A long-term intensive behavioral treatment study in patients with persistent vegetative state or minimally conscious state.

Abstract

OBJECTIVE: Persistent vegetative state is regarded as "permanent", if it persists for more than 1 year for traumatic aetiology, or for more than 3 months for other aetiologies. This is also the case for patients in a minimally conscious state. In order to investigate possible improvements after this period we treated and observed 7 such patients over a period of 6 months. DESIGN AND METHODS: An ABA-BAB study design was used, with sensory stimulation and social-tactile intervention as treatment regimes. Changes were documented by clinical evaluation and blind behavioural assessment through video monitoring. RESULTS: Clinical scores improved significantly after treatment. Video assessment also indicated significant changes in the patients' behaviour. During the initial period of therapy, social tactile interaction improved patients' activity, while sensory stimulation impaired activity. During the main part of therapy, both types of treatment yielded similar positive results. CONCLUSION: This study indicates the possibility of achieving behavioural improvements with regard to the responsiveness of patients with long-lasting persistent vegetative state and minimally conscious state by use of long-term treatment.