Reference : A Heartbeat Away From Consciousness: Heart Rate Variability Entropy can discriminate ...
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A 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 mailto [Université de Liège - ULiège > > > Doct. sc. méd. (paysage)]
Larroque, Stephen Karl mailto [Université de Liège - ULiège > > GIGA : Coma Group >]
Bahri, Mohamed Ali mailto [Université de Liège - ULiège > > GIGA-CRC In vivo Imaging >]
Heine, Lizette mailto []
Martial, Charlotte mailto [Université de Liège - ULiège > > GIGA : Coma Group >]
Carrière, Manon mailto [Université de Liège - ULiège > > GIGA : Coma Group >]
Charland-Verville, Vanessa mailto [Université de Liège - ULiège > > GIGA-CRC In vivo Imaging >]
Aubinet, Charlène mailto [Université de Liège - ULiège > > GIGA : Coma Group >]
VANHAUDENHUYSE, Audrey mailto [Centre Hospitalier Universitaire de Liège - CHU > Département d'Anesthésie et réanimation > Centre interdisciplinaire d'algologie >]
Chatelle, Camille mailto [Université de Liège - ULiège > > GIGA : Coma Group >]
Laureys, Steven mailto [Université de Liège - ULiège > > GIGA : Coma Group >]
Di Perri, Carol mailto [Université de Liège - ULiège > > GIGA : Coma Group >]
Human Brain Project - International Conference - Understanding Consciousness
du 21 juin 2018 au 22 juin 2018
[en] 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.

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.
Coma Science Group
This research was supported by: University and Hospital of Liège, F.R.S.-F.N.R.S., French Speaking Community Concerted Research Action (ARC 12-17/01), Center-TBI (FP7-HEALTH- 602150), Human Brain Project (EU-H2020-fetflagship-hbp-sga1-ga720270), Luminous project (EU-H2020-fetopen-ga686764), James McDonnell Foundation, Mind Science Foundation, IAP research network P7/06 of the Belgian Government (Belgian Science Policy), Public Utility Foundation “Université Européenne du Travail”, "Fondazione Europea di Ricerca Biomedica", Bial Foundation, Belgian National Plan Cancer (139), European Space Agency, Belspo and European Commission.
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