Preserved somatosensory discrimination predicts consciousness recovery in unresponsive wakefulness syndrome |
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Authors: | Rossella Spataro Alexander Heilinger Brendan Allison Domenico De Cicco Santino Marchese Cesare Gregoretti Vincenzo La Bella Christoph Guger |
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Institution: | 1. Department of Experimental Biomedicine and Clinical Neurosciences, ALS Clinical Research Center, University of Palermo, Palermo, Italy;2. Guger Technologies OG, Graz, Austria;3. g.tec Medical Engineering GmbH, Schiedlberg, Austria;4. Cognitive Science Department, University of California at San Diego, La Jolla, CA, USA;5. Neurorehabilitation Unit, Istituti Clinici Scientifici (ICS) Maugeri, Sciacca, Italy;6. Respiratory Intensive Care Unit, ARNAS Civico General Hospital, Palermo, Italy;7. Department of Biopathology and Medical Biotechnologies (DIBIMED), University of Palermo, Palermo, Italy |
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Abstract: | ObjectiveTo assess somatosensory discrimination and command following using a vibrotactile P300-based Brain-Computer Interface (BCI) in Unresponsive Wakefulness Syndrome (UWS), and investigate the predictive role of this cognitive process on the clinical outcomes.MethodsThirteen UWS patients and six healthy controls each participated in two experimental runs in which they were instructed to count vibrotactile stimuli delivered to the left or right wrist. A BCI determined each subject’s task performance based on EEG measures. All of the patients were followed up six months after the BCI assessment, and correlations analysis between accuracy rates and clinical outcome were investigated.ResultsFour UWS patients demonstrated clear EEG-based indices of task following in one or both paradigms, which did not correlate with clinical factors. The efficacy of somatosensory discrimination strongly correlated (VT2: R?=?0.89, p?=?0.0000002, VT3: R?=?0.81, p?=?0.002) with the clinical outcome at 6-months. The BCI system also yielded the expected results with healthy controls.ConclusionsNeurophysiological correlates of somatosensory discrimination can be detected in clinically unresponsive patients and are associated with recovery of behavioural responsiveness at six months.SignificanceQuantitative measurements of somatosensory discrimination may increase the diagnostic accuracy of persons with DOCs and provide useful prognostic information. |
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Keywords: | Disorders of consciousness Brain-computer interface Somatosensory perception P300 Minimal consciousness (MCS) Unresponsive wakefulness state (UWS) |
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