Can Salient Stimuli Enhance Responses in Disorders of Consciousness? A Systematic Review

Alfonso Magliacano, Francesco De Bellis, Alejandro Galvao-Carmona, Anna Estraneo, Luigi Trojano

Research output: Contribution to journalReview articlepeer-review


Purpose of Review: Diagnostic classification of patients with disorders of consciousness (DoC) is based on clinician’s observation of volitional behaviours. However, patients’ caregivers often report higher levels of responsiveness with respect to those observed during the clinical assessment. Thus, increasing efforts have been aimed at comprehending the effects of self-referential and emotional stimuli on patients’ responsiveness. Here we systematically reviewed the original experimental studies that compared behavioural and electrophysiological responses with salient vs. neutral material in patients in vegetative state/unresponsive wakefulness syndrome or in minimally conscious state. Recent Findings: Most of the reviewed studies showed that salient stimuli (i.e. patient’s own or familiar faces, patient’s own name, and familiar voices) seem to elicit a higher amount of behavioural or electrophysiological responses with respect to neutral pictures or sounds. Importantly, a quite high percentage of patients seem to respond to salient stimuli only. Summary: The present review could foster use of personally salient stimuli in assessing DoC. However, the low overall quality of evidence and some limitations in the general reviewing process might induce caution in transferring these suggestions into clinical practice.

Original languageEnglish
Article number98
JournalCurrent Neurology and Neuroscience Reports
Issue number12
Publication statusPublished - Dec 1 2019


  • Clinical evaluation
  • Disorders of consciousness
  • Minimally conscious state
  • Saliency-self-related stimuli
  • Vegetative state

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology


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