Assessment of pain perception in patients with disorders of consciousness : a behavioral and neurophysiological bedside approach

Because patients with disorders of consciousness (DoC) are unable to communicate verbally, the assessment of their pain perception is highly problematic and probably, often inadequate. The aim of this thesis was to develop non-invasive means to assess the ability of these patients to perceive pain that are usable at bedside, independently of the patients’ communication skills. The approach is twofold: the behavioral approach helps refining the use of the Nociception Coma Scale – Revised in a clinical context and the understanding of its neural correlates; the neurophysiological approach demonstrates the need of a specific approach dedicated to patients with DoC and assesses several methods of somatosensory stimulus presentation to create an experimental setup which is easily transportable and usable at bedside. Understanding how pain experience emerges from the brain is essential for ethical and clinical implications of these discoveries on the care of these highly vulnerable patients.(MED - Sciences médicales) -- UCL, 202