Electromyographic decoding of response to command in disorders of consciousness

Article; Adolescent; Adult; Aged; Child; Cohort Studies; Consciousness Disorders; Electromyography; Female; Humans; Male; Middle Aged; Motor Activity; Muscle, Skeletal; Neuropsychological Tests; Point-of-Care Testing; Speech Perception; Upper Extremity; Young Adult

Abstract :

[en] Objective: To propose a new methodology based on single-trial analysis for detecting residual response to command with EMG in patients with disorders of consciousness (DOC), overcoming the issue of trial dependency and decreasing the influence of a patient's fluctuation of vigilance or arousal over time on diagnostic accuracy. Methods: Forty-five patients with DOC (18 with vegetative/unresponsive wakefulness syndrome [VS/UWS], 22 in a minimally conscious state [MCS], 3 who emerged from MCS [EMCS], and 2 with locked-in syndrome [LIS]) and 20 healthy controls were included in the study. Patients were randomly instructed to either move their left or right hand or listen to a control command ("It is a sunny day") while EMG activity was recorded on both arms. Results: Differential EMG activity was detected in all MCS cases displaying reproducible response to command at bedside on multiple assessments, even though only 6 of the 14 individuals presented a behavioral response to command on the day of the EMG assessment. An EMG response was also detected in all EMCS and LIS patients, and 2 MCS patients showing nonreflexive movements without command following at the bedside. None of the VS/UWS presented a response to command with this method. Conclusions: This method allowed us to reliably distinguish between different levels of consciousness and could potentially help decrease diagnostic errors in patients with motor impairment but presenting residual motor activity. © 2016 American Academy of Neurology.

Disciplines :

Neurology
Neurosciences & behavior

Author, co-author :

Lesenfants, Damien ^✱; Université de Liège - ULiège > Service administratif de la Fac. (FPLSE)

Habbal, Dina ^✱; Coma Science Group, GIGA-Research, CHU University Hospital of Liège, Belgium

Chatelle, Camille ; Université de Liège - ULiège > GIGA : Coma Group

Schnakers, Caroline ; Department of Neurosurgery, UCLA, Los Angeles, CA, United States

Laureys, Steven ; Université de Liège - ULiège > GIGA : Coma Group

Noirhomme, Quentin ; Université de Liège - ULiège > Centre de recherches du cyclotron

^✱ These authors have contributed equally to this work.

Language :

English

Title :

Electromyographic decoding of response to command in disorders of consciousness

Publication date :

2016

Journal title :

Neurology

ISSN :

0028-3878

eISSN :

1526-632X

Publisher :

Lippincott Williams and Wilkins

Volume :

Issue :

Pages :

2099-2107

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 15 January 2019

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