Disorders of Consciousness, Language and Communication Following Severe Brain Injury

Patients with severe brain injuries and disorders of consciousness (DoC) represent a complex clinical population in terms of diagnosis, prognosis, and management, including critical ethical considerations. Behavioral assessment scales remain the primary tools for evaluating the level of consciousnes...

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Main Authors: Charlène Aubinet, Anaïs Gillet, Amandine Regnier
Format: Article
Language:English
Published: Ubiquity Press 2025-06-01
Series:Psychologica Belgica
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Online Access:https://account.psychologicabelgica.com/index.php/up-j-pb/article/view/1381
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author Charlène Aubinet
Anaïs Gillet
Amandine Regnier
author_facet Charlène Aubinet
Anaïs Gillet
Amandine Regnier
author_sort Charlène Aubinet
collection DOAJ
description Patients with severe brain injuries and disorders of consciousness (DoC) represent a complex clinical population in terms of diagnosis, prognosis, and management, including critical ethical considerations. Behavioral assessment scales remain the primary tools for evaluating the level of consciousness of these patients following a coma; however, they heavily depend on language and communication abilities. This reliance can lead to underestimating residual consciousness in cases where language impairments go undetected. Accordingly, the latest international guidelines on DoC diagnosis have highlighted aphasia as a significant confounding factor that must be addressed. On the other hand, accurately assessing residual language abilities is essential for better characterizing the patient’s cognitive profile. This, in turn, enables neuropsychologists and speech-language therapists to tailor and plan effective rehabilitation programs. This review examines the current literature on language function and communication skills in patients with DoC, detailing the latest tools for assessing and managing language and consciousness in individuals with severe brain injuries. We explore the critical role of language function in evaluating residual consciousness, particularly in DoC behavioral diagnoses and in identifying covert consciousness through neuroimaging passive or active paradigms. Furthermore, we discuss how therapies aimed at recovering consciousness—such as pharmacological treatments, electromagnetic therapies, sensory or cognitive stimulation, and communication aids like brain-computer interfaces—may also impact or rely on language function and communication abilities. Further research is needed to refine methodologies and better understand the interplay between language processing, communication and levels of consciousness.
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spelling doaj-art-75bb2da93f42422b85ef3a5110eaa0942025-08-20T03:28:01ZengUbiquity PressPsychologica Belgica2054-670X2025-06-01651169–188169–18810.5334/pb.13811366Disorders of Consciousness, Language and Communication Following Severe Brain InjuryCharlène Aubinet0https://orcid.org/0000-0001-5095-5583Anaïs Gillet1https://orcid.org/0009-0003-7107-8112Amandine Regnier2https://orcid.org/0000-0001-5135-128XComa Science Group, GIGA-Consciousness, GIGA Institute, University of Liège; NeuroRehab & Consciousness Clinic, Neurology Department, University Hospital of Liège; Psychology and Neuroscience of Cognition Research Unit, University of LiègeComa Science Group, GIGA-Consciousness, GIGA Institute, University of Liège; NeuroRehab & Consciousness Clinic, Neurology Department, University Hospital of LiègeComa Science Group, GIGA-Consciousness, GIGA Institute, University of Liège; NeuroRehab & Consciousness Clinic, Neurology Department, University Hospital of LiègePatients with severe brain injuries and disorders of consciousness (DoC) represent a complex clinical population in terms of diagnosis, prognosis, and management, including critical ethical considerations. Behavioral assessment scales remain the primary tools for evaluating the level of consciousness of these patients following a coma; however, they heavily depend on language and communication abilities. This reliance can lead to underestimating residual consciousness in cases where language impairments go undetected. Accordingly, the latest international guidelines on DoC diagnosis have highlighted aphasia as a significant confounding factor that must be addressed. On the other hand, accurately assessing residual language abilities is essential for better characterizing the patient’s cognitive profile. This, in turn, enables neuropsychologists and speech-language therapists to tailor and plan effective rehabilitation programs. This review examines the current literature on language function and communication skills in patients with DoC, detailing the latest tools for assessing and managing language and consciousness in individuals with severe brain injuries. We explore the critical role of language function in evaluating residual consciousness, particularly in DoC behavioral diagnoses and in identifying covert consciousness through neuroimaging passive or active paradigms. Furthermore, we discuss how therapies aimed at recovering consciousness—such as pharmacological treatments, electromagnetic therapies, sensory or cognitive stimulation, and communication aids like brain-computer interfaces—may also impact or rely on language function and communication abilities. Further research is needed to refine methodologies and better understand the interplay between language processing, communication and levels of consciousness.https://account.psychologicabelgica.com/index.php/up-j-pb/article/view/1381disorders of consciousnesslanguagecommunicationneurorehabilitationaphasiacoma
spellingShingle Charlène Aubinet
Anaïs Gillet
Amandine Regnier
Disorders of Consciousness, Language and Communication Following Severe Brain Injury
Psychologica Belgica
disorders of consciousness
language
communication
neurorehabilitation
aphasia
coma
title Disorders of Consciousness, Language and Communication Following Severe Brain Injury
title_full Disorders of Consciousness, Language and Communication Following Severe Brain Injury
title_fullStr Disorders of Consciousness, Language and Communication Following Severe Brain Injury
title_full_unstemmed Disorders of Consciousness, Language and Communication Following Severe Brain Injury
title_short Disorders of Consciousness, Language and Communication Following Severe Brain Injury
title_sort disorders of consciousness language and communication following severe brain injury
topic disorders of consciousness
language
communication
neurorehabilitation
aphasia
coma
url https://account.psychologicabelgica.com/index.php/up-j-pb/article/view/1381
work_keys_str_mv AT charleneaubinet disordersofconsciousnesslanguageandcommunicationfollowingseverebraininjury
AT anaisgillet disordersofconsciousnesslanguageandcommunicationfollowingseverebraininjury
AT amandineregnier disordersofconsciousnesslanguageandcommunicationfollowingseverebraininjury