The Clinical Diagnostic Utility of Electrophysiological Techniques in Assessment of Patients With Disorders of Consciousness Following Acquired Brain Injury: A Systematic Review.
Brain Injuries, Traumatic/complications/diagnosis/therapy; Clinical Decision-Making/methods; Consciousness Disorders/diagnosis/etiology; Electrodiagnosis/methods; Electrophysiology/methods; Female; Humans; Male; Prognosis; Sensitivity and Specificity; Severity of Illness Index
Abstract :
[en] 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.
Schnakers, Caroline; University of Oslo > Department of Psychology
Lovstad, Marianne
Language :
English
Title :
The Clinical Diagnostic Utility of Electrophysiological Techniques in Assessment of Patients With Disorders of Consciousness Following Acquired Brain Injury: A Systematic Review.
Publication date :
2017
Journal title :
Journal of Head Trauma Rehabilitation
ISSN :
0885-9701
eISSN :
1550-509X
Publisher :
Lippincott Williams & Wilkins, United States - Maryland
Tononi G, Koch C,. The neural correlates of consciousness: an update. Ann N Y Acad Sci. 2008; 1124: 239-261.
de Graaf TA, Hsieh PJ, Sack AT,. The "correlates" in neural correlates of consciousness. Neurosci Biobehav Rev. 2012; 36 (1): 191-197.
Fins JJ, Illes J, Bernat JL, Hirsch J, Laureys S, Murphy E,. Neuroimaging and disorders of consciousness: envisioning an ethical research agenda. Am J Bioeth. 2008; 8 (9): 3-12.
Block N, Carmel D, Fleming SM, Consciousness science: real progress and lingering misconceptions. Trends Cogn Sci. 2014; 18 (11): 556-557.
Stender J, Gosseries O, Bruno MA, Diagnostic precision of PET imaging and functional MRI in disorders of consciousness: a clinical validation study. Lancet (Lond, Engl). 2014; 384 (9942): 514-522.
Vanhaudenhuyse A, Demertzi A, Schabus M, Two distinct neuronal networks mediate the awareness of environment and of self. J Cogn Neurosci. 2011; 23 (3): 570-578.
Jang SH, Kwon HG,. The direct pathway from the brainstem reticular formation to the cerebral cortex in the ascending reticular activating system: a diffusion tensor imaging study. Neurosci Lett. 2015; 606: 200-203.
Boly M, Moran R, Murphy M, Connectivity changes underlying spectral EEG changes during propofol-induced loss of consciousness. J Neurosci. 2012; 32 (20): 7082-7090.
Laureys S, Celesia GG, Cohadon F, Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome. BMC Med. 2010; 8: 68.
Giacino JT, Ashwal S, Childs N, The minimally conscious state: definition and diagnostic criteria. Neurology. 2002; 58 (3): 349-353.
Giacino J, Whyte J,. The vegetative and minimally conscious states: current knowledge and remaining questions. J Head Trauma Rehabil. 2005; 20 (1): 30-50.
Bruno MA, Vanhaudenhuyse A, Thibaut A, Moonen G, Laureys S,. From unresponsive wakefulness to minimally conscious PLUS and functional locked-in syndromes: recent advances in our understanding of disorders of consciousness. J Neurol. 2011; 258 (7): 1373-1384.
Bruno MA, Majerus S, Boly M, Functional neuroanatomy underlying the clinical subcategorization of minimally conscious state patients. J Neurol. 2012; 259 (6): 1087-1098.
Di Perri C, Heine L, Amico E, Soddu A, Laureys S, Demertzi A,. Technology-based assessment in patients with disorders of consciousness. Ann Dell'Istituto Super di Sanita. 2014; 50 (3): 209-220.
Peterson A, Cruse D, Naci L, Weijer C, Owen AM,. Risk, diagnostic error, and the clinical science of consciousness. Neuro Image Clin. 2015; 7: 588-597.
Andrews K, Murphy L, Munday R, Littlewood C,. Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit. BMJ (Clin Res ed.). 1996; 313 (7048): 13-16.
Childs NL, Mercer WN, Childs HW,. Accuracy of diagnosis of persistent vegetative state. Neurology. 1993; 43 (8): 1465-1467.
Schnakers C, Vanhaudenhuyse A, Giacino J, Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment. BMC Neurol. 2009; 9: 35.
Giacino JT, Fins JJ, Laureys S, Schiff ND,. Disorders of consciousness after acquired brain injury: the state of the science. Nat Rev Neurol. 2014; 10 (2): 99-114.
Giacino JT, Katz DI, Whyte J,. Neurorehabilitation in disorders of consciousness. Semin Neurol. 2013; 33 (2): 142-156.
American Congress of Rehabilitation Medicine Brain Injury-Interdisciplinary Special Interest Group, Disorders of Consciousness Task Force, Seel RT, Sherer M, Assessment scales for disorders of consciousness: evidence-based recommendations for clinical practice and research. Arch Phys Med Rehabil. 2010; 91 (12): 1795-1813.
Laureys S, Boly M,. The changing spectrum of coma. Nat Clin Pract Neurol. 2008; 4 (10): 544-546.
Daltrozzo J, Wioland N, Mutschler V, Kotchoubey B,. Predicting coma and other low responsive patients outcome using event-related brain potentials: a meta-analysis. Clin Neurophysiol. 2007; 118 (3): 606-614.
Bodart O, Laureys S, Gosseries O,. Coma and disorders of consciousness: scientific advances and practical considerations for clinicians. Semin Neurol. 2013; 33 (2): 83-90.
Owen AM, Coleman MR, Boly M, Davis MH, Laureys S, Pickard JD,. Detecting awareness in the vegetative state. Science. 2006; 313 (5792): 1402.
Schnakers C, Giacino JT, Lovstad M, Preserved covert cognition in noncommunicative patients with severe brain injury? Neurorehabil Neural Repair. 2015; 29 (4): 308-317.
Schnakers C, Perrin F, Schabus M, Voluntary brain processing in disorders of consciousness. Neurology. 2008; 71 (20): 1614-1620.
Monti MM, Vanhaudenhuyse A, Coleman MR, Willful modulation of brain activity in disorders of consciousness. N Engl J Med. 2010; 362 (7): 579-589.
Bardin JC, Fins JJ, Katz DI, Dissociations between behavioural and functional magnetic resonance imaging-based evaluations of cognitive function after brain injury. Brain J Neurol. 2011; 134 (Pt 3): 769-782.
Monti MM, Coleman MR, Owen AM,. Neuroimaging and the vegetative state: resolving the behavioral assessment dilemma? Ann N Y Acad Sci. 2009; 1157: 81-89.
Owen AM, Schiff ND, Laureys S,. A new era of coma and consciousness science. Prog Brain Res. 2009; 177: 399-411.
Schnakers C,. Clinical assessment of patients with disorders of consciousness. Arch Ital Biol. 2012; 150 (2/3): 36-43.
Duncan CC, Barry RJ, Connolly JF, Event-related potentials in clinical research: guidelines for eliciting, recording, and quantifying mismatch negativity, P300, and N400. Clin Neurophysiol. 2009; 120 (11): 1883-1908.
Soltani M, Knight RT,. Neural origins of the P300. Crit Rev Neurobiol. 2000; 14 (3/4): 199-224.
Pfurtscheller G, Aranibar A,. Event-related cortical desynchronization detected by power measurements of scalp EEG. Electroencephalogr Clin Neurophysiol. 1977; 42 (6): 817-826.
Sauseng P, Klimesch W,. What does phase information of oscillatory brain activity tell us about cognitive processes? Neurosci Biobehav Rev. 2008; 32 (5): 1001-1013.
Noirhomme Q, Brecheisen R, Lesenfants D, Antonopoulos G, Laureys S,. "Look at my classifier's result": Disentangling unresponsive from (minimally) conscious patients. [published online ahead of Print 12, 2015]. Neuroimage. doi: 10.1016/j.neuroimage.2015.12.006.
Naci L, Monti MM, Cruse D, Brain-computer interfaces for communication with nonresponsive patients. Ann Neurol. 2012; 72 (3): 312-323.
Mills KR,. The basics of electromyography. J Neurol Neurosurg Psychiatry. 2005; 76 (suppl 2): ii32-ii35.
Enders H, Nigg BM,. Measuring human locomotor control using EMG and EEG: current knowledge, limitations and future considerations. Eur J Sport Sci. 2015: 1-11.
Owen AM,. Using functional magnetic resonance imaging and electroencephalography to detect consciousness after severe brain injury. Handb Clin Neurol. 2015; 127: 277-293.
Bender A, Jox RJ, Grill E, Straube A, Lule D,. Persistent vegetative state and minimally conscious state: a systematic review and meta-analysis of diagnostic procedures. Deutsches Arzteblatt Int. 2015; 112 (14): 235-242.
Kondziella D, Friberg CK, Frokjaer VG, Fabricius M, Moller K,. Preserved consciousness in vegetative and minimal conscious states: systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2016; 87 (5): 485-492.
Harrison AH, Connolly JF,. Finding a way in: a review and practical evaluation of fMRI and EEG for detection and assessment in disorders of consciousness. Neurosci Biobehav Rev. 2013; 37 (8): 1403-1419.
Luaute J, Maucort-Boulch D, Tell L, Long-term outcomes of chronic minimally conscious and vegetative states. Neurology. 2010; 75 (3): 246-252.
Gosseries O, Zasler ND, Laureys S,. Recent advances in disorders of consciousness: focus on the diagnosis. Brain Inj. 2014; 28 (9): 1141-1150.
Laureys S, Schiff ND,. Coma and consciousness: paradigms (re)framed by neuroimaging. Neuroimage. 2012; 61 (2): 478-491.
De Salvo S, Bramanti P, Marino S,. Clinical differentiation and outcome evaluation in vegetative and minimally conscious state patients: the neurophysiological approach. Funct Neurol. 2012; 28 (3): 155-162.
Luaute J, Morlet D, Mattout J,. BCI in patients with disorders of consciousness: clinical perspectives. Ann Phys Rehabil Med. 2015; 58 (1): 29-34.
Gawryluk JR, D'Arcy RC, Connolly JF, Weaver DF,. Improving the clinical assessment of consciousness with advances in electrophysiological and neuroimaging techniques. BMC Neurol. 2010; 10: 11.
Rosenbaum AM, Giacino JT,. Clinical management of the minimally conscious state. Handb Clin Neurol. 2015; 127: 395-410.
Kable AK, Pich J, Maslin-Prothero SE,. A structured approach to documenting a search strategy for publication: a 12 step guideline for authors. Nurse Educ Today. 2012; 32 (8): 878-886.
Moher D, Shamseer L, Clarke M, Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015; 4: 1.
Deeks JJ, Wisniewski S, Davenport C,. Chapter 4: Guide to the Contents of a Cochrane Diagnostic Test Accuracy Protocol. The Cochrane Collaboration; 2013. http://srdta.cochrane.org/.
Liberati A, Altman DG, Tetzlaff J, The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009; 6 (7): e1000100.
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group,. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009; 151 (4): 264-269, W264.
Shamseer L, Moher D, Clarke M, Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015; 349: g7647.
Whiting PF, Rutjes AW, Westwood ME, QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011; 155 (8): 529-536.
Gibson RM, Fernandez-Espejo D, Gonzalez-Lara LE, Multiple tasks and neuroimaging modalities increase the likelihood of detecting covert awareness in patients with disorders of consciousness. Front Hum Neurosci. 2014; 8: 950.
Horki P, Bauernfeind G, Klobassa DS, Detection of mental imagery and attempted movements in patients with disorders of consciousness using EEG. Front Hum Neurosci. 2014; 8: 1009.
Bekinschtein TA, Coleman MR, Niklison IJ, Pickard JD, Manes FF,. Can electromyography objectively detect voluntary movement in disorders of consciousness? J Neurol Neurosurg Psychiatry. 2008; 79 (7): 826-828.
Cruse D, Chennu S, Chatelle C, Relationship between etiology and covert cognition in the minimally conscious state. Neurology. 2012; 78 (11): 816-822.
Risetti M, Formisano R, Toppi J, On ERPs detection in disorders of consciousness rehabilitation. Front Hum Neurosci. 2013; 7: 775.
Faugeras F, Rohaut B, Weiss N, Event related potentials elicited by violations of auditory regularities in patients with impaired consciousness. Neuropsychologia. 2012; 50 (3): 403-418.
Rohaut B, Faugeras F, Chausson N, Probing ERP correlates of verbal semantic processing in patients with impaired consciousness. Neuropsychologia. 2015; 66: 279-292.
Sitt JD, King J-R, Karoui IEl, Large scale screening of neural signatures of consciousness in patients in a vegetative or minimally conscious state. Brain J Neurol. 2014; 137 (8): 2258-2270.
Habbal D, Gosseries O, Noirhomme Q, Volitional electromyographic responses in disorders of consciousness. Brain Inj. 2014; 28 (5/6): 533.
Lotte F, Congedo M, Lecuyer A, Lamarche F, Arnaldi B,. A review of classification algorithms for EEG-based brain-computer interfaces. J Neural Eng. 2007; 4 (2): R1-R13.
King J, Faugeras F, Gramfort A, Single-trial decoding of auditory novelty responses facilitates the detection of residual consciousness. NeuroImage. 2013; 83: 726-738.
Lechinger J, Chwala-Schlegel N, Fellinger R, Mirroring of a simple motor behavior in disorders of consciousness. Clin Neurophysiol. 2013; 124 (1): 27-34.
Pan J, Xie Q, He Y, Detecting awareness in patients with disorders of consciousness using a hybrid brain-computer interface. J Neural Eng. 2014; 11 (5): 056007.
Li Y, Pan J, He Y, Detecting number processing and mental calculation in patients with disorders of consciousness using a hybrid brain-computer interface system. BMC Neurol. 2015; 15: 259.
Cruse D, Chennu S, Chatelle C, Bedside detection of awareness in the vegetative state: a cohort study. The Lancet. 2011; 378 (9809): 2088-2094.
Fellinger R, Klimesch W, Schnakers C, Cognitive processes in disorders of consciousness as revealed by EEG time-frequency analyses. Clin Neurophysiol. 2011; 122 (11): 2177-2184.
Hauger SL, Schnakers C, Andersson S, Neurophysiological indicators of residual cognitive capacity in the minimally conscious state. Behav Neurol. 2015; 2015: 145913.
Lule D, Noirhomme Q, Kleih SC, Probing command following in patients with disorders of consciousness using a brain-computer interface. Clin Neurophysiol. 2013; 124 (1): 101-106.
Chennu S, Finoia P, Kamau E, Dissociable endogenous and exogenous attention in disorders of consciousness. NeuroImage Clin. 2013; 3: 450-461.
Real RG, Veser S, Erlbeck H, Information processing in patients in vegetative and minimally conscious states. Clin Neurophysiol. 2016; 127 (2): 1395-1402.
Pokorny C, Klobassa DS, Pichler G, The auditory P300-based single-switch brain-computer interface: paradigm transition from healthy subjects to minimally conscious patients. Artif Intell Med. 2013; 59 (2): 81-90.
Bekinschtein TA, Dehaene S, Rohaut B, Tadel F, Cohen L, Naccache L,. Neural signature of the conscious processing of auditory regularities. PNAS Proc Natl Acad Sci USA. 2009; 106 (5): 1672-1677.
Faugeras F, Rohaut B, Weiss N, Probing consciousness with event-related potentials in the vegetative state. Neurology. 2011; 77 (3): 264-268.
Fischer C, Dailler F, Morlet D,. Novelty P3 elicited by the subject's own name in comatose patients. Clin Neurophysiol. 2008; 119 (10): 2224-2230.
Fischer C, Luaute J, Morlet D,. Event-related potentials (MMN and novelty P3) in permanent vegetative or minimally conscious states. Clin Neurophysiol. 2010; 121 (7): 1032-1042.
Perrin F, Schnakers C, Schabus M, Brain response to one's own name in vegetative state, minimally conscious state, and locked-in syndrome. Arch Neurol. 2006; 63 (4): 562-569.
Cavinato M, Volpato C, Silvoni S, Sacchetto M, Merico A, Piccione F,. Event-related brain potential modulation in patients with severe brain damage. Clin Neurophysiol. 2011; 122 (4): 719-724.
Giacino JT, Schnakers C, Rodriguez-Moreno D, Kalmar K, Schiff N, Hirsch J,. Behavioral assessment in patients with disorders of consciousness: gold standard or fool's gold? Prog Brain Res. 2009; 177: 33-48.
Majerus S, Bruno MA, Schnakers C, Giacino JT, Laureys S,. The problem of aphasia in the assessment of consciousness in brain-damaged patients. Prog Brain Res. 2009; 177: 49-61.
Boly M, Coleman MR, Davis MH, When thoughts become action: an fMRI paradigm to study volitional brain activity in noncommunicative brain injured patients. Neuroimage. 2007; 36 (3): 979-992.
Weijer C, Peterson A, Webster F, Ethics of neuroimaging after serious brain injury. BMC Med Ethics. 2014; 15: 41.
Goldfine AM, Bardin JC, Noirhomme Q, Fins JJ, Schiff ND, Victor JD,. Reanalysis of Bedside detection of awareness in the vegetative state: a cohort study. Lancet (Lond Engl). 2013; 381 (9863): 289-291.
Cruse D, Chennu S, Chatelle C, Reanalysis of "Bedside detection of awareness in the vegetative state: A cohort study": authors' reply. Lancet. 2013; 381 (9863): 291-292.
Tzovara A, Simonin A, Oddo M, Rossetti AO, De Lucia M,. Neural detection of complex sound sequences in the absence of consciousness. Brain J Neurol. 2015; 138 (5): 1160-1166.
Naccache L, King JR, Sitt J, Neural detection of complex sound sequences or of statistical regularities in the absence of consciousness? Brain J Neurol. 2015; 138 (Pt 12): e395.
Tzovara A, Simonin A, Oddo M, Rossetti AO, De Lucia M,. Reply: Neural detection of complex sound sequences or of statistical regularities in the absence of consciousness? Brain J Neurol. 2015; 138 (Pt 12): e396.
Müller-Putz GR, Kaiser V, Solis-Escalante T, Pfurtscheller G,. Fast set-up asynchronous brain-switch based on detection of foot motor imagery in 1-channel EEG. Med Biol Eng Comput. 2010; 48 (3): 229-233.
Müller-Putz GR, Pokorny C, Klobassa DS, Horki P,. A single-switch BCI based on passive and imagined movements: toward restoring communication in minimally conscious patients. Int J Neural Syst. 2013; 23 (2): 1250037.
Newcombe RG,. Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med. 1998; 17 (8): 857-872.
