Article (Scientific journals)
Preserved Covert Cognition in Noncommunicative Patients With Severe Brain Injury?
Schnakers, Caroline; Giacino, Joseph T; Løvstad, Marianne et al.
2015In Neurorehabilitation and Neural Repair


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Keywords :
vegetative state, minimally conscious state, consciousness, attention, event-related potentials
Abstract :
[en] Background. Despite recent evidence suggesting that some severely brain-injured patients retain some capacity for topdown processing (covert cognition), the degree of sparing is unknown. Objective. Top-down attentional processing was assessed in patients in minimally conscious (MCS) and vegetative states (VS) using an active event-related potential (ERP) paradigm. Methods. A total of 26 patients were included (38 ± 12 years old, 9 traumatic, 21 patients >1 year postonset): 8 MCS+, 8 MCS−, and 10 VS patients. There were 14 healthy controls (30 ± 8 years old). The ERP paradigm included (1) a passive condition and (2) an active condition, wherein the participant was instructed to voluntarily focus attention on his/her own name. In each condition, the participant’s own name was presented 100 times (ie, 4 blocks of 25 stimuli). Results. In 5 MCS+ patients as well as in 3 MCS− patients and 1 VS patient, an enhanced P3 amplitude was observed in the active versus passive condition. Relative to controls, patients showed a response that was (1) widely distributed over frontoparietal areas and (2) not present in all blocks (3 of 4). In patients with covert cognition, the amplitude of the response was lower in frontocentral electrodes compared with controls but did not differ from that in the MCS+ group. Conclusion. The results indicate that volitional top-down attention is impaired in patients with covert cognition. Further investigation is crucially needed to better understand top-down cognitive functioning in this population because this may help refine brain-computer interface–based communication strategies.
Research center :
Centre, University of Liège and University Hospital of Liège, Sart Tilman,
Disciplines :
Neurosciences & behavior
Author, co-author :
Schnakers, Caroline ;  Université de Liège - ULiège
Giacino, Joseph T;  Spaulding Rehabilitation Hospital and Harvard Medical School, Boston,et JFK Johnson Rehabilitation Institute, Edison, NJ, USA
Løvstad, Marianne;  Spaulding Rehabilitation Hospital and Harvard Medical School, Boston,
Habbal, Dina ;  Université de Liège - ULiège > Doct. sc. médicales (Bologne)
Boly, Melanie;  Université de Liège - ULiège
Di, Haibo;  Hangzhou Normal University, Hangzhou, China
Majerus, Steve  ;  Université de Liège - ULiège > Département de Psychologie : cognition et comportement > Psychopathologie cognitive
Laureys, Steven  ;  Centre Hospitalier Universitaire de Liège - CHU > Neurologie Sart Tilman
Language :
Title :
Preserved Covert Cognition in Noncommunicative Patients With Severe Brain Injury?
Publication date :
Journal title :
Neurorehabilitation and Neural Repair
Publisher :
SAGE Science Press, United States - California
Name of the research project :
Preserved Covert Cognition in Noncommunicative Patients With Severe Brain Injury?
Available on ORBi :
since 31 March 2015


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