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See detailNear-death experiences Are they self-defining?
Cassol, Helena ULiege; D'Argembeau, Arnaud ULiege; Charland-Verville, Vanessa ULiege et al

Poster (2018, October 19)

Background: Near-Death Experiences (NDEs) are profound psychological events with highly emotional and self-related content, typically encompassing transcendental and mystical elements and occurring when ... [more ▼]

Background: Near-Death Experiences (NDEs) are profound psychological events with highly emotional and self-related content, typically encompassing transcendental and mystical elements and occurring when people come close to death (Greyson, 2000). These experiences appear to have significant consequences on peoples’ lives (so-called "NDE experiencers" or "NDErs"; e.g., Noyes, 1980). Given their documented life-transforming effects and their reported importance, NDE memories appear to share similarities with a particular type of autobiographical memories referred to as a self-defining memories (SDMs; Blagov and Singer, 2004). SDMs are the building blocks of identity (Blagov and Singer, 2004) and contribute, in particular, to the sense of self-continuity (Conway et al., 2004) which represents the ability to consider oneself as an entity that extends back into the past and forward into the future (Chandler, 1994). <br />Objectives: This study aimed at 1) assessing if NDE memories are considered as SDMs and 2) determining whether the potential self-defining dimension of NDEs is due to their phenomenal content or their circumstances of appearance (i.e., presence or absence of impeding death). <br />Methods: 71 participants were screened using the Greyson NDE scale (48 real NDErs and 23 NDErs-like who had lived a similar experience in absence of life threat; Greyson, 1983). This 16-item multiple-choice validated scale enables to quantify the richness of the experience (scores ranging from 0 to 32) and allows a standardized identification of NDEs (cut-off score of 7). Participants described their two main self-defining memories (SDMs) and completed the Centrality of Event Scale (CES; Berntsen and Rubin, 2006) for each one of them. The CES is a 20-item scale (scores ranging from 0 to 100) designed to assess how central the event is to their identity. Proportions of NDErs who recalled their NDE were calculated for each subgroup (real NDErs and NDErs-like) and a Pearson’s chi square test was performed to compare ratios between them. Later, all participants were divided into two subgroups depending on whether or not they recalled their NDE (no matter its context of occurrence; "NDE recalled" and "NDE not recalled"). The last step of analyses focused on the CES scale and was only carried out on the “NDE recalled” subgroup. Differences in CES total scores between the NDE memory and the other SDM were assessed using a Student’s t-test. Additionally, a Spearman’s correlation was performed to examine associative strength between CES and Greyson NDE scale total scores. <br />Results: Real NDErs and NDErs-like did not differ regarding the proportion of NDErs who recalled their NDE (30 real NDErs out of 48 and 11 NDErs-like out of 23; p=0.24), suggesting that the self-defining aspect of the experience could be explained by its phenomenological content rather than context of occurrence. These participants (n=41) rated the NDE memory as more central to their identity as compared to the other SDM (p<0.001). Furthermore, the richness of the NDE memory (Greyson NDE scale scores) was positively associated to its centrality (CES scores; p<0.01). <br />Conclusions: The self-defining status of NDE memories confirms that they constitute an important part of NDErs’ personal identity and highlights the importance for clinicians to facilitate their integration within the self. SDMs are indeed essential to one’s sense of self-continuity, which is crucial for psychological well-being. [less ▲]

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See detailConsciousness and near-death experiences: what is known, what is new
Martial, Charlotte ULiege

Conference given outside the academic context (2018)

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See detailA Heartbeat Away From Consciousness: Heart Rate Variability Entropy can discriminate disorders of consciousness and is correlated with resting-state fMRI brain connectivity of the Central Autonomic Network
Riganello, Francesco ULiege; Larroque, Stephen Karl ULiege; Bahri, Mohamed Ali ULiege et al

Poster (2018, October)

Motivation: Heart rate variability (HRV) reflects the heart-brain two-way dynamic interactions[1-5]. HRV entropy analysis quantifies the unpredictability and complexity of the heart rate beats intervals ... [more ▼]

Motivation: Heart rate variability (HRV) reflects the heart-brain two-way dynamic interactions[1-5]. HRV entropy analysis quantifies the unpredictability and complexity of the heart rate beats intervals and over multiple time scales using multiscale entropy (MSE)[6-8]. The complexity index (CI) provides a score of a system’s complexity by aggregating the MSE measures over a range of time scales[8]. Most HRV entropy studies have focused on acute traumatic patients using task-based designs[9]. We here investigate the CI and its discriminative power in chronic patients with unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS) at rest, and its relation to brain functional connectivity. Methods: We investigated the CI in short (CIs) and long (CIl) time scales in 16 UWS and 17 MCS sedated. CI for MCS and UWS groups were compared using a Mann-Whitney exact test. Spearman’s correlation tests were conducted between the Coma Recovery Scale-revised (CRS-R) and both CI. Discriminative power of both CI was assessed with One-R machine learning model. Correlation between CI and brain connectivity (detected with functional magnetic resonance imagery using seed-based and hypothesis-free intrinsic connectivity) was investigated using a linear regression in a subgroup of 12 UWS and 12 MCS patients with sufficient image quality. Results and Discussion: Significant differences were found between MCS and UWS for CIs and CIl (0.0001≤p≤0.006). Significant correlations were found between CRS-R and CIs and CIl (0.0001≤p≤0.026). The One-R classifier selected CIl as the best discriminator between UWS and MCS with 85% accuracy, 19% false positive rate and 12% false negative rate after a 10-fold cross-validation test. Positive correlations were observed between CI and brain areas belonging to the autonomic system. CI was found to be significantly higher in MCS compared to UWS patients, with high discriminative power and lower false negative rate than the reported misdiagnosis rate of human assessors, providing an easy, inexpensive and non-invasive diagnosis tool. CI is correlated to functional connectivity changes in brain regions belonging to the autonomic nervous system, suggesting that CI can provide an indirect way to screen and monitor connectivity changes in this neural system. Future studies should investigate further the extent of CI’s predictive power for other pathologies in the disorders of consciousness spectrum. [less ▲]

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See detailUn si brillant cerveau: les états limites de conscience
Martial, Charlotte ULiege

Conference given outside the academic context (2018)

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See detailA Heartbeat Away From Consciousness: Heart Rate Variability Entropy Can Discriminate Disorders of Consciousness and Is Correlated With Resting-State fMRI Brain Connectivity of the Central Autonomic Network
Riganello, Francesco ULiege; Larroque, Stephen Karl ULiege; Bahri, Mohamed Ali ULiege et al

in Frontiers in Neurology (2018), 9

Background: Disorders of consciousness are challenging to diagnose, with inconsistent behavioral responses, motor and cognitive disabilities, leading to approximately 40% misdiagnoses. Heart rate ... [more ▼]

Background: Disorders of consciousness are challenging to diagnose, with inconsistent behavioral responses, motor and cognitive disabilities, leading to approximately 40% misdiagnoses. Heart rate variability (HRV) reflects the complexity of the heart-brain two-way dynamic interactions. HRV entropy analysis quantifies the unpredictability and complexity of the heart rate beats intervals. We here investigate the complexity index (CI), a score of HRV complexity by aggregating the non-linear multi-scale entropies over a range of time scales, and its discriminative power in chronic patients with unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS), and its relation to brain functional connectivity. Methods: We investigated the CI in short (CIs) and long (CIl) time scales in 14 UWS and 16 MCS sedated. CI for MCS and UWS groups were compared using a Mann-Whitney exact test. Spearman's correlation tests were conducted between the Coma Recovery Scale-revised (CRS-R) and both CI. Discriminative power of both CI was assessed with One-R machine learning model. Correlation between CI and brain connectivity (detected with functional magnetic resonance imagery using seed-based and hypothesis-free intrinsic connectivity) was investigated using a linear regression in a subgroup of 10 UWS and 11 MCS patients with sufficient image quality. Results: Higher CIs and CIl values were observed in MCS compared to UWS. Positive correlations were found between CRS-R and both CI. The One-R classifier selected CIl as the best discriminator between UWS and MCS with 90% accuracy, 7% false positive and 13% false negative rates after a 10-fold cross-validation test. Positive correlations were observed between both CI and the recovery of functional connectivity of brain areas belonging to the central autonomic networks (CAN). Conclusion: CI of MCS compared to UWS patients has high discriminative power and low false negative rate at one third of the estimated human assessors' misdiagnosis, providing an easy, inexpensive and non-invasive diagnostic tool. CI reflects functional connectivity changes in the CAN, suggesting that CI can provide an indirect way to screen and monitor connectivity changes in this neural system. Future studies should assess the extent of CI's predictive power in a larger cohort of patients and prognostic power in acute patients. [less ▲]

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See detailHypnosis: from science to clinic
FAYMONVILLE, Marie-Elisabeth ULiege; LAUREYS, Steven ULiege; Martial, Charlotte ULiege et al

Conference (2018, August 24)

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See detailDMT models the near-death experience
Timmermann, Christopher; Roseman, Leor; Williams, Luke et al

in Frontiers in Psychology (2018)

Near-death experiences (NDEs) are complex subjective experiences, which have been previously associated to the psychedelic experience and more specifically to the experience induced by the potent ... [more ▼]

Near-death experiences (NDEs) are complex subjective experiences, which have been previously associated to the psychedelic experience and more specifically to the experience induced by the potent serotonergic, N,N-Dimethyltryptamine (DMT). Potenital similarities between both subjective states have been noted previously, including the subjective feeling of transcending one’s body and entering an alternative realm, perceiving and communicating with sentient ‘entities’ and themes related to death and dying. In this within-subjects placebo-controled study we aimed to test the similarities between the DMT state and NDEs, by administering DMT and placebo to 13 healthy participants, who then completed a validated and widely used measure of NDEs. Results revealed significant increases in phenomenological features associated to the NDE, following DMT administration compared to placebo. Also, we found significant relationships between the NDE scores and DMT-induced ego-dissolution and mystical-type experiences, as well as a significant association between NDE scores with personality trait ‘absorption’ and delusional ideation measured at baseline. Furthermore, we found a significant overlap in nearly all of the NDE phenomenological features when comparing DMT-induced NDEs with a matched group of ‘actual’ NDE experiencers. These results reveal a striking similarity between these states that warrants further investigation. [less ▲]

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See detailMemories of near-death experiences: Are they self-defining?
Cassol, Helena ULiege; D'Argembeau, Arnaud ULiege; Charland-Verville, Vanessa ULiege et al

Poster (2018, June 28)

Introduction. Memories of near-death experiences (NDEs) are characterized by a rich phenomenology and appear to be firmly anchored. It has been proposed that this phenomenology could be explained by the ... [more ▼]

Introduction. Memories of near-death experiences (NDEs) are characterized by a rich phenomenology and appear to be firmly anchored. It has been proposed that this phenomenology could be explained by the significance of NDEs for personal identity; however, the centrality of this event to individuals’ (so-called “experiencers”) lives and identities remains unexplored. Objectives. Given the significance and consequentiality of NDEs, this study aimed at determining whether memories of NDEs could be considered as a particular type of autobiographical memories, referred to as “Self-Defining Memories” (SDMs), which are central to one’s self-understanding. Furthermore, we intended to explore if NDEs memories are more central to experiencers’ identities and life stories as compared to other SDMs. Methods. We recruited 47 volunteers who had experienced a NDE (identified using the Greyson NDE scale) in a life threatening situation. Volunteers were invited to complete a task asking to describe two SDMs and, for each of them, they completed the Centrality of Event Scale (CES). Results. The majority of volunteers (60%) recalled their NDE among the reported SDMs. The memory of the NDE scored significantly higher on the CES as compared to the other SDM, showing that this experience was considered as being particularly central to their identity. Furthermore, we found that volunteers who described more intense NDEs memories also considered them as more central to their identities. Conclusions. The self-defining status of NDEs memories confirms that they are central to experiencers’ identities and highlights the importance for clinicians to facilitate their integration within the self. [less ▲]

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See detailA Heartbeat Away From Consciousness: Heart Rate Variability Entropy can discriminate disorders of consciousness and is correlated with resting-state fMRI brain connectivity of the Central Autonomic Network
Riganello, Francesco ULiege; Larroque, Stephen Karl ULiege; Bahri, Mohamed Ali ULiege et al

Poster (2018, June 21)

Motivation: Heart rate variability (HRV) reflects the heart-brain two-way dynamic interactions[1-5]. HRV entropy analysis quantifies the unpredictability and complexity of the heart rate beats intervals ... [more ▼]

Motivation: Heart rate variability (HRV) reflects the heart-brain two-way dynamic interactions[1-5]. HRV entropy analysis quantifies the unpredictability and complexity of the heart rate beats intervals and over multiple time scales using multiscale entropy (MSE)[6-8]. The complexity index (CI) provides a score of a system’s complexity by aggregating the MSE measures over a range of time scales[8]. Most HRV entropy studies have focused on acute traumatic patients using task-based designs[9]. We here investigate the CI and its discriminative power in chronic patients with unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS) at rest, and its relation to brain functional connectivity. Methods: We investigated the CI in short (CIs) and long (CIl) time scales in 16 UWS and 17 MCS sedated. CI for MCS and UWS groups were compared using a Mann-Whitney exact test. Spearman’s correlation tests were conducted between the Coma Recovery Scale-revised (CRS-R) and both CI. Discriminative power of both CI was assessed with One-R machine learning model. Correlation between CI and brain connectivity (detected with functional magnetic resonance imagery using seed-based and hypothesis-free intrinsic connectivity) was investigated using a linear regression in a subgroup of 12 UWS and 12 MCS patients with sufficient image quality. Results and Discussion: Significant differences were found between MCS and UWS for CIs and CIl (0.0001≤p≤0.006). Significant correlations were found between CRS-R and CIs and CIl (0.0001≤p≤0.026). The One-R classifier selected CIl as the best discriminator between UWS and MCS with 85% accuracy, 19% false positive rate and 12% false negative rate after a 10-fold cross-validation test. Positive correlations were observed between CI and brain areas belonging to the autonomic system. CI was found to be significantly higher in MCS compared to UWS patients, with high discriminative power and lower false negative rate than the reported misdiagnosis rate of human assessors, providing an easy, inexpensive and non-invasive diagnosis tool. CI is correlated to functional connectivity changes in brain regions belonging to the autonomic nervous system, suggesting that CI can provide an indirect way to screen and monitor connectivity changes in this neural system. Future studies should investigate further the extent of CI’s predictive power for other pathologies in the disorders of consciousness spectrum. [less ▲]

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See detailDynamic inter-regional coordination patterns as specific predictors of consciousness
Demertzi, Athina ULiege; Tagliazucchi, Enzo; Dehaene, Stanislas et al

Poster (2018, June 17)

Background and aims: To date, specific signatures of conscious states in humans remain elusive. Contemporary theories concur that such markers can be traced to temporally evolving brain processes instead ... [more ▼]

Background and aims: To date, specific signatures of conscious states in humans remain elusive. Contemporary theories concur that such markers can be traced to temporally evolving brain processes instead of static descriptions of brain activity. Methods: Dynamic fMRI connectivity patterns (states) by means of clustering of phase-based coherence was estimated on 47 healthy and 112 patients diagnosed in vegetative state/unresponsive wakefulness syndrome (VS/UWS) or in a minimally conscious state (MCS). To validate whether the patterns captured properties of awareness, out-of-sample generalization was performed on patients with cognitive-motor dissociation (i.e. lacking overt conscious behaviour yet evidenced using functional neuroimaging), and on anesthetised patients, under the premise that complex signatures would disappear uniformly across all subjects. Results: A pattern of long-range positive/negative coherence had a higher probability of occurring in healthy and MCS patients. A pattern of low inter-areal coordination, mostly similar to anatomy, was more likely to occur in VS/UWS. Inter-state transitioning was flexible for healthy and MCS and more rigid for VS/UWS patients. Unconscious patients were more likely to avoid the exploration of the complex connectivity state. The generalization to cognitive-motor dissociation predicted the occurrence of the complexconnectivity state. The generalization to propofol anaesthesia showed an equalization of occurrence probabilities of all patterns regardless of clinical diagnosis. Conclusion: The dynamics of inter-areal coordination contain information specific to conscious awareness. The rigid and less metastable dynamics in VS/UWS could account for the limited mental capacities in these patients. The minute identification of these patterns and their external manipulation could account for non-invasive restoration of consciousness. [less ▲]

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See detailTranscranial direct current stimulation unveils covert consciousness
Thibaut, Aurore ULiege; Chatelle, Camille ULiege; VANHAUDENHUYSE, Audrey ULiege et al

in Brain Stimulation (2018), 11(3), 642-644

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See detailFantasy proneness in near-death experiencers
Martial, Charlotte ULiege; Cassol, Helena ULiege; CHARLAND-VERVILLE, Vanessa ULiege et al

Poster (2018, June)

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See detailFantasy proneness correlates with the intensity of near-death experience
Martial, Charlotte ULiege; Cassol, Helena ULiege; Charland-Verville, Vanessa ULiege et al

in Frontiers in Psychiatry (2018)

Little is known about the personality characteristics of those who have experienced a “Near-Death Experience” (NDE). One interesting candidate is fantasy proneness. We studied this trait in individuals ... [more ▼]

Little is known about the personality characteristics of those who have experienced a “Near-Death Experience” (NDE). One interesting candidate is fantasy proneness. We studied this trait in individuals who developed NDEs in the presence (i.e., classical NDEs) or absence (i.e., NDEs-like) of a life-threatening situation. We surveyed a total of 228 individuals. From those, 108 qualified as NDE experiencers (i.e., Greyson NDE scale total score ≥ 7): 51 had their NDEs in the context of a life‐threatening situation; 57 had their NDEs not related to a life-threatening situation. From those who did not meet the criteria to be considered “experiencers”, 20 had their NDE in the absence of a life-threatening situation; 50 had faced death but did not recall a NDE and finally, 50 were healthy people without a history of life threat and/or NDE. All participants completed a measure of NDE intensity (the Greyson NDE scale) and a measure of fantasy proneness (the Creative Experiences Questionnaire). People reporting NDEs-like scored higher on fantasy proneness than those reporting classical NDEs, individuals whose experiences did not meet the NDE criteria and matched controls. By contrast, individuals reporting classical NDEs showed similar engagement in fantasy as matched controls. The reported intensity of the experiences was positively correlated with engagement in fantasy. Our findings support the view that strong engagement in fantasy by individuals recalling NDEs-like might make these persons more likely to report such subjective experiences when exposed to suitable physiological and/or psychological conditions (e.g., meditation, syncope). [less ▲]

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See detailVivid memories from hell: A systematic analysis of distressing near-death experiences accounts
Cassol, Helena ULiege; Martial, Charlotte ULiege; Annen, Jitka ULiege et al

Poster (2018, May 18)

Background: Near-death experiences (NDEs) are associated to positive affects, however, a small proportion is depicted as distressing. Only a few studies have addressed these frightening events, and yet ... [more ▼]

Background: Near-death experiences (NDEs) are associated to positive affects, however, a small proportion is depicted as distressing. Only a few studies have addressed these frightening events, and yet they could trigger long-lasting emotional trauma. Objectives: We aimed at 1) looking into the proportion of distressing NDEs in a sample of NDE narratives; 2) running a categorization of distressing narratives based on Greyson and Bush’s classification: “inverse”, “void” or “hellish” NDEs; and 3) comparing the content of distressing NDEs with “classical” NDEs (which include typical features and are not considered as negative). Methods: NDE experiencers were invited to write down their experience and complete the Memory Characteristics Questionnaire (to assess its phenomenological characteristics) as well as the Greyson NDE scale (to characterize the content of the NDE). Distressing narratives were identified and a text analysis was conducted to classify each narrative into one of the negative subcategories. Content and intensity of distressing and classical NDEs memories were then compared using Mann Whitney U tests based on answers to questionnaires. Results: First, we found that distressing NDEs represent 18% of our sample. Second, the text analysis confirmed Greyson and Bush’s classification and highlighted that our subsample includes 14 inverse (56%), 8 hellish (32%) and 3 void (12%) accounts. Finally, memories of distressing NDEs are considered as detailed as memories of classical NDEs. Apart from positive affects, distressing NDEs contain as much typical features as classical NDEs. Still poorly studied, distressing NDEs deserve careful consideration to ensure their integration into NDE experiencers’ identity. [less ▲]

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See detailAre memories of near-death experiences self-defining?
Cassol, Helena ULiege; D'Argembeau, Arnaud ULiege; Charland-Verville, Vanessa ULiege et al

Conference (2018, May 18)

Introduction. Memories of near-death experiences (NDEs) are characterized by a rich phenomenology and appear to be firmly anchored. It has been proposed that this phenomenology could be explained by the ... [more ▼]

Introduction. Memories of near-death experiences (NDEs) are characterized by a rich phenomenology and appear to be firmly anchored. It has been proposed that this phenomenology could be explained by the significance of NDEs for personal identity; however, the centrality of this event to individuals’ (so-called “experiencers”) lives and identities remains unexplored. Objectives. Given the significance and consequentiality of NDEs, this study aimed at determining whether memories of NDEs could be considered as a particular type of autobiographical memories, referred to as “Self-Defining Memories” (SDMs), which are central to one’s self-understanding. Furthermore, we intended to explore if NDEs memories are more central to experiencers’ identities and life stories as compared to other SDMs. Methods. We recruited 47 volunteers who had experienced a NDE (identified using the Greyson NDE scale) in a life threatening situation. Volunteers were invited to complete a task asking to describe two SDMs and, for each of them, they completed the Centrality of Event Scale (CES). Results. The majority of volunteers (60%) recalled their NDE among the reported SDMs. The memory of the NDE scored significantly higher on the CES as compared to the other SDM, showing that this experience was considered as being particularly central to their identity. Furthermore, we found that volunteers who described more intense NDEs memories also considered them as more central to their identities. Conclusions. The self-defining status of NDEs memories confirms that they are central to experiencers’ identities and highlights the importance for clinicians to facilitate their integration within the self. [less ▲]

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See detailRandomized controlled trial of home-based 4-week tDCS in chronic minimally conscious state
Martens, Géraldine ULiege; Lejeune, Nicolas ULiege; O'Brien, Anthony et al

in Brain Stimulation (2018)

Background Patients with chronic disorders of consciousness face a significant lack of treatment options. Objective We aimed at investigating the feasibility and the behavioral effects of home-based ... [more ▼]

Background Patients with chronic disorders of consciousness face a significant lack of treatment options. Objective We aimed at investigating the feasibility and the behavioral effects of home-based transcranial direct current stimulation (tDCS), applied by relatives or caregivers, in chronic patients in minimally conscious state (MCS). Methods Each participant received, in a randomized order, 20 sessions of active and 20 sessions of sham tDCS applied over the prefrontal cortex for 4 weeks; separated by 8 weeks of washout. Level of consciousness was assessed using the Coma Recovery Scale-Revised before the first stimulation (baseline), after the end of the 20 tDCS sessions (direct effects) and 8 weeks after the end of each stimulation period (long-term effects). Reported adverse events and data relative to the adherence (i.e., amount of sessions effectively received) were collected as well. Results Twenty-seven patients completed the study and 22 patients received at least 80% of the stimulation sessions. All patients tolerated tDCS well, no severe adverse events were noticed after real stimulation and the overall adherence (i.e., total duration of stimulation) was good. A moderate effect size (0.47 and 0.53, for modified intention to treat and per protocol analysis, respectively) was observed at the end of the 4 weeks of tDCS in favor of the active treatment. Conclusions We demonstrated that home-based tDCS can be used adequately outside a research facility or hospital by patients’ relatives or caregivers. In addition, 4 weeks of tDCS moderately improved the recovery of signs of consciousness in chronic MCS patients. [less ▲]

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See detailCharacterization of near-death experiences and their experiencers
Martial, Charlotte ULiege

Doctoral thesis (2018)

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See detailRegional brain volumetry and brain function in severely brain-injured patients
Annen, Jitka ULiege; Frasso, Gianluca; Crone, Julia et al

in Annals of Neurology (2018)

Detailed reference viewed: 129 (21 ULiège)