Dissociations between spontaneous electroencephalographic features and the perturbational complexity index in the minimally conscious state.
MCS
PCI
alpha
delta
electroencephalogram
Journal
The European journal of neuroscience
ISSN: 1460-9568
Titre abrégé: Eur J Neurosci
Pays: France
ID NLM: 8918110
Informations de publication
Date de publication:
Mar 2024
Mar 2024
Historique:
revised:
21
12
2023
received:
22
03
2023
accepted:
13
02
2024
pubmed:
5
3
2024
medline:
5
3
2024
entrez:
5
3
2024
Statut:
ppublish
Résumé
The analysis of spontaneous electroencephalogram (EEG) is a cornerstone in the assessment of patients with disorders of consciousness (DoC). Although preserved EEG patterns are highly suggestive of consciousness even in unresponsive patients, moderately or severely abnormal patterns are difficult to interpret. Indeed, growing evidence shows that consciousness can be present despite either large delta or reduced alpha activity in spontaneous EEG. Quantifying the complexity of EEG responses to direct cortical perturbations (perturbational complexity index [PCI]) may complement the observational approach and provide a reliable assessment of consciousness even when spontaneous EEG features are inconclusive. To seek empirical evidence of this hypothesis, we compared PCI with EEG spectral measures in the same population of minimally conscious state (MCS) patients (n = 40) hospitalized in rehabilitation facilities. We found a remarkable variability in spontaneous EEG features across MCS patients as compared with healthy controls: in particular, a pattern of predominant delta and highly reduced alpha power-more often observed in vegetative state/unresponsive wakefulness syndrome (VS/UWS) patients-was found in a non-negligible number of MCS patients. Conversely, PCI values invariably fell above an externally validated empirical cutoff for consciousness in all MCS patients, consistent with the presence of clearly discernible, albeit fleeting, behavioural signs of awareness. These results confirm that, in some MCS patients, spontaneous EEG rhythms may be inconclusive about the actual capacity for consciousness and suggest that a perturbational approach can effectively compensate for this pitfall with practical implications for the individual patient's stratification and tailored rehabilitation.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
934-947Subventions
Organisme : Ministero della Salute
ID : GR-2016-02361494
Organisme : Ministero della Salute
ID : Ricerca Corrente 2022-2024
Organisme : European Union's Horizon 2020
ID : 785907
Organisme : European Union's Horizon 2020
ID : 945539
Organisme : Tiny Blue Dot Foundation
Organisme : Fondazione Regionale per la Ricerca Biomedica, Project ERAPERMED2019-101
ID : 779282
Organisme : Canadian Institute for Advanced Research
Organisme : Ministero dell'Università e della Ricerca
ID : PRIN2022
Informations de copyright
© 2024 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.
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