{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:12:57Z","timestamp":1790136777213,"version":"4.0.1"},"reference-count":64,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,4,10]],"date-time":"2022-04-10T00:00:00Z","timestamp":1649548800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Occasionally, patients show dramatic recovery from disorders of consciousness (DOC) under intrathecal baclofen (ITB), an established treatment option for severe supraspinal spasticity. Anecdotal explanations for ITB\u2010related recovery of cognition include modulation of afferent impulses at the spinal level, thereby reducing spasticity\u2010related proprioceptive information overload within cortico\u2013thalamo\u2013cortical connections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In this retrospective patient chart analysis, we assessed whether a reduction in spasticity would be associated with an increase in Coma Recovery Scale revised (CRS\u2010R) scores in a larger sample of patients than previously published.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From a hospital\u2010based ITB treatment register, we extracted data from 26 patients with DOC and severe supraspinal spasticity who improved by &gt;2 points on the Coma Recovery Scale revised (CRS\u2010R) within 6 months after ITB treatment initiation. We assessed Modified Ashworth scale (MAS) scores and CRS\u2010R scores on admission (PRE) and 3 and 6 months after initiation of ITB treatment (3M, 6M). We performed correlation analysis of the scores and their respective changes (PRE to 3M, 3M to 6M). We also correlated the time from acute event until ITB initiation to CRS\u2010R scores at 3M and 6M.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ITB led to significant improvement in spasticity based on MAS scores, which did not correlate to the improvements seen in CRS\u2010R total and subscale scores. Daily ITB dose did neither correlate to MAS scores nor to CRS\u2010total scores in the whole patient group, but after 3 months, ITB dose correlated to some CRS\u2010R subscale scores in some patient subgroups. Time until ITB treatment did not correlate to CRS\u2010R scores later on.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data confirm that ITB may exert beneficial effects in selected DOC patients with respect to improved cognitive functions, which, however, do not correlate to its antispastic effect. The lack of correlation between time to ITB and CRS\u2010R outcome, but significant CRS\u2010R improvements following pump implantation, renders spontaneous remissions unlikely and leaves room for alternative pharmacological mechanisms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.2566","type":"journal-article","created":{"date-parts":[[2022,4,10]],"date-time":"2022-04-10T13:09:42Z","timestamp":1649596182000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["On the recovery of disorders of consciousness under intrathecal baclofen administration for severe spasticity\u2014An observational study"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3126-9427","authenticated-orcid":false,"given":"Lucas\u2010Michael","family":"Halbmayer","sequence":"first","affiliation":[{"name":"Department of Neurology Hochzirl Hospital  Zirl 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