New diagnostic tools and markers of recovery in consciousness disorders

In recent years, advances in medicine, intensive care and diagnostic imaging procedures, have increased the number of patients who survive acute brain injuries and that are in a vegetative or minimally conscious state. However there are not sufficient findings to evaluate and quantify the severity of the initial and secondary processes destructive and therefore there are not effective therapeutic measures to effectively predict the outcome. It has been argued that diagnostic approaches such as biochemical and neurophysiological markers would provide evidence for pathology progression and help guide therapy development. To date, studies have not found a marker matching such an ideal .For this reason, neuron-specific enolase, S100 calcium binding protein B, myelin basic protein, creatine kinase brain isoenzyme, glial fibrilary acidic protein, plasma desoxyribonucleic acid, brain-derived neurotrophic factor and ubiquitin carboxy-terminal hydrolase-L1 have been proposed as potential markers for cell damage in the central nervous system, to improve the diagnosis and the evaluation of outcome after injury. Also, the neurophysiological examinations, such as Electroencephalogram (EEG), Evoked Potentials (EPs), including olfactory event-related potentials, and Electroencephalogram, in association with functional Magnetic Resonance Imaging, allow monitoring of clinical conditions and they can be a valuable support for the outcome evaluation and clinical differentiation between vegetative or minimally conscious state.