References of "Chatelle, Camille"
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See detailConscious while being considered in an unresponsive wakefulness syndrome for 20 years
VANHAUDENHUYSE, Audrey ULiege; Charland-Verville, Vanessa ULiege; Thibaut, Aurore ULiege et al

in Frontiers in Neurology (2018), 9(AUG),

Despite recent advances in our understanding of consciousness disorders, accurate diagnosis of severely brain-damaged patients is still a major clinical challenge. We here present the case of a patient ... [more ▼]

Despite recent advances in our understanding of consciousness disorders, accurate diagnosis of severely brain-damaged patients is still a major clinical challenge. We here present the case of a patient who was considered in an unresponsive wakefulness syndrome/vegetative state for 20 years. Repeated standardized behavioral examinations combined to neuroimaging assessments allowed us to show that this patient was in fact fully conscious and was able to functionally communicate. We thus revised the diagnosis into an incomplete locked-in syndrome, notably because the main brain lesion was located in the brainstem. Clinical examinations of severe brain injured patients suffering from serious motor impairment should systematically include repeated standardized behavioral assessments and, when possible, neuroimaging evaluations encompassing magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography. © 2018 Vanhaudenhuyse, Charland-Verville, Thibaut, Chatelle, Tshibanda, Maudoux, Faymonville, Laureys and Gosseries. [less ▲]

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See detailFluctuation in behavioral responsiveness in severely brain-injured patients
Chatelle, Camille ULiege; Thibaut, Aurore ULiege; Gosseries, Olivia ULiege et al

in European Journal of Neurology (2018), 25(2), 90276

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See detailConscience et états de conscience altérée
Cassol, Helena ULiege; Wolff, Audrey ULiege; Chatelle, Camille ULiege et al

in Jourdan, C; Pellas, F; Luauté, J (Eds.) et al Etats de conscience altérée (2018)

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See detailFeasibility of an EEG-based brain-computer interface in the intensive care unit.
Chatelle, Camille ULiege; Spencer, Camille A.; Cash, Sydney S. et al

in Clinical Neurophysiology (2018), 129(8), 1519-1525

OBJECTIVE: We tested the feasibility of deploying a commercially available EEG-based brain-computer interface (BCI) in the intensive care unit (ICU) to detect consciousness in patients with acute ... [more ▼]

OBJECTIVE: We tested the feasibility of deploying a commercially available EEG-based brain-computer interface (BCI) in the intensive care unit (ICU) to detect consciousness in patients with acute disorders of consciousness (DoC) or locked-in syndrome (LIS). METHODS: Ten patients (9 DoC, 1 LIS) and 10 healthy subjects (HS) were enrolled. The BCI utilized oddball auditory evoked potentials, vibrotactile evoked potentials (VTP) and motor imagery (MoI) to assess consciousness. We recorded the assessment completion rate and the time required for assessment, and we calculated the sensitivity and specificity of each paradigm for detecting behavioral signs of consciousness. RESULTS: All 10 patients completed the assessment, 9 of whom required less than 1h. The LIS patient reported fatigue before the end of the session. The HS and LIS patient showed more consistent BCI responses than DoC patients, but overall there was no association between BCI responses and behavioral signs of consciousness. CONCLUSIONS: The system is feasible to deploy in the ICU and may confirm consciousness in acute LIS, but it was unreliable in acute DoC. SIGNIFICANCE: The accuracy of the paradigms for detecting consciousness must be improved and the duration of the protocol should be shortened before this commercially available BCI is ready for clinical implementation in the ICU in patients with acute DoC. [less ▲]

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See detailToward an Attention-Based Diagnostic Tool for Patients With Locked-in Syndrome
Lesenfants, D.; Habbal, D.; Chatelle, Camille ULiege et al

in Clinical EEG and Neuroscience (2018), 49(2), 122-135

Electroencephalography (EEG) has been proposed as a supplemental tool for reducing clinical misdiagnosis in severely brain-injured populations helping to distinguish conscious from unconscious patients ... [more ▼]

Electroencephalography (EEG) has been proposed as a supplemental tool for reducing clinical misdiagnosis in severely brain-injured populations helping to distinguish conscious from unconscious patients. We studied the use of spectral entropy as a measure of focal attention in order to develop a motor-independent, portable, and objective diagnostic tool for patients with locked-in syndrome (LIS), answering the issues of accuracy and training requirement. Data from 20 healthy volunteers, 6 LIS patients, and 10 patients with a vegetative state/unresponsive wakefulness syndrome (VS/UWS) were included. Spectral entropy was computed during a gaze-independent 2-class (attention vs rest) paradigm, and compared with EEG rhythms (delta, theta, alpha, and beta) classification. Spectral entropy classification during the attention-rest paradigm showed 93% and 91% accuracy in healthy volunteers and LIS patients respectively. VS/UWS patients were at chance level. EEG rhythms classification reached a lower accuracy than spectral entropy. Resting-state EEG spectral entropy could not distinguish individual VS/UWS patients from LIS patients. The present study provides evidence that an EEG-based measure of attention could detect command-following in patients with severe motor disabilities. The entropy system could detect a response to command in all healthy subjects and LIS patients, while none of the VS/UWS patients showed a response to command using this system. © 2016, © EEG and Clinical Neuroscience Society (ECNS) 2016. [less ▲]

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See detailAssessment of nociception and pain in participants with unresponsive or minimally conscious state after acquired brain injury: the relationship between the Coma Recovery Scale-Revised and the Nociception Coma Scale-Revised
Chatelle, Camille ULiege; Hauger, Solveig; Martial, Charlotte ULiege et al

in Archives of Physical Medicine and Rehabilitation (2018)

Objectives: To investigate the relation between consciousness and nociceptive responsiveness (ie, Nociception Coma Scale–Revised [NCS-R]), to examine the suitability of the NCS-R for assessing nociception ... [more ▼]

Objectives: To investigate the relation between consciousness and nociceptive responsiveness (ie, Nociception Coma Scale–Revised [NCS-R]), to examine the suitability of the NCS-R for assessing nociception in participants with disorders of consciousness (DOC), and to replicate previous findings on psychometric properties of the scale. Design: Specialized DOC program. Setting: Specialized DOC program and university hospitals. Participants: Participants (N=85) diagnosed with DOC. Interventions: Not applicable. Main Outcome Measures: We prospectively assessed consciousness with the Coma Recovery Scale–Revised (CRS-R). Responses during baseline, non-noxious, and noxious stimulations were scored with the NCS-R and CRS-R oromotor and motor subscales. Results: CRS-R total scores correlated with NCS-R total scores and subscores. CRS-R motor subscores correlated with NCS-R total scores and motor subscores, and CRS-R oromotor subscores correlated with NCS-R total scores as well as verbal and facial expression subscores. There was a difference between unresponsive wakefulness syndrome and minimally conscious state in the proportion of grimacing and/or crying participants during noxious conditions. We replicated previous findings on psychometric properties of the scale but found a different score as the best threshold for nociception. Conclusions: We report a strong relation between the responsiveness to nociception and the level of consciousness. The NCS-R seems to be a valuable tool for assessing nociception in an efficient manner, but additional studies are needed to allow recommendations for clinical assessment of subjective pain experience. © 2018 American Congress of Rehabilitation Medicine [less ▲]

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See detailDecreased integration of EEG source-space networks in disorders of consciousness
Rizkallah, Jennifer; Annen, Jitka ULiege; Modolo, Julien et al

E-print/Working paper (2018)

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See detailAssessing Command-Following and Communication With Vibro-Tactile P300 Brain-Computer Interface Tools in Patients With Unresponsive Wakefulness Syndrome.
Guger, Christoph; Spataro, Rossella; Pellas, Frederic et al

in Frontiers in Neuroscience (2018), 12

Persons diagnosed with disorders of consciousness (DOC) typically suffer from motor disablities, and thus assessing their spared cognitive abilities can be difficult. Recent research from several groups ... [more ▼]

Persons diagnosed with disorders of consciousness (DOC) typically suffer from motor disablities, and thus assessing their spared cognitive abilities can be difficult. Recent research from several groups has shown that non-invasive brain-computer interface (BCI) technology can provide assessments of these patients' cognitive function that can supplement information provided through conventional behavioral assessment methods. In rare cases, BCIs may provide a binary communication mechanism. Here, we present results from a vibrotactile BCI assessment aiming at detecting command-following and communication in 12 unresponsive wakefulness syndrome (UWS) patients. Two different paradigms were administered at least once for every patient: (i) VT2 with two vibro-tactile stimulators fixed on the patient's left and right wrists and (ii) VT3 with three vibro-tactile stimulators fixed on both wrists and on the back. The patients were instructed to mentally count either the stimuli on the left or right wrist, which may elicit a robust P300 for the target wrist only. The EEG data from -100 to +600 ms around each stimulus were extracted and sub-divided into 8 data segments. This data was classified with linear discriminant analysis (using a 10 x 10 cross validation) and used to calibrate a BCI to assess command following and YES/NO communication abilities. The grand average VT2 accuracy across all patients was 38.3%, and the VT3 accuracy was 26.3%. Two patients achieved VT3 accuracy >/=80% and went through communication testing. One of these patients answered 4 out of 5 questions correctly in session 1, whereas the other patient answered 6/10 and 7/10 questions correctly in sessions 2 and 4. In 6 other patients, the VT2 or VT3 accuracy was above the significance threshold of 23% for at least one run, while in 4 patients, the accuracy was always below this threshold. The study highlights the importance of repeating EEG assessments to increase the chance of detecting command-following in patients with severe brain injury. Furthermore, the study shows that BCI technology can test command following in chronic UWS patients and can allow some of these patients to answer YES/NO questions. [less ▲]

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See detailTheta network centrality correlates with tDCS response in disorders of consciousness
Thibaut, Aurore ULiege; Chennu, S.; Chatelle, Camille ULiege et al

in Brain Stimulation (2018), 11(6), 1407-1409

[No abstract available]

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See detailBCI performance and brain metabolism profile in severely brain-injured patients without response to command at bedside
Annen, Jitka ULiege; Blandiaux, Séverine ULiege; Lejeune, Nicolas ULiege et al

in Frontiers in Neuroscience (2018)

Detection and interpretation of signs of "covert command following" in patients with disorders of consciousness (DOC) remains a challenge for clinicians. In this study, we used a tactile P3-based BCI in ... [more ▼]

Detection and interpretation of signs of "covert command following" in patients with disorders of consciousness (DOC) remains a challenge for clinicians. In this study, we used a tactile P3-based BCI in 12 patients without behavioral command following, attempting to establish "covert command following." These results were then confronted to cerebral metabolism preservation as measured with glucose PET (FDG-PET). One patient showed "covert command following" (i.e., above-threshold BCI performance) during the active tactile paradigm. This patient also showed a higher cerebral glucose metabolism within the language network (presumably required for command following) when compared with the other patients without "covert command-following" but having a cerebral glucose metabolism indicative of minimally conscious state. Our results suggest that the P3-based BCI might probe "covert command following" in patients without behavioral response to command and therefore could be a valuable addition in the clinical assessment of patients with DOC. [less ▲]

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See detailHeart Rate Variability as an indicator of nociceptive pain in disorders of consciousness?
Riganello, Francesco ULiege; Chatelle, Camille ULiege; Schnakers, Caroline et al

in Journal of Pain and Symptom Management (2018)

CONTEXT: Heart rate variability (HRV) is thought to reflect the affective and physiological aspects of pain and is emerging as a possible descriptor of the functional brain organization contributing to ... [more ▼]

CONTEXT: Heart rate variability (HRV) is thought to reflect the affective and physiological aspects of pain and is emerging as a possible descriptor of the functional brain organization contributing to homeostasis. OBJECTIVES: To investigate whether the short-term Complexity Index (CIs; short-term Complexity Index), a measure of HRV complexity, is useful to discriminate responses to potentially noxious and non-noxious stimulation in patients with different levels of consciousness. METHODS: Twenty-two patients (11 minimally conscious state [MCS], 11 vegetative state/unresponsive wakefulness syndrome [VS/UWS]) and 14 healthy controls [HC] were enrolled. We recorded the electrocardiographic response and calculated the CIs before (baseline), during, and following non-noxious and noxious stimulation. Mann-Whitney and Wilcoxon's tests were used to investigate differences in CIs according to the level of consciousness (i.e., HC vs patients and VS/UWS vs MCS) and the three conditions (i.e., baseline, non-noxious, noxious). The correlation between the three conditions and the Coma Recovery Scale-Revised (CRS-R) was investigated by Spearman's correlations. RESULTS: We observed higher CIs values in HC as compared with patients during baseline (p<.034) and following the noxious stimulation (p<.0001). We also found higher values in MCS vs VS/UWS patients following the noxious condition (p<.001) and lower values in the noxious vs non-noxious condition solely for the VS/UWS group (p<.007). A correlation was found between CIs in noxious condition and CRS-R scores. CONCLUSION: Our results suggest a less complex autonomic response to noxious stimuli in VS/UWS patients. Such method may help to better understand sympathovagal response to potentially painful stimulation in brain-injured patients. [less ▲]

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See detailPhysical therapy in patients with disorders of consciousness: Impact on spasticity and muscle contracture
Thibaut, Aurore ULiege; Wannez, S.; Deltombe, T. et al

in NeuroRehabilitation (2018), 42(2), 199-205

BACKGROUND: Spasticity is a frequent complication after severe brain injury, which may prevent the rehabilitation process and worsen the patients' quality of life. OBJECTIVES: In this study, we ... [more ▼]

BACKGROUND: Spasticity is a frequent complication after severe brain injury, which may prevent the rehabilitation process and worsen the patients' quality of life. OBJECTIVES: In this study, we investigated the correlation between spasticity, muscle contracture, and the frequency of physical therapy (PT) in subacute and chronic patients with disorders of consciousness (DOC). METHODS: 109 patients with subacute and chronic disorders of consciousness (Vegetative state/Unresponsive wakefulness syndrome - VS/UWS; minimally conscious state - MCS and patients who emerged from MCS - EMCS) were included in the study (39 female; mean age: 40±13.5y; 60 with traumatic etiology; 35 VS/UWS, 68 MCS, 6 EMCS; time since insult: 38±42months). The number of PT sessions (i.e., 20 to 30 minutes of conventional stretching of the four limbs) was collected based on patients' medical record and varied between 0 to 6 times per week (low PT=0-3 and high PT=4-6 sessions per week). Spasticity was measured with the Modified Ashworth Scale (MAS) on every segment for both upper (UL) and lower limbs (LL). The presence of muscle contracture was assessed in every joint. We tested the relationship between spasticity and muscle contracture with the frequency of PT as well as other potential confounders such as time since injury or anti-spastic medication intake. RESULTS: We identified a negative correlation between the frequency of PT and MAS scores as well as the presence of muscle contracture. We also identified that patients who received less than four sessions per week were more likely to be spastic and suffer from muscle contracture than patients receiving 4 sessions or more. When separating subacute (3 to 12 months post-insult) and chronic (>12months post-insult) patients, these negative correlations were only observed in chronic patients. A logit regression model showed that frequency of PT influenced spasticity, whereas neither time since insult nor medication had a significant impact on the presence of spasticity. On the other hand, PT, time since injury and medication seemed to be associated with the presence of muscle contracture. CONCLUSION: Our results suggest that, in subacute and chronic patients with DOC, PT could have an impact on patients' spasticity and muscles contractures. Beside PT, other factors such as time since onset and medication seem to influence the development of muscle contractures. These findings support the need for frequent PT sessions and regular re-evaluation of the overall spastic treatment for patients with DOC. [less ▲]

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See detailEvaluation de la douleur chez le patient cérébrolésé en état de conscience altérée
Martens, Géraldine ULiege; Blandiaux, Séverine ULiege; Wolff, Audrey ULiege et al

in Jourdan, C; Pellas, F; Luauté, J (Eds.) et al Etats de conscience altérée (2018)

La douleur se définit comme une “expérience sensorielle et émotionnelle désagréable associée à un dommage tissulaire potentiel ou réel” [1]. La douleur est donc une expérience subjective négative ... [more ▼]

La douleur se définit comme une “expérience sensorielle et émotionnelle désagréable associée à un dommage tissulaire potentiel ou réel” [1]. La douleur est donc une expérience subjective négative consciente. La nociception, quant à elle, correspond au “processus neuronal de codage des stimuli nociceptifs ( traduit et codé par les nocicepteurs)” et n’engendre pas nécessairement de la douleur. Certaines conditions, comme l’état de conscience altérée (ECA), peuvent entraver une évaluation optimale de la douleur. Néanmoins, l’évaluation de cette douleur est un élément important de la prise en charge clinique ainsi que du diagnostic, puisque le simple fait de ne pas pouvoir communiquer verbalement ne peut écarter la possibilité qu’un individu présente des douleurs [2]. De plus, de nombreuses situations en phase aigüe (mise en place d’un cathéter, polytraumatisme, etc.) ou chronique (présence de spasticité, d’escarres, etc.) peuvent être des sources potentielles de douleur pour les patients en ECA, celles-ci pouvant alors entraver la rééducation et diminuer leur qualité de vie [3]. Bien que nous ne puissions pas utiliser le compte rendu subjectif du patient non communicant, les outils dont nous disposons actuellement nous permettent malgré tout d’étudier ce qui se passe au niveau cérébral en réponse à des stimulations potentiellement douloureuses, ce qui nous permet de mieux comprendre et de tenter d’inférer la présence de douleur potentielle chez ces patients. Par ailleurs, nous pouvons également observer les réponses du patient à son chevet, comme pratiqué avec d’autres populations non communicantes telles que les patients déments et les nouveau-nés. Ce chapitre tentera d’apporter des clés permettant de mieux appréhender et gérer les signes de douleurs potentielles chez ces patients, sur la base des études de neuro-imagerie et des instruments cliniques disponibles. [less ▲]

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See detailFunctional Networks in Disorders of Consciousness
Bodien, Yelena; Chatelle, Camille ULiege; Edlow, Brian

in Seminars in Neurology (2017), 37

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See detailEarly detection of consciousness in patients with acute severe traumatic brain injury
Edlow, Brian; Chatelle, Camille ULiege; Spencer, Camille et al

in Brain: a Journal of Neurology (2017), 140

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See detailControlled clinical trial of repeated prefrontal tDCS in patients with chronic minimally conscious state.
Thibaut, Aurore ULiege; Wannez, Sarah ULiege; Donneau, Anne-Françoise ULiege et al

in Brain Injury (2017), 31(4), 466-474

OBJECTIVES: To assess the effects of repeated transcranial direct current stimulation (tDCS) sessions on the level of consciousness in chronic patients in minimally conscious state (MCS). METHODS: In this ... [more ▼]

OBJECTIVES: To assess the effects of repeated transcranial direct current stimulation (tDCS) sessions on the level of consciousness in chronic patients in minimally conscious state (MCS). METHODS: In this randomized double-blind sham-controlled crossover study, we enrolled 16 patients in chronic MCS. For 5 consecutive days, each patient received active or sham tDCS over the left prefrontal cortex (2 mA during 20 min). Consciousness was assessed with the Coma Recovery Scale-Revised (CRS-R) before the first stimulation (baseline), after each stimulation (day 1-day 5) and 1 week after the end of each session (day 12). RESULTS: A treatment effect (p = 0.013; effect size = 0.43) was observed at the end of the active tDCS session (day 5) as well as 1 week after the end of the active tDCS session (day 12; p = 0.002; effect size = 0.57). A longitudinal increase of the CRS-R total scores was identified for the active tDCS session (p < 0.001), while no change was found for the sham session (p = 0.64). Nine patients were identified as responders (56%). CONCLUSION: Our results suggest that repeated (5 days) left prefrontal tDCS improves the recovery of consciousness in some chronic patients in MCS, up to 1 week after the end of the stimulations. [less ▲]

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See detailThe repetition of behavioral assessments in diagnosis of disorders of consciousness.
Wannez, Sarah ULiege; Heine, Lizette ULiege; Thonnard, Marie et al

in Annals of Neurology (2017), 81(6), 883-889

OBJECTIVE: To determine whether repeated examinations using the Coma Recovery Scale-Revised (CRS-R) have an impact on diagnostic accuracy of patients with disorders of consciousness and to provide ... [more ▼]

OBJECTIVE: To determine whether repeated examinations using the Coma Recovery Scale-Revised (CRS-R) have an impact on diagnostic accuracy of patients with disorders of consciousness and to provide guidelines regarding the number of assessments required for obtaining a reliable diagnosis. METHODS: One hundred twenty-three adult patients with chronic disorders of consciousness were referred to our tertiary center. They were assessed at least six times with the CRS-R within a 10-day period. Clinical diagnoses based on one, two, three, four, and five Coma Recovery Scale-Revised assessments were compared with a reference diagnosis (ie, the highest behavioral diagnosis obtained after six evaluations) using nonparametric statistics. Results were considered significant at p < 0.05 corrected for multiple comparisons. RESULTS: The number of assessments had a significant effect on the clinical diagnosis. Up to the fourth examination, the diagnosis was still statistically different from the reference diagnosis based on six CRS-R assessments. Compared to this reference diagnosis, the first evaluation led to 36% of misdiagnoses. INTERPRETATION: The number of CRS-R assessments has an impact on the clinical diagnosis of patients with chronic disorders of consciousness. Up to the fourth examinations, behavioral fluctuations may still impact the diagnostic accuracy. We here suggest performing at least five assessments in each patient with disorders of consciousness within a short time interval (eg, 2 weeks) to reduce misdiagnosis. Ann Neurol 2017;81:883-889 Ann Neurol 2017;81:883-889. [less ▲]

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See detailThe Clinical Diagnostic Utility of Electrophysiological Techniques in Assessment of Patients With Disorders of Consciousness Following Acquired Brain Injury: A Systematic Review.
Hauger, S. L.; Schanke, A.-K.; Andersson, S. et al

in Journal of Head Trauma Rehabilitation (2017), 32(3), 185-196

OBJECTIVE: To investigate the diagnostic utility of electrophysiological recordings during active cognitive tasks in detecting residual cognitive capacities in patients with disorders of consciousness ... [more ▼]

OBJECTIVE: To investigate the diagnostic utility of electrophysiological recordings during active cognitive tasks in detecting residual cognitive capacities in patients with disorders of consciousness (DoC) after severe acquired brain injury. DESIGN: Systematic review of empirical research in MEDLINE, Embase, PsycINFO, and Cochrane from January 2002 to March 2016. MAIN MEASURES: Data extracted included sample size, type of electrophysiological technique and task design, rate of cognitive responders, false negatives and positives, and excluded subjects from the study analysis. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used for quality appraisal of the retrieved literature. RESULTS: Twenty-four studies examining electrophysiological signs of command-following in patients with DoC were identified. Sensitivity rates in healthy controls demonstrated variable accuracy across the studies, ranging from 71% to 100%. In patients with DoC, specificity and sensitivity rates varied in the included studies, ranging from 0% to 100%. Pronounced heterogeneity was found between studies regarding methodological approaches, task design, and procedures of analysis, rendering comparison between studies challenging. CONCLUSION: We are still far from establishing precise recommendations for standardized electrophysiological diagnostic procedures in DoC, but electrophysiological methods may add supplemental diagnostic information of covert cognition in some patients with DoC. [less ▲]

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See detailBrain networks predict metabolism, diagnosis and prognosis at the bedside in disorders of consciousness.
Chennu, Srivas; Annen, Jitka ULiege; Wannez, Sarah ULiege et al

in Brain: a Journal of Neurology (2017), 140(8), 2120-2132

Recent advances in functional neuroimaging have demonstrated novel potential for informing diagnosis and prognosis in the unresponsive wakeful syndrome and minimally conscious states. However, these ... [more ▼]

Recent advances in functional neuroimaging have demonstrated novel potential for informing diagnosis and prognosis in the unresponsive wakeful syndrome and minimally conscious states. However, these technologies come with considerable expense and difficulty, limiting the possibility of wider clinical application in patients. Here, we show that high density electroencephalography, collected from 104 patients measured at rest, can provide valuable information about brain connectivity that correlates with behaviour and functional neuroimaging. Using graph theory, we visualize and quantify spectral connectivity estimated from electroencephalography as a dense brain network. Our findings demonstrate that key quantitative metrics of these networks correlate with the continuum of behavioural recovery in patients, ranging from those diagnosed as unresponsive, through those who have emerged from minimally conscious, to the fully conscious locked-in syndrome. In particular, a network metric indexing the presence of densely interconnected central hubs of connectivity discriminated behavioural consciousness with accuracy comparable to that achieved by expert assessment with positron emission tomography. We also show that this metric correlates strongly with brain metabolism. Further, with classification analysis, we predict the behavioural diagnosis, brain metabolism and 1-year clinical outcome of individual patients. Finally, we demonstrate that assessments of brain networks show robust connectivity in patients diagnosed as unresponsive by clinical consensus, but later rediagnosed as minimally conscious with the Coma Recovery Scale-Revised. Classification analysis of their brain network identified each of these misdiagnosed patients as minimally conscious, corroborating their behavioural diagnoses. If deployed at the bedside in the clinical context, such network measurements could complement systematic behavioural assessment and help reduce the high misdiagnosis rate reported in these patients. These metrics could also identify patients in whom further assessment is warranted using neuroimaging or conventional clinical evaluation. Finally, by providing objective characterization of states of consciousness, repeated assessments of network metrics could help track individual patients longitudinally, and also assess their neural responses to therapeutic and pharmacological interventions. [less ▲]

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See detailObjective assessment of visual pursuit in patients with disorders of consciousness: an exploratory study.
Wannez, Sarah ULiege; Hoyoux, Thomas; Langohr, Thomas et al

in Journal of Neurology (2017)

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