initiative Trust Fund Craig H. Neilsen Foundation

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  13. Stuart Yablon, MD,
    14. Scientific Advisory Boards:

    1. Codman; honorarium, payment of travel related expenses, scientific advisor regarding intrathecal baclofen therapy for spasticity (2008) Allergan; honorarium, payment of travel related expenses, scientific advisor regarding botulinum neurotoxin therapy for spasticity (2008, 2009) Merz; honorarium, payment of travel related expenses, scientific advisor regarding botulinum neurotoxin therapy for spasticity (2008-11)

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. Associate editor, PM&R (journal), 2008-15 Editorial Advisory Board, Neurorehabilitation and Neural Repair (journal), 1996-2002

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. (1) Flowonix Medical Inc.; scientific advisor regarding intrathecal baclofen therapy for spasticity (2017).

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical procedures or imaging studies:

    1. (1) Methodist Physician Associates, Methodist Rehabilitation Center, Jackson, MS, USA; I treat patients with acquired brain injury, including patients with spasticity, and perform botulinum neurotoxin injections in our center's Spasticity Clinic. Approximately 5% of my FTE effort is currently directed toward treatment of patients in the Spasticity Clinic. (2) Division of Physical Medicine and Rehabilitation, Department of Neurological Surgery, University of Mississippi Medical Center, Jackson, MS, USA; I treat patients with acquired brain injury, including patients with spasticity, and perform botulinum neurotoxin injections in our center's Spasticity Clinic. Approximately 5% of my FTE effort is currently directed toward treatment of patients in the Spasticity Clinic.

    Research Support, Commercial Entities:

    1. Medtronic; research grant regarding intrathecal baclofen for spasticity (2004-2009).

    Research Support, Government Entities:

    1. National Institute for Disability and Rehabilitation Research (NIDRR) , co-PI, H133A020514 (Traumatic Brain Injury Model System of Mississsippi); (2002-2006) National Institute for Disability and Rehabilitation Research (NIDRR) , co-PI, H133A031713 (A Multicenter Prospective Randomized Controlled Trial of the Effectiveness of Amantadine Hydrochloride in Promoting Recovery of Function Following Severe TBI); (2003-2008)

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. (1) Prepared affidavit and gave deposition as an expert witness on behalf of defense in a medical malpractice lawsuit; 2008. (2) Prepared affidavit as an expert witness on behalf of defense in a personal injury-negligence lawsuit; 2008. (3) Prepared affidavit as an expert witness on behalf of defense in a personal injury-negligence lawsuit; 2018. (4) Gave deposition as an expert witness on behalf of defense in a medical malpractice lawsuit; 2018.

  14. Thomas S.D. Getchius,
    15. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. March 2017: Received reimbursement for faculty travel expenses to the New York Academy of Medicine.

    Editorial Boards:

    1. NONE

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  15. Gary S. Gronseth, MD and
    16. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for Travel or Speaker Honoraria:

    1. NONE

    Editorial Boards:

    1. (1) Neurology Now, Editorial advisory board, Inception- Present (2) Neurology, Associate Editor, 2013-Present

    Patents:

    1. NONE

    Publishing Royalties:

    1. NONE

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. NONE

    Speakers' Bureaus:

    1. NONE

    Other Activities:

    1. NONE

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. NONE

    Research Support, Academic Entities:

    1. NONE

    Research Support, Foundations and Societies:

    1. American Academy of Neurology

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  16. Melissa J. Armstrong, MD, MSc
    17. Scientific Advisory Boards:

    1. NONE

    Gifts:

    1. NONE

    Funding for travel or speaker honoraria:

    1. (1) American Academy of Neurology, traveling to guideline subcommitee meetings

    Editorial Boards:

    1. (1) Neurology, Level of Evidence Editorial Board, 2012- current

    Patents:

    1. NONE

    Publishing Royalties:

    1. (1) Parkinson's Disease: Improving Patient Care, Oxford University Press, 2014

    Employment, Commercial Entity:

    1. NONE

    Consultancies:

    1. (1) American Academy of Neurology Evidence-Based Medicine Methodology Consultant

    Speakers' Bureaus:

    1. NONE

    Other activities:

    1. (1) Medscape CME (2016 writing, speaking honoraria, 2018 speaking honoraria)

    Clinical Procedures or Imaging Studies:

    1. NONE

    Research Support, Commercial Entities:

    1. NONE

    Research Support, Government Entities:

    1. (1) ARHQ, K08HS024159, PI, 2015-2020

    Research Support, Academic Entities:

    1. (1) TBI Endpoints Development Initiative (2016-2017)

    Research Support, Foundations and Societies:

    1. NONE

    Stock/Stock Options/Board of Directors Compensation:

    1. NONE

    License Fee Payments, Technology or Inventions:

    1. NONE

    Royalty Payments, Technology or Inventions:

    1. NONE

    Stock/Stock Options, Research Sponsor:

    1. NONE

    Stock/Stock Options, Medical Equipment & Materials:

    1. NONE

    Legal Proceedings:

    1. NONE

  1. From the Department of Physical Medicine and Rehabilitation (J.T.G.), Spaulding Rehabilitation Hospital and Harvard Medical School; Department of Psychiatry (J.T.G.), Massachusetts General Hospital, Boston; Department of Neurology (D.I.K.), Boston University School of Medicine; Braintree Rehabilitation Hospital (D.I.K.), MA; Department of Neurology and Neuroscience (N.D.S.), Weill Cornell Medical College, New York, NY; Moss Rehabilitation Research Institute (J.W.), Elkins Park, PA; Bronson Neuroscience Center (E.J.A.), Bronson Methodist Hospital, Kalamazoo, MI; Department of Pediatrics, Division of Child Neurology (S.A.), Loma Linda University School of Medicine, CA; Department of Neurology (R.B.), University of Rochester Medical Center, NY; Indiana University Department of Physical Medicine & Rehabilitation (F.M.H.), University of Indiana School of Medicine, Indianapolis; Coma Science Group–GIGA Research and Department of Neurology (S.L.), Sart Tillman Liège University & University Hospital, Liège, Belgium; Department of Neurology (G.S.F.L.), Uniformed Services University of Health Sciences, Bethesda; Department of Neurology (G.S.F.L.), Johns Hopkins University, Baltimore, MD; James A. Haley Veterans' Hospital (R.N.-R.), US Department of Veterans Affairs, Tampa, FL; Crawford Research Institute (R.T.S.), Shepherd Center, Atlanta, GA; Center for Rehabilitation Science and Engineering, Department of Physical Medicine & Rehabilitation (R.T.S.), Virginia Commonwealth University School of Medicine, Richmond; Division of Physical Medicine & Rehabilitation (S.Y.), University of Mississippi School of Medicine; Brain Injury Program (S.Y.), Methodist Rehabilitation Center, Jackson, MS; Heart Rhythm Society (T.S.D.G.), Washington, DC; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City; and Department of Neurology (M.J.A.), University of Florida College of Medicine, Gainesville.
  1. Correspondence
    American Academy of Neurology guidelines{at}aan.com
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