"Complete motor locked-in" and consequences for the concept of minimally conscious state.

The demonstration by Monti et al. (2010) of willful modulation of brain activity in persistent vegetative state implies the exceptional condition of a "complete motor locked-in syndrome." As a consequence, the contradictory character of the diagnosis minimally conscious state should be recognized because behaviorally observed minimal cognitive responsiveness does not exclude a higher level of well-differentiated self-consciousness. Introduction of the descriptive entities "complete motor locked-in syndrome" and "minimal cognitive responsiveness" is therefore advocated in the service of diagnostic precision.