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Comment & Response
May 2016

Peripheral Causes of Cognitive Motor Dissociation in Patients With Vegetative or Minimally Conscious State—Reply

Author Affiliations
  • 1School of Psychology, University of Birmingham, Birmingham, England
  • 2The Brain and Mind Institute, The University of Western Ontario, London, Ontario, Canada
JAMA Neurol. 2016;73(5):608-609. doi:10.1001/jamaneurol.2016.0143

In Reply We thank Latronico for the comments regarding our article.1 Latronico proposed that peripheral nervous system and muscle pathology2 may have contributed to the lack of behavioral responses exhibited by our patient. As mentioned in our Discussion section, Shea and Bayne3 had previously argued a similar peripheral explanation for the absence of overt motor behavior in patients with preserved covert motor behavior.4 In vegetative and minimally conscious patients, peripheral damage is most commonly related to motor axonal neuropathy,5 which, as Latronico points out, is a major cause of paralysis.2

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