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MDLinxSource of Hidden Consciousness in ‘Comatose’ Brain Injury Patients Found

Hidden consciousness occurs in 15% to 25% of brain injury patients from head trauma, brain hemorrhage, or cardiac arrest.

Columbia researchers have made a significant discovery in understanding hidden consciousness, or cognitive motor dissociation (CMD), in brain injury patients. This condition, affecting 15% to 25% of such patients, has puzzled medical professionals as patients appear unconscious but retain some awareness. The study’s findings could revolutionize the way physicians identify and predict recovery in brain-injured patients, offering insights into the specific brain circuits that are disrupted.

Key Points:

  • The study used EEG and a technique called bi-clustering analysis to examine 107 brain injury patients, detecting CMD in 21 of them.
  • All CMD patients had intact brain structures for arousal and command comprehension but deficits in regions responsible for integrating motor commands with output.
  • The findings may lead to screening for hidden consciousness using widely available structural brain imaging.

Additional Points:

  • Previous research by the same team found that subtle brainwaves detectable with EEG are strong predictors of hidden consciousness and recovery.
  • More research is needed before these approaches can be applied to clinical practice.
  • MRI may offer a simpler way to identify patients requiring further screening and diagnosis.


  • This groundbreaking study has identified the specific brain injuries underlying hidden consciousness, paving the way for better identification, prediction of recovery, and potential clinical applications for brain-injured patients.

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“Our study suggests that patients with hidden consciousness can hear and comprehend verbal commands, but they cannot carry out those commands because of injuries in brain circuits that relay instructions from the brain to the muscles.”

Jan Claassen, MD
Study Leader
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