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Persistent Vegetative State (Vegetative State)

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Vegetative state refers to the neurocognitive status of individuals with severe brain damage, in whom physiologic functions (sleep-wake cycles, autonomic control, and breathing) persist, but awareness (including all cognitive function and emotion) is abolished.

Also Known As:

Vegetative State; Permanent Vegetative State; PVS (Persistent Vegetative State); Persistent Unawareness State; Post-Comatose Unawareness State; Post-Traumatic Unawareness State; Postcomatose Unawareness State; Posttraumatic Unawareness State; Prolonged Post-Traumatic Unawareness; Transient Vegetative State; Minimally Conscious States; PVSs (Persistent Vegetative State); Permanent Vegetative States; Persistent Unawareness States; Persistent Vegetative States; Post Comatose Unawareness State; Post Traumatic Unawareness State; Post Traumatic Vegetative State; Post-Comatose Unawareness States; Post-Traumatic Unawareness States; Post-Traumatic Unawareness, Prolonged; Post-Traumatic Unawarenesses, Prolonged; Post-Traumatic Vegetative States; Postcomatose Unawareness States; Posttraumatic Unawareness States; Prolonged Post Traumatic Unawareness; Prolonged Post-Traumatic Unawarenesses; State, Minimally Conscious; State, Permanent Vegetative; State, Persistent Unawareness; State, Persistent Vegetative; State, Post-Comatose Unawareness; State, Post-Traumatic Unawareness; State, Post-Traumatic Vegetative; State, Postcomatose Unawareness; State, Posttraumatic Unawareness; State, Transient Vegetative; State, Vegetative; States, Minimally Conscious; States, Permanent Vegetative; States, Persistent Unawareness; States, Persistent Vegetative; States, Post-Comatose Unawareness; States, Post-Traumatic Unawareness; States, Post-Traumatic Vegetative; States, Postcomatose Unawareness; States, Posttraumatic Unawareness; States, Transient Vegetative; States, Vegetative; Transient Vegetative States; Unawareness State, Persistent; Unawareness State, Post-Comatose; Unawareness State, Post-Traumatic; Unawareness State, Postcomatose; Unawareness State, Posttraumatic; Unawareness States, Persistent; Unawareness States, Post-Comatose; Unawareness States, Post-Traumatic; Unawareness States, Postcomatose; Unawareness States, Posttraumatic; Unawareness, Prolonged Post-Traumatic; Unawarenesses, Prolonged Post-Traumatic; Vegetative State, Permanent; Vegetative State, Post-Traumatic; Vegetative State, Transient; Vegetative States; Vegetative States, Permanent; Vegetative States, Persistent; Vegetative States, Post-Traumatic; Vegetative States, Transient; Minimally Conscious State; Post-Traumatic Vegetative State; Vegetative State, Persistent

Networked: 394 relevant articles (12 outcomes, 41 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Coma (Comas)
2.	Brain Injuries (Brain Injury)
3.	Spasm (Spasms)
4.	Seizures (Seizure)
5.	Myoclonus (Nocturnal Myoclonus)

Experts

1.	Laureys, Steven: 13 articles (01/2015 - 01/2005)
2.	Navarro, Jorge: 6 articles (10/2015 - 02/2009)
3.	Thibaut, Aurore: 6 articles (01/2015 - 10/2013)
4.	Schiff, Nicholas D: 6 articles (01/2013 - 06/2009)
5.	Buonocunto, Francesca: 5 articles (10/2015 - 02/2009)
6.	Singh, Nirbhay N: 5 articles (10/2015 - 02/2009)
7.	O'Reilly, Mark F: 5 articles (10/2015 - 02/2009)
8.	Lancioni, Giulio E: 5 articles (10/2015 - 02/2009)
9.	Bruno, Marie-Aurélie: 5 articles (01/2015 - 08/2013)
10.	Gosseries, Olivia: 5 articles (01/2015 - 08/2013)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Persistent Vegetative State:

1.	zolpidem (Ambien)FDA LinkGeneric 10/01/2010 - "The aim of this study was to determine if zolpidem is associated with improved responsiveness or regional cerebral perfusion in patients with persistent vegetative states. " 01/01/2006 - "The long term efficacy of zolpidem in the permanent vegetative state is described in three patients. " 01/01/2014 - "To study the Zolpidem arousing effect in persistent vegetative state (PVS) patients combining clinical evaluation, autonomic assessment by heart rate variability (HRV), and EEG records. " 10/01/2010 - "Zolpidem for persistent vegetative state--a placebo-controlled trial in pediatrics." 02/01/2015 - "Transient awakening from vegetative state: is high-dose zolpidem more effective?"
2.	Glucose (Dextrose)FDA LinkGeneric 10/01/1991 - "Patients who subsequently remained in a vegetative state or died had significantly higher glucose levels both on admission and postoperatively than patients who had good outcome or moderate disability (217 +/- 12 mg/dl vs. 167 +/- 6 mg/dl or 12.1 +/- 0.7 mmol/liter vs. 9.3 +/- 0.3 mmol/liter on admission, and 240 +/- 16 mg/dl vs. 156 +/- 5 mg/dl or 13.3 +/- 0.9 mmol/liter vs. 8.9 +/- 0.3 mmol/liter postoperatively) (p less than 0.0001). " 07/01/1993 - "Serial positron emission tomography/2-deoxy-2[18F]fluoro-D-glucose studies demonstrated persistent global reduction of cerebral glucose metabolism, results similar to those found in adults in persistent vegetative states. " 01/01/2015 - "Quantitative rates of brain glucose metabolism distinguish minimally conscious from vegetative state patients." 02/01/2012 - "In acute vegetative state (AVS, duration <1 month), overall glucose utilization was significantly reduced in comparison with age-matched controls. " 10/01/2010 - "Compared with controls, patients with permanent vegetative state demonstrated decreased cerebral glucose metabolism in the left precuneus, both posterior cingulate cortices, the left superior parietal lobule (P(corrected) < 0.001), and increased cerebral glucose metabolism in the both cerebellum and the right supramarginal cortices (P(corrected) < 0.001). "
3.	Baclofen FDA LinkGeneric 10/01/2014 - "Intrathecal baclofen (ITB) pump is a therapeutic option for persistent vegetative state and minimal conscious state patients that have associated spasticity. " 07/01/2009 - "Sporadic cases of recovery from persistent vegetative state (PVS) after administration of intrathecal baclofen (ITB) have been reported without giving any possible explanation for its paradoxical effect. " 07/01/2009 - "Intrathecal baclofen in patients with persistent vegetative state: 2 hypotheses." 01/01/2007 - "Sporadic cases of dramatic recovery from persistent vegetative state after intrathecal administration of baclofen have been reported. " 01/01/2006 - "Sporadic episodes of dramatic recovery from persistent vegetative state are reported after intrathecal administration of baclofen. "
4.	Levodopa (L Dopa)FDA LinkGeneric 01/01/1978 - "Clinical analysis of patients recovered from persistent vegetative state, with special emphasis on the therapeutic and prophylactic effects of L-DOPA (author's transl)." 07/01/2005 - "Levodopa treatment for patients in persistent vegetative or minimally conscious states." 12/01/1999 - "[A case of primary brain-stem injury recovered from persistent vegetative state after L-dopa administration]." 03/01/1978 - "[Cerebrospinal fluid amine metabolites and L-dopa in vegetative state patients (author's transl)]." 12/01/1999 - "L-dopa should be considered as the drugs of pharmacological intervention for the patients of masked parkinsonism behind "pseudo" persistent vegetative state whose dopaminergic systems might have been damaged."
5.	SodiumIBA 06/12/1986 - "Seven patients recovered from coma after the serum sodium level was increased to 131 mmol per liter, but coma recurred two to six days later and ended in either death or a persistent vegetative state. " 04/01/2011 - "Multivariate analysis showed that factors associated with poor outcome (death, vegetative state or severe disability) were: PRISM ≥24 (P=0.03; OR: 5.75); GCS ≤8 (P=0.04; OR:2.42); Cerebral edema (P=0.03; OR:2.23); lesion type VI according to Traumatic Coma Data Bank Classification (P=0.002; OR:55.95); Hypoxemia (P=0.02; OR:2.97) and sodium level >145 mmol/l (P=0.04; OR: 4.41). " 06/23/1999 - "Among patients who had fluid restriction only, plasma sodium levels were increased by 3 (2) mmol/L in 41 hours and patients had a CPC of 4.6 (0.7) (4 = persistent vegetative state; 5 = death). "
6.	CatecholaminesIBA 04/01/1989 - "DCS increased rCBF, enhanced the metabolism of catecholamines in CSF, and improved the EEG in patients in persistent vegetative states." 01/01/1994 - "Functional state of hearing is mediated by vegetative state including catecholamines content." 04/01/1989 - "We describe the clinical EEG, rCBF, and biochemical changes in cerebrospinal fluid (CSF) caused by DCS in patients in persistent vegetative states: (1) eight of these cases showed good clinical improvement; (2) most patients were young and the CT scan did not show large, diffuse, definite or bilateral low density areas in cortex, brainstem of thalmus; (3) neurostimulation increased rCBF (cerebral blood flow) in many parts of the brain in cases with vegetative states; blood flow increased in the cerebrum, cerebellum and brainstem; (4) neurostimulation enhanced the metabolism of catecholamines in CSF, NE, DA, DOPAC, HVA, and 5HIAA increased, but 3MT and 5HT decreased in CSF. "
7.	Naloxone (Narcan)FDA LinkGeneric 04/01/2013 - "According to the GOS, one month's follow-up showed that of the three 30 cases in the routine medication, naloxone and EA groups, 6, 12 and 14 were improved, 8, 10 and 10 moderate handicap, 8, 3 and 2 severe handicap, 5, 3 and 2 vegetative state, and 3, 2 and 2 dead, with the arousal rates being 46. "
8.	Dopamine (Intropin)FDA LinkGeneric 11/01/2004 - "Differential time and related appearance of signs, indicating improvement in the state of consciousness in vegetative state traumatic brain injury (VS-TBI) patients after initiation of dopamine treatment."
9.	Carbamazepine (Tegretol)FDA LinkGeneric 01/01/2013 - "Within days following the administration of carbamazepine, there was remarkable improvement in the myoclonus and he was able to ambulate independently for a period of 4 months at which time he unfortunately progressed to a vegetative state. "
10.	Neurotransmitter Agents (Neurotransmitter)IBA 03/01/2011 - "The purpose of the study is to assess the impact of superselective neurotransmitter metabolic therapy in patients in a vegetative state. " 05/01/2002 - "To study the relationships between the pathogenesis of persistent vegetative state (PVS) and the levels of monoamine neurotransmitters in plasmas and cerebrospinal fluids (CSFs) in patients with PVS. " 01/01/2005 - "To detect the amino acid neurotransmitters in cerebrospinal fluid of patients in persistent vegetative state (PVS) to define their relation to the clinical manifestations of the patients. " 01/01/2005 - "[Detection of amino acid neurotransmitters in cerebrospinal fluid of patients in persistent vegetative state]." 05/01/2002 - "[The research on monoamine neurotransmitters changes in plasma and cerebrospinal fluid in patients with persistent vegetative state]."

Therapies and Procedures

1.	Deep Brain Stimulation 04/15/2012 - "Deep brain stimulation (DBS) has shown promise in the treatment of many neurological and psychiatric disorders as well as a disorder of consciousness, the minimally conscious state (MCS). " 10/01/1990 - "Based on these findings, chronic deep-brain stimulation represents a useful kind of treatment that can lead to emergence from a persistent vegetative state, if the candidate is selected by electrophysiological studies 2 months after the initial insult and if the stimulation is applied for more than 6-8 months using a high-safety chronic deep-brain stimulating instrument." 01/01/2014 - "The aim of the present paper was to investigate the fundamental ethical issues of Deep Brain Stimulation (DBS) on patients remaining in Persistent Vegetative State (PVS). " 01/01/2014 - "Deep brain stimulation in persistent vegetative States: ethical issues governing decision making." 01/01/2013 - "This chapter considers the use of central thalamic deep brain stimulation (CT/DBS) to support arousal regulation mechanisms in the minimally conscious state (MCS). "
2.	Wheelchairs (Wheel Chair) 05/01/1995 - "Neurological disability index (Dyken) improved from 70% to 10%; speech and higher cerebral functions improved from aphasia and almost vegetative states to verbal communicable level; motor dysfunction from bedridden to wheel chair level; and myoclonic and other seizures were controlled. "
3.	Anesthesia 03/01/2013 - "The PET data of sleep, vegetative state, and anesthesia show metabolic reductions from rest, uniformly >20% across, indicating no region is selectively reduced when consciousness is lost. " 06/01/2012 - "Moreover, recent evidence suggests that also the state of consciousness, for example, in vegetative state patients or during sleep and anesthesia, is closely related to the scope and extent of residual recurrent interactions among brain regions." 01/01/2008 - "Because this primitive arousal function underlies all motivated behavioral responses, cognitive functions, and emotional expression, disorders of generalized arousal can be associated with a large number of problems in medicine and public health, including vegetative states, attentional disorders, depression, occupational hazards, and problems with sleep and anesthesia. " 12/01/1987 - "Such metabolic hypoactivity has precedent only in deep anesthesia and supports clinical evidence that cerebral cognitive function is lost in the vegetative state, leaving a body that can no longer think or experience pain." 01/01/2009 - "In recent years, a number of studies compared brain activity in comatose and vegetative state patients to that in healthy volunteers, and in other conditions of reduced consciousness such as sleep, anesthesia, or epileptic seizures. "
4.	Enteral Nutrition (Feeding, Tube) 03/01/2006 - "Their conclusions include the following: (a) the use of a feeding tube inserted directly in to the stomach constituted artificial treatment; (b) the treatment prolonged biological life but did not lead to a cure and did not restore health; (c) quality of life was absent for the patient, with no sensation and no motor or cognitive functioning; and (d) by preponderance of medical opinion, she would have chosen not to live in a persistent vegetative state. " 04/01/2004 - "Ethics roundtable debate: withdrawal of tube feeding in a patient with persistent vegetative state where the patients wishes are unclear and there is family dissension." 11/01/2002 - "Finally, enteral nutrition is routinely used to feed demented patients and those in a vegetative state. " 03/01/2002 - "Finally, enteral nutrition is routinely used to feed demented patients and those in a vegetative state. " 03/01/2000 - "In Bland the House of Lords held it lawful to withdraw tube-feeding from a patient in a 'persistent vegetative state' (pvs), even with intent to kill him. "
5.	Euthanasia (Mercy Killing) 01/01/2015 - "Nurse who drove debate on euthanasia in India dies after 42 years in vegetative state." 02/01/2000 - "The implications of the follow-up are discussed in the context of assumptions made about quality of life and decision making about euthanasia in brain injured people who are severely disabled, but are not in a vegetative state." 01/01/1996 - "Euthanasia and persistent vegetative state individuals: the role and moral status of autonomy." 01/01/2005 - "From the legal sanction of physician-assisted suicide, the euthanasia movement now tries to advance the legal protection for "mercy killing." Terri was diagnosed with persistent vegetative state, a term that is outdated, vague and imprecise and that likens a human being to a vegetable. " 08/24/1996 - "Euthanasia, physician-assisted suicide, and persistent vegetative state."