Disorders of consciousness articles from across Nature Portfolio

This Review reviews changes introduced into the US brain death/death by neurological criteria (BD/DNC) guidelines in 2023 and compares these guidelines with those formulated elsewhere in the world. The authors highlight controversies and legal challenges in BD/DNC determination and discuss future research priorities.

Two recent studies leverage the same French population-based disease registry to describe real-world medication prescription patterns, patient characteristics and treatment effectiveness in people with schizophrenia. These studies also identify disparities in the health care and outcomes of these individuals compared with those of the general population.

Disorders of consciousness (DOCs), including vegetative and minimally conscious states, represent a financial, medical and ethical conundrum. Recently published guidelines for the diagnosis, prognosis and treatment of DOCs should lead us to reconsider our management strategies for these challenging disorders.

A committee has developed a guideline on prolonged disorders of consciousness. Caution in prognostication is advocated because patients who have been unconscious or barely conscious for a long time might improve. The new guideline voices concern about persistent vegetative state as a clinical diagnosis but also rejects several unsupported therapies.