References of "Cassol, Helena"
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See detailClinical and neuroimaging improvements after apomorphine treatment in a patient with chronic disorders of consciousness following brain hemorrhage
Sanz, Leandro ULiege; Lejeune, Nicolas; Blandiaux, Séverine ULiege et al

in Brain Injury (in press)

Background: There are few available therapeutic options to promote recovery among patients with disorders of consciousness (DOC). Among pharmacological treatments, apomorphine, a dopamine agonist, has ... [more ▼]

Background: There are few available therapeutic options to promote recovery among patients with disorders of consciousness (DOC). Among pharmacological treatments, apomorphine, a dopamine agonist, has exhibited promising behavioral effects in traumatic brain injury. Its efficacy among patients with non-traumatic brain injury has never been documented and its action on brain activity remains unknown. We report the case of a patient with DOC following intracranial hemorrhage, who was treated with apomorphine in a prospective open-label study. Methods/design: A 47-year-old woman with chronic DOC (minimally conscious state; MCS) following spontaneous rupture of a left carotidal aneurysm (132 days since onset), was treated with apomorphine for 30 days. The drug was administered via subcutaneous infusions 12 hours per day, with escalating doses up to 6 mg/h. The patient was monitored 30 days before initiation of therapy, during treatment and 30 days after withdrawal, using the Coma Recovery Scale – Revised (CRS-R). High-density electroencephalography (hdEEG) and fluorodeoxyglucose positron emission tomography (FDG-PET) were acquired before and after treatment. Outcome measures included CRS-R diagnosis, FDG-PET standardized uptake values, a multivariate classifier integrating 68 individual hdEEG markers and hdEEG functional connectivity using debiased weighted phase lag index. Results: Before treatment, CRS-R scores were compatible with a diagnosis of unresponsive wakefulness syndrome (UWS) in 8/9 evaluations, and with a MCS- only once. During treatment, the patient was diagnosed as UWS in 2/8 evaluations, MCS- in 5/8 evaluations and MCS+ once, characterized by the presence of reproducible response to command. After treatment withdrawal, she was diagnosed UWS once and MCS- in 4/5 evaluations. Compared to 54 healthy controls, FDG-PET whole brain metabolism revealed a 59% metabolic drop before treatment and 51% after treatment, with increases in right temporal, parietal and frontal cortical areas. The multivariate classifier using resting-state hdEEG data was in favor of a UWS before treatment, while it indicated a MCS after treatment. Most of the individual markers increased after treatment, including alpha and beta spectral power, spectral entropy, Kolmogorov complexity and permutation entropy. Functional connectivity analyses also indicated an increase in network centrality predominant in the alpha frequency band after treatment compared to before treatment. Discussion: After treatment with apomorphine, this patient showed improvements both at the clinical and neuroimaging levels. While signs of consciousness were only observed once at baseline, most of the assessments performed during and after treatment led to a diagnosis of MCS. Notably, a reproducible response to command was observed once during treatment, leading to a change of diagnosis. Brain activity measures all increased after treatment compared to before treatment. These multimodal improvements suggest that apomorphine may be efficient to promote the recovery of non-traumatic DOC patients, and that its action can be measured through different changes in brain imaging markers. Clinical trial identifiers: EudraCT 2018-003144-23; Clinicaltrials.gov NCT03623828 [less ▲]

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See detailLes expériences de mort imminente
Cassol, Helena ULiege; Martial, Charlotte ULiege; Laureys, Steven ULiege et al

in MethIS (in press)

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See detailStudy of the impact of non-pharmacological techniques (self-hypnosis/self-care) on cognitive complaints in cancer patients
Bicego, Aminata Yasmina ULiege; Grégoire, Charlotte; Cassol, Helena ULiege et al

Conference (2019, May 30)

Cancer diagnosis generates a number of physical, psychological and cognitive impairments such as memory, attentional and informational processing deficits that can undermine patients’ quality of life (QoL ... [more ▼]

Cancer diagnosis generates a number of physical, psychological and cognitive impairments such as memory, attentional and informational processing deficits that can undermine patients’ quality of life (QoL). Self-hypnosis combined to self-care learning have been used in the past years to treat these symptoms, at the moment of diagnosis, during and/or after the cancer treatments. However, the impact of self-hypnosis/self-care upon cognitive difficulties has not been investigated yet.The aim of this study is to better understand the impact of self hypnosis/self-care upon the cognitive functions by means of the Functional Assessment of Cancer Therapy-Cognitive Function1 (FACT-COG). [less ▲]

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See detailDiagnostic accuracy of a CRS-R modified score in patients with disorders of consciousness.
Annen, Jitka ULiege; Filippini, Maria Maddalena ULiege; Bonin, Estelle ULiege et al

in Brain Injury (2019, March 16)

Introduction The Coma Recovery Scale-Revised (CRS-R) is the gold standard diagnostic tool for assessing patients with disorders of consciousness (DOC) after severe acquired brain injury (Giacino, Kalmar ... [more ▼]

Introduction The Coma Recovery Scale-Revised (CRS-R) is the gold standard diagnostic tool for assessing patients with disorders of consciousness (DOC) after severe acquired brain injury (Giacino, Kalmar and Whyte, 2004; Seel et al., 2010). Differential diagnosis of DOC includes the unresponsive wakefulness syndrome (UWS;(Laureys et al., 2010)), characterized by the recovery of eye-opening but no behavioral evidence of self or environmental awareness, and the minimally conscious state (MCS; (Giacino et al., 2002)) defined by clearly discernible but inconsistent behavioral signs of conscious awareness. The CRS-R assesses reflexes and cognitively mediated behavior in six domains, namely auditory (4 items), visual (5 items), motor (6 items), oromotor (3 items), communication (2 items) and arousal (3 items). Items in every subscale are hierarchically ordered (i.e. reflexive to cognitively-mediated behaviors; higher level behaviors correspond to higher level of neurologic functioning and ability to demonstrate lower-level behaviors or disappearance of pathological behaviors as sign of recovery) and can be used to infer the patient’s level of consciousness (La Porta et al., 2013; Gerrard, Zafonte and Giacino, 2014). Several studies on DOC investigating markers of consciousness, recovery and treatment used the CRS-R total score (i.e. addition of the highest scores reached for each subscale) as regressor in neuroimaging analyses (Bruno et al., 2012; Thibaut et al., 2012; Margetis et al., 2014; Bagnato et al., 2015). However, ignoring the hierarchy of the subscales in the CRS-R total score reduces the sensitivity for the diagnosis of MCS patients (i.e., 100% specificity for UWS but false negative diagnostic error of 22%, with a cut-off CRS-R total score of 10 (Bodien et al., 2016)). In addition, the ordinal nature of the CRS-R total score make it limited to use with parametric statistical tests (e.g., requiring normal distribution). A solution to this problem has been proposed by Sattin and colleagues (2015) who computed a CRS-R modified score (CRS-R MS1), by considering reflexes and cognitively mediated behaviors separately, reliably distinguishing between UWS and MCS patients. These authors also argue that the interpretation of the total CRS-R scores is limited due to “the underlying assumption that if a patient is able to show higher-level behaviors, he/she is also able to show lower-level responses”. Sattin et al. (2015) propose to account for the number of presented responses in every subscale (i.e., every items in a subscale should be assessed and scored). One major drawback to this approach is that according to the CRS-R guidelines, the assessor should start assessing the highest item and move to the next subscale once an item is scored, in line with the hierarchical organization of the scale. This means that, if the CRS-R is performed according to the guidelines (for which the CRS-R has been validated), the CRS-R modified score cannot be calculated. Even if assessing all items might be valid, it is unlikely to be done in many clinical and research settings as it would increase assessment time and fatigue the patient. We here propose to adapt the CRS-R MS1 by considering only the highest score reached on every subscale, respecting the CRS-R guidelines. Methods One-hundred twenty-four patients admitted to the University Hospital of Liège were assessed multiple times with the CRS-R, at least once including the assessment of all items. Patients for whom the CRS-R assessment including all items provided the same diagnosis as the patient’s final diagnosis were selected. The study was approved by the ethics committee of the University Hospital of Liège and the legal guardians of patients gave written informed consent for participation in the study, in accordance with the Declaration of Helsinki. The CRS-R total score and two CRS-R MS were calculated for every patient. The CRS-R MS combines scores for reflexes and cognitive behaviors of every CRS-R subscale which can be used to obtain the CSR-R MS from a transposition matrix. The CRS-R MS1 was calculated as previously described (Sattin et al., 2015), and the CRS-R MS2 only used the highest score in every subscale (i.e., assuming that lower items were successful). Statistics were performed in R (R Core team, 2012). We assessed group differences in age (two sample t-test), time since injury (two sample t-test) and etiology (χ2 test). Receiver Operating Characteristic were calculated to obtain the sensitivity and specificity at several classification thresholds (package pROC (Robin et al., 2011)). We calculated the correlation between the CRSR MS1 and CRSR MS2 using Pearson correlation, and both scores with the CRS-R total score using Spearman correlation. Finally, we used a Kolmogorov-Smirnoff test to evaluate whether CRSR MS1 and CRSR MS2 come from different distributions (i.e., if one approach provides additional information over the other). Results Eighty-five MCS patients (26 females; mean age 40.4 (SD±17.4) years old; 43 traumatic; mean time since injury 2.7 (SD±4.0) years) and 39 UWS patients (14 females; mean age 50.6 (SD±16.5) years old; 29 traumatic; mean time since injury 1.2 (SD±1.8) years) were included in the study. MCS patients were older (t(77.6)-3.15, p<0.002 95%CI[-16.7, -3.7]), were in a more chronic stage (t(121.9)=2.9, p = 0.005, 95%CI[974,427]), and suffered more often from a traumatic brain injury (χ2=6.8, p = 0.01) than UWS patients. The ROC analysis for both MS showed an AUC of 1 (cut-off:8.315, 100% specificity and sensitivity). The ROC analysis for the CRS-R total score showed an AUC of 0.94 (cut-off:9, sensitivity = 100%, specificity = 67%). A correlation was found between the CRSR total score and both the CRSR MS1 (r = 0.94, p < 0.0001, figure 1A) and CRSR MS2 (r = 0.96, p < 0.0001, figure 1B). The two CRS-R MS correlated (r = 0.96, p = 0.0001, figure 1C). CRSR MS1 and CRSR MS2 were drawn from the same distribution (D(124)= 0.13, p = 0.25). Discussion CRSR MS2 correlated strongly with the CRSR MS1, and perfectly discriminated UWS from MCS patients. As for accurate diagnosis the CRS-R should be repeated (preferably five times (Wannez et al., 2018)) short assessments are preferred, and possibly also reduce effects of fatigue. Second, the CRSR MS2 can be calculated with CRS-R assessments performed according to the CRS-R guidelines, facilitating its use in clinical environments, and in research settings where CRSR MS2 can be used pro- and retrospectively for research protocols. Furthermore, the results indicate that the two modified scores share the same distribution. This suggests that assessing all CRS-R items as proposed previously does not significantly contribute to the stratification of patients. The CRSR MS2 code is available via: Github A remaining limitation of the proposed score is that it does not allow to distinguish MCS minus (i.e. showing language independent signs of awareness, like visual pursuit) from MCS plus (i.e. showing language dependent signs of awareness) patients, or emergence from MCS. However, a clear consensus about the diagnostic criteria is needed before an updated modified score can be provided. In conclusion, the current analyses show that the calculation of the CRS-R modified score using the highest item in every subscale is valid for clinical diagnosis, and provides perspective for its use for research. Figure Figure 1. Correlation between the CRS-R total score and the CRS-R MS1 (1A), CRSR MS2 (1B), and between the two modified CRS-R scores (1C). MCS plus patients are here characterized by command following, intelligible verbalization and/or intentional communication. Acknowledgements This project has received funding from the University and University Hospital of Liege, the Belgian National Funds for Scientific Research (FRS-FNRS), the European Union’s Horizon 2020 Framework Programme for Research and Innovation under the Specific Grant Agreement No. 785907 (Human Brain Project SGA2) the Luminous project (EU-H2020-fetopenga686764), the Center-TBI project (FP7-HEALTH- 602150), the Public Utility Foundation ‘Université Européenne du Travail’, “Fondazione Europea di Ricerca Biomedica”, the Bial Foundation, the Mind Science Foundation and the European Commission, the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 778234, European Space Agency (ESA) and the Belgian Federal Science Policy Office (BELSPO) for their support in the framework of the PRODEX Programme. CC is a post-doctoral Marie Sklodowska-Curie fellow (H2020-MSCA-IF-2016-ADOC-752686), and SL is research director at FRS-FNRS. We are highly grateful to the members of the Liège Coma Science Group for their assistance in clinical evaluations, and we thank all the patients and their families and the Neurology department of the University hospital of Liège. [less ▲]

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See detailIs auditory localization a sign of consciousness? Evidence from neuroimaging and electrophysiology
Carrière, Manon ULiege; Cassol, Helena ULiege; Aubinet, Charlène ULiege et al

Conference (2019, March 16)

Background Auditory localization is often part of the clinical evaluation of patients recovering from coma. There is however no clear consensus whether it should be considered as a reflex or as a ... [more ▼]

Background Auditory localization is often part of the clinical evaluation of patients recovering from coma. There is however no clear consensus whether it should be considered as a reflex or as a conscious behavior. For example, auditory localisation corresponds to the diagnosis of unresponsive wakefulness syndrome (UWS) in the Coma Recovery Scale-Revised, while it is considered a sign of consciousness in other post-coma scales. This study aims to determine if auditory localization reflects conscious processing in patients with disorders of consciousness. Methods We first evaluated the proportion of patients with and without auditory localisation in 186 patients with severe brain injury, including 64 UWS, 28 minimally conscious minus (MCS-), 71 minimally conscious plus (MCS+), i.e., language relatively preserved) and 23 who emerged from MCS (EMCS). We then measured brain metabolism using fluorine-18 fluorodeoxyglucose positron emission tomography, functional connectivity using magnetic resonance imaging (MRI) and high-density electroencephalography (EEG) in patients in UWS with and without auditory localization. Findings Auditory localization was observed in 12% of patients in UWS, 46% of patients in MCS-, 62% of patients in MCS+ and 78% of patients in EMCS. Brain metabolism of patients in UWS without auditory localization was mostly restricted to primary areas, whereas a more widespread activity, including associative areas, was observed in patients in UWS with auditory localisation. Brain functional connectivity was also higher in patients in UWS with auditory localisation in the frontoparietal fMRI resting state network, along with higher EEG connectivity in alpha frequency band, compared to patients without auditory localization. Finally, differences were also found regarding the outcome, as the survival rate at two years appeared to be significantly higher in UWS patients with auditory localization as compared to those without auditory localization. Interpretation. Both clinical data in post-comatose patients and neuroimaging examinations in UWS patients with and without auditory localization support the idea that auditory localization should be considered as a sign of consciousness. [less ▲]

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See detailInternational validation of the Phone Outcome Questionnaire for patients with Disorders Of Consciousness
Wolff, Audrey ULiege; Estraneo, Anna; Noé, Quique et al

Poster (2019, March 15)

Assessing the evolution of severely brain-injured patients with disorders of consciousness (DOC) with current tools like the Glasgow Outcome Scale-Extended (GOS-E) remains a challenge. At the bedside, the ... [more ▼]

Assessing the evolution of severely brain-injured patients with disorders of consciousness (DOC) with current tools like the Glasgow Outcome Scale-Extended (GOS-E) remains a challenge. At the bedside, the most reliable diagnostic tool is currently the Coma Recovery Scale-Revised. The CRS-R distinguishes patients with unresponsive wakefulness syndrome (UWS) from patients in minimally conscious state (MCS) and patients who have emerged from MCS (EMCS). This international multi-centric study aims to validate a phone outcome questionnaire (POQ) based on the CRS-R and compare it to the CRS-R performed at the bedside and to the GOS-E which evaluates the level of disability and assigns patient’s in outcomes categories. The POQ will allow clinicians to probe the evolution of patient’s state of consciousness based on caregivers feedback. This research project is part of the International Brain Injury Association, Disorders of Consciousness-Special Interest Group (DOCSIG) and DOCMA consortium. [less ▲]

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See detailNociception Coma Scale Revised allows to identify patients with preserved neural basis for pain experience.
Bonin, Estelle ULiege; Lejeune, Nicolas; Thibaut, Aurore ULiege et al

Poster (2019, March 14)

The Nociception Coma Scale-Revised (NCS-R) was developed to help assessing pain in non-communicative patients with disorders of consciousness (DOC). Several studies have shown its sensitivity in assessing ... [more ▼]

The Nociception Coma Scale-Revised (NCS-R) was developed to help assessing pain in non-communicative patients with disorders of consciousness (DOC). Several studies have shown its sensitivity in assessing responses to acute noxious stimuli. However, they failed to determine a reliable cut-off score that could be used to infer pain processing in these patients. This retrospective cross-sectional study aimed to determine an NCS-R cut-off score supporting preserved neural basis for pain experience, based on brain metabolism as measured by fluorodeoxyglucose positron emission tomography (FDG-PET). We included FDG-PET confirmed patient with unresponsive wakefulness syndrome (UWS) (n=13) and looked at their highest NCS-R total scores. As the highest score was 4, we determined the cut-off of 5 and compared the brain metabolism of these patients with matched DOC patients with a cut-off score ≥ 5 (i.e., potential pain) and healthy controls. We found a higher global cerebral metabolism in healthy subjects compared with both patients’ groups and also in patients with potential pain compared with FDG-PET confirmed UWS. We observed a preserved metabolism in the left insula in patients with potential pain when compared with FDG-PET confirmed UWS. We also found a preservation of the connectivity between the left insula and the medial frontal gyrus in patients with potential pain compared with FDG-PET confirmed UWS. Our data suggest that using the cut-off score of 5 can be helpful to improve pain management in DOC patients. Future studies should focus on patients showing scores below this cut-off to better characterize their profile and improve cares. [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

in Neuroscience of Consciousness (2019), 5(1),

Some people report memories of near-death experiences (NDEs) after facing situations of impending death and these memories appear to have significant consequences on their lives (here referred to as “real ... [more ▼]

Some people report memories of near-death experiences (NDEs) after facing situations of impending death and these memories appear to have significant consequences on their lives (here referred to as “real NDE experiencers”; real NDErs). We assessed to what extent NDE memories are considered self-defining: memories that help people to define clearly how they see themselves. We screened 71 participants using the Greyson NDE scale (48 real NDErs and 23 NDErs-like who had lived a similar experience in absence of a threat to their life). Participants described their two main self-defining memories (SDMs). For each SDM, they completed the Centrality of Event Scale (CES) to assess how central the event is to their identity. The two subgroups 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). Real NDErs and NDErs-like who recalled their NDE (n ¼ 41) reported richer experiences as assessed by the Greyson NDE scale. Furthermore, these participants rated their NDE memory as more central to their identity as compared to other SDMs, and the richness of the NDE memory was positively associated to its centrality (CES scores). Overall, these findings suggest that the self-defining aspect of the experience might be related to its phenomenological content rather than its circumstances of occurrence. 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. [less ▲]

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See detailNeurochemical models of near-death experiences: a large-scale study based on the semantic similarity of written reports
Martial, Charlotte ULiege; Cassol, Helena ULiege; Charland-Verville, Vanessa ULiege et al

in Consciousness and Cognition (2019)

The real or perceived proximity to death often results in a non-ordinary state of consciousness characterized by phenomenological features such as the perception of leaving the body boundaries, feelings ... [more ▼]

The real or perceived proximity to death often results in a non-ordinary state of consciousness characterized by phenomenological features such as the perception of leaving the body boundaries, feelings of peace, bliss and timelessness, life review, the sensation of traveling through a tunnel and an irreversible threshold. Near-death experiences (NDEs) are comparable among individuals of different cultures, suggesting an underlying neurobiological mechanism. Anecdotal accounts of the similarity between NDEs and certain drug-induced altered states of consciousness prompted us to perform a large-scale comparative analysis of these experiences. After assessing the semantic similarity between ≈15,000 reports linked to the use of 165 psychoactive substances with 625 NDE narratives, we determined that the N-methyl-D-aspartate (NMDA) receptor antagonist ketamine consistently resulted in reports most similar to those associated with NDEs. Ketamine was followed by Salvia divinorum (a plant containing a potent and selective κ receptor agonist) and a series of serotonergic psychedelics, including the endogenous serotonin 2A receptor agonist N,N Dimethyltryptamine (DMT). This similarity was driven by semantic concepts related to consciousness of the self and the environment, but also by those associated with the therapeutic, ceremonial and religious aspects of drug use. Our analysis sheds light on the long-standing link between certain drugs and the experience of “dying“, suggests that ketamine could be used as a safe and reversible experimental model for NDE phenomenology, and supports the speculation that endogenous NMDA antagonists with neuroprotective properties may be released in the proximity of death. [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

in NeuroImage: Clinical (2019), 23

Increasing evidence links disorders of consciousness (DOC) with disruptions in functional connectivity between distant brain areas. However, to which extent the balance of brain network segregation and ... [more ▼]

Increasing evidence links disorders of consciousness (DOC) with disruptions in functional connectivity between distant brain areas. However, to which extent the balance of brain network segregation and integration is modified in DOC patients remains unclear. Using high-density electroencephalography (EEG), the objective of our study was to characterize the local and global topological changes of DOC patients' functional brain networks. Resting state high-density-EEG data were collected and analyzed from 82 participants: 61 DOC patients recovering from coma with various levels of consciousness (EMCS (n=6), MCS+ (n=29), MCS- (n=17) and UWS (n=9)), and 21 healthy subjects (i.e., controls). Functional brain networks in five different EEG frequency bands and the broadband signal were estimated using an EEG connectivity approach at the source level. Graph theory-based analyses were used to evaluate their relationship with decreasing levels of consciousness as well as group differences between healthy volunteers and DOC patient groups. Results showed that networks in DOC patients are characterized by impaired global information processing (network integration) and increased local information processing (network segregation) as compared to controls. The large-scale functional brain networks had integration decreasing with lower level of consciousness. [less ▲]

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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 detailCERVEAU ET CONSCIENCE: QUE NOUS DIT LA RECHERCHE ET L'ÉTUDE DES EXPÉRIENCES DE MORT IMMINENTE ?
Cassol, Helena ULiege

Conference given outside the academic context (2018)

Les expériences de mort imminente désignent un phénomène mental associant des éléments mystiques et spirituels, et survenant généralement suite à une situation de danger réel ou perçu. Ces expériences ... [more ▼]

Les expériences de mort imminente désignent un phénomène mental associant des éléments mystiques et spirituels, et survenant généralement suite à une situation de danger réel ou perçu. Ces expériences comprennent un ensemble de caractéristiques distinguables parmi lesquelles nous pouvons citer un sentiment de paix et de bien-être intenses, la sensation d’être hors de son corps physique et d’exister en dehors de lui, la vision d’une lumière brillante décrite par certains comme ayant une origine mystique et provoquant une attirance inexorable, une perception altérée du temps, ainsi que l’entrée dans un monde non terrestre. Les expériences de mort imminente sont de plus en plus rapportées comme reflétant une réalité physiologique et psychologique clairement identifiable d'importance clinique et scientifique. Cependant, la définition et les causes du phénomène ainsi que l'identification des « expérienceurs » (personnes ayant vécu ces expériences) sont encore sujettes à débat. Bien que le phénomène a été fréquemment décrit et exploité par les médias, son étude scientifique est plutôt récente et manque encore de données expérimentales rigoureuses. Au cours de cette conférence, nous tenterons de faire le point sur les recherches qui ont tenté de comprendre et de mieux décrire les expériences de mort imminente. [less ▲]

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See detailBrain, behavior, and cognitive interplay in disorders of consciousness: A multiple case study
Aubinet, Charlène ULiege; Murphy, Leslie; Bahri, Mohamed Ali ULiege et al

in Frontiers in Neurology (2018), 9(665), 1-10

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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 detailA multiple case study investigating the sub-categorization of the minimally conscious state
Aubinet, Charlène ULiege; Panda, Rajanikant ULiege; Cassol, Helena ULiege et al

Poster (2018, June 28)

The minimally conscious state (MCS) was sub-categorized in MCS+ and MCS- based on language-related behaviors (i.e., command-following, intelligible verbalization or intentional communication). Due to ... [more ▼]

The minimally conscious state (MCS) was sub-categorized in MCS+ and MCS- based on language-related behaviors (i.e., command-following, intelligible verbalization or intentional communication). Due to pronosis implications, it is important to detect signs of MCS+ and evaluate patients’ likelihood to recover such behaviors. We here aim to describe behavioral and neuroimaging data of severe brain-injured patients who evolved from MCS- to MCS+. Four patients were thus assessed at two time points by means of repeated Coma Recovery Scale-Revised. During their first week of assessments, they were diagnosed as MCS-. They later recovered language-related behaviors (i.e., MCS+), when reassessed during their second week of evaluations. All patients underwent a positron emission tomography (PET-scan) and magnetic resonance imaging (including voxel-based morphometry – VBM) exams during both weeks of assessments. We here compared the neuroimaging differences between the two exams in these four patients. PET-scan results showed that all patients presented partial recovery of metabolism in temporal lobules, reflecting compensation either from left-sided language areas or from their contralateral regions. VBM results showed that two patients presented a significant increase of grey matter volume, particularly concerning either bilateral frontal areas or the left caudate, which was related to memory, learning and language abilities. The other two patients did not show difference in grey matter structure between MCS- and MCS+. We conclude that the clinical evolution of patients from MCS- to MCS+ suggests the reappearance of language-based behavioral signs, but also the partial recovery of metabolism and grey matter structure in cerebral regions that are involved in language processing. All patients recovered signs of MCS+ at an advance chronic stage. These neuroimaging results highlight the remaining neuroplasticity in chronic MCS. [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 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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