Semin Neurol 2022; 42(03): 273-282
DOI: 10.1055/s-0042-1755561
Review Article

Language Assessment in Patients with Disorders of Consciousness

1   Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
2   Centre du Cerveau, University Hospital of Liège, Liège, Belgium
3   Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
Caroline Schnakers
4   Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, California
Steve Majerus
3   Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
› Author Affiliations
Funding This study was supported by the University and University Hospital of Liege, the Belgian National Funds for Scientific Research (FRS-FNRS), the European Union's Horizon 2020 Framework Programme for Research and Innovation under the Specific Grant Agreement No. 945539 (Human Brain Project SGA3), the European Space Agency (ESA), and the Belgian Federal Science Policy Office (BELSPO) in the framework of the PRODEX Programme, the Center-TBI project (FP7-HEALTH-602150), the Public Utility Foundation “Université Européenne du Travail,” “Fondazione Europea di Ricerca Biomedica,” the BIAL Foundation, the Mind Science Foundation and the European Commission, the fund Generet, the King Baudouin Foundation, the Mind-Care foundation, DOCMA project [EU-H2020-MSCA–RISE–778234]. S.M. is research director at FRS-FNRS.


The assessment of residual language abilities in patients with disorders of consciousness (DoC) after severe brain injury is particularly challenging due to their limited behavioral repertoire. Moreover, associated language impairment such as receptive aphasia may lead to an underestimation of actual consciousness levels. In this review, we examine past research on the assessment of residual language processing in DoC patients, and we discuss currently available tools for identifying language-specific abilities and their prognostic value. We first highlight the need for validated and sensitive bedside behavioral assessment tools for residual language abilities in DoC patients. As regards neuroimaging and electrophysiological methods, the tasks involving higher level linguistic commands appear to be the most informative about level of consciousness and have the best prognostic value. Neuroimaging methods should be combined with the most appropriate behavioral tools in multimodal assessment protocols to assess receptive language abilities in DoC patients in the most complete and sensitive manner.

Publication History

Article published online:
13 September 2022

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