临床神经外科杂志2025，Vol.22Issue(3)：241-247,7.DOI:10.3969/j.issn.1672-7770.2025.03.001
慢性意识障碍命名与分类专家共识
Expert consensus on nomenclature and classification of prolonged disorders of consciousness
摘要
Abstract
Disorders of consciousness(DoC)refers to the state of impaired consciousness caused by severe traumatic brain injury.Over the past three decades,driven by advancements in functional imaging and neuroelectrophysiological technologies,significant progress has been made in consciousness science,making the research of consciousness and DoC hot topics in clinical neuroscience.To enhance clinicians' awareness and precise understanding of DoC and provide guidance for standardized assessment and management,a hierarchical and progressive DoC classification system based on evidence-based definitions,diagnostic criteria,and assessment methods has been developed.This system integrates recommendation grading systems referring to U.S.,European,and U.K.practice guidelines for DoC patients' management and international guideline standardization frameworks.The system deconstructs prolonged DoC(pDoC)into two core dimensions:arousal and awareness,resulting in seven recommendation statements.These statments clarify clinical entities such as vegetative state/unresponsive wakefulness syndrome(VS/UWS),minimally conscious state(MCS)and its subtypes(MCS+and MCS-),and emergence from MCS(EMCS).Notably,it introduces cognitivemotor dissociation(CMD)as a diagnostic concept for states of covert consciousness.Furthermore,the consensus refines pediatric DoC assessment criteria,emphasizing the impact of developmental characteristics on diagnosis.It also proposes explicitly to distinguish locked-in syndrome(LIS)from the DoC spectrum.This framework aims to standardize DoC diagnosis and provide actionable clinical guidance.关键词
意识/意识障碍/昏迷/植物状态/无反应觉醒综合征/微意识状态/闭锁综合征/认知运动分离/专家共识Key words
consciousness/disorders of consciousness/diagnostic standard/coma/vegetative state/unresponsive wakefulness syndrome/minimally conscious state/locked-in syndrome/expert consensus分类
临床医学引用本文复制引用
中国神经科学学会意识与意识障碍分会,中国康复医学会意识障碍康复专业委员会,中国康复医学会颅脑创伤康复专业委员会,谢秋幼,何江弘,章文斌,宋为群,张皓,冯英..慢性意识障碍命名与分类专家共识[J].临床神经外科杂志,2025,22(3):241-247,7.基金项目
国家自然科学基金资助项目(82171174,82371184) （82171174,82371184）
广东省重点领域研发计划项目(2023B0303020003) （2023B0303020003）
科技创新2030"脑科学研究"重大项目(2021ZD0204300) （2021ZD0204300）
