Treatments and systems of care for patients with severe acute brain injury have advanced substantially over the past 20 years since the minimally conscious state (MCS) was first described,1 leading to improved survival and functional outcomes. Nonetheless, some survivors still experience prolonged disorders of consciousness (pDoC), the most severe form of disability that such patients and their families endure. There is a profound clinical, social, and financial impact of pDoC on patients, families, and care systems, but our understanding of pDoC, while improving, remains limited and our individual treatments and systems of care for these patients even more so. In this issue of Neurology®, Overbeek et al.2 make an important contribution to this field by providing high-quality epidemiologic data on the subgroup of patients with pDoC most likely to improve—those in MCS—and by demonstrating the feasibility and scientific value of highly organized systems of care for patients with pDoC.
