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@ARTICLE{Schnakers:151505,
      author       = {Schnakers, C. and Bessou, H. and Rubi-Fessen, I. and
                      Hartmann, A. and Fink, Gereon Rudolf and Meister, I. and
                      Giacino, J. T. and Laureys, S. and Majerus, S.},
      title        = {{I}mpact of aphasia on consciousness assessment.},
      journal      = {Neurorehabilitation and neural repair},
      volume       = {29},
      number       = {1},
      issn         = {1545-9683},
      address      = {Thousand Oaks, Calif.},
      publisher    = {Sage},
      reportid     = {FZJ-2014-01443},
      pages        = {41-47},
      year         = {2015},
      abstract     = {Background. Previous findings suggest that language
                      disorders may occur in severely brain-injured patients and
                      could interfere with behavioral assessments of
                      consciousness. However, no study investigated to what extent
                      language impairment could affect patients’ behavioral
                      responses. Objective. To estimate the impact of receptive
                      and/or productive language impairments on consciousness
                      assessment. Methods. Twenty-four acute and subacute stroke
                      patients with different types of aphasia (global, n = 11;
                      Broca, n = 4; Wernicke, n = 3; anomic, n = 4; mixed, n = 2)
                      were recruited in neurology and neurosurgery units as well
                      as in rehabilitation centers. The Coma Recovery
                      Scale–Revised (CRS-R) was administered. Results. We
                      observed that $25\%$ (6 out of 24) of stroke patients with a
                      diagnosis of aphasia and $54\%$ (6 out of 11) of patients
                      with a diagnosis of global aphasia did not reach the maximal
                      CRS-R total score of 23. An underestimation of the
                      consciousness level was observed in 3 patients with global
                      aphasia who could have been misdiagnosed as being in a
                      minimally conscious state, even in the absence of any
                      documented period of coma. More precisely, lower subscores
                      were observed on the communication, motor, oromotor, and
                      arousal subscales. Conclusion. Consciousness assessment may
                      be complicated by the co-occurrence of severe language
                      deficits. This stresses the importance of developing new
                      tools or identifying items in existing scales, which may
                      allow the detection of language impairment in severely
                      brain-injured patients.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {572 - (Dys-)function and Plasticity (POF3-572)},
      pid          = {G:(DE-HGF)POF3-572},
      typ          = {PUB:(DE-HGF)16},
      UT           = {WOS:000346241700005},
      pubmed       = {pmid:24743226},
      doi          = {10.1177/1545968314528067},
      url          = {https://juser.fz-juelich.de/record/151505},
}