Low- and medium-rate auditory steady-state responses in patients with prolonged disorders of consciousness correlate with Coma Recovery Scale - Revised score

Diagnosis of consciousness in patients with prolonged disorders of consciousness (PDOC) remains challenging since their responsiveness is often very impaired, while their assessment depends on observable behavior. The aim of this proof-of-concept study was to evaluate whether low- and medium-rate am...

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Bibliographic Details
Published in:International journal of psychophysiology 2019-10, Vol.144, p.56-62
Main Authors: Górska, Urszula, Binder, Marek
Format: Article
Language:English
Subjects:
40 Hz
Acoustic Stimulation
Adolescent
Adult
Aged
Auditory Perception - physiology
Auditory Perceptual Disorders - diagnosis
Auditory Perceptual Disorders - physiopathology
Auditory steady-state response
Auditory system
Cerebral Cortex - physiopathology
CRS-R score
Disorders of consciousness
Electroencephalography
Electroencephalography - methods
Female
Hearing - physiology
Humans
Male
Middle Aged
Persistent Vegetative State - diagnosis
Persistent Vegetative State - physiopathology
Severity of Illness Index
Young Adult
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Summary:Diagnosis of consciousness in patients with prolonged disorders of consciousness (PDOC) remains challenging since their responsiveness is often very impaired, while their assessment depends on observable behavior. The aim of this proof-of-concept study was to evaluate whether low- and medium-rate amplitude-modulated (AM) auditory steady-state responses (ASSRs) can be sensitive to the state of PDOC patients and may thus serve as a diagnostic tool which does not explicitly depend on a patient's cooperation. EEG was recorded from nine unresponsive wakefulness syndrome/vegetative state (UWS/VS) and eight minimally conscious state (MCS)/emergence from MCS patients during stimulation with two-minute trains of simple tones, amplitude modulated (AM) by 4 Hz, 6 Hz, 8 Hz, 12 Hz, 20 Hz, 40 Hz. The obtained ASSRs were then related to the Coma Recovery Scale – Revised (CRS-R) diagnosis and its total score. We observed significant correlations between mean inter-trial phase coherence (PC) (averaged across all stimulation frequencies) and total CRS-R score, as well as between 40 Hz relative power (RP) and total CRS-R score. Moreover, both parameters significantly differed between the patient groups. Our preliminary results suggest that a passive auditory stimulation protocol consisting of low- and medium-rate ASSRs might be used as an objective estimate of the level of neural dysfunction in PDOC patients. Consequently, the integrity of the auditory system appears to be an important predictor of the actual state of consciousness in PDOC patients. •Low- and medium rate ASSRs correlate with total CRS-R score.•40 Hz relative power is lower in UWS as compared to MCS patients.•Averaged phase coherence from 4 to 40 Hz ASSRs is decreased in UWS patients.
ISSN:0167-8760
1872-7697
DOI:10.1016/j.ijpsycho.2019.08.001