Probing consciousness in a sensory-disconnected paralyzed patient.

Brain/physiopathology; Consciousness Disorders/diagnosis/physiopathology; Electroencephalography; Functional Neuroimaging; Humans; Male; Middle Aged; Quadriplegia/physiopathology; brain functional imagery; consciousness; disorder of consciousness; locked-in syndrome; quantitative EEG

Abstract :

[en] BACKGROUND: Diagnosis of consciousness can be very challenging in some clinical situations such as severe sensory-motor impairments. CASE STUDY: We report the case study of a patient who presented a total "locked-in syndrome" associated with and a multi-sensory deafferentation (visual, auditory and tactile modalities) following a protuberantial infarction. RESULT: In spite of this severe and extreme disconnection from the external world, we could detect reliable evidence of consciousness using a multivariate analysis of his high-density resting state electroencephalogram. This EEG-based diagnosis was eventually confirmed by the clinical evolution of the patient. CONCLUSION: This approach illustrates the potential importance of functional brain-imaging data to improve diagnosis of consciousness and of cognitive abilities in critical situations in which the behavioral channel is compromised such as deafferented locked-in syndrome.

Disciplines :

Neurology

Author, co-author :

Rohaut, Benjamin

Raimondo, Federico ; Université de Liège - ULiège > Consciousness-Coma Science Group

Galanaud, Damien

Valente, Melanie

Sitt, Jacobo Diego

Naccache, Lionel

Language :

English

Title :

Probing consciousness in a sensory-disconnected paralyzed patient.

Publication date :

2017

Journal title :

Brain Injury

ISSN :

0269-9052

eISSN :

1362-301X

Publisher :

Taylor and Francis, Abingdon, United Kingdom

Volume :

Issue :

Pages :

1398-1403

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 17 January 2020

Statistics

Number of views

34 (1 by ULiège)

Number of downloads

1 (1 by ULiège)

More statistics

Scopus citations^®

Scopus citations^®
without self-citations

OpenCitations

Bibliography

Rohaut B, Faugeras F, Naccache L., Neurology of consciousness impairments. In: Stevens RD, Sharshar T and Ely EW, editors. Brain disorders in critical illness. Cambridge, UK: Cambridge University Press; 2013.
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.
Owen AM, Owen AM, Coleman MR, Coleman MR, Boly M, Boly M, Davis MH, Davis MH, Laureys S, Laureys S, et al. Detecting awareness in the vegetative state. Science. 2006;313:2006.
Cruse D, Chennu S, Chatelle C, Bekinzschtein TA, Fernández-Espejo D, Pickard JD, Laureys S, Owen AM., Bedside detection of awareness in the vegetative state: a cohort study. Lancet. 2011;378(9809):2088–94.
Bekinschtein TA, Dehaene S, Rohaut B, Tadel F, Cohen L, Naccache L., Neural signature of the conscious processing of auditory regularities. Proc Natl Acad Sci. 2009;106(5):1672–7.
Faugeras F, Rohaut B, Weiss N, Bekinschtein TA, Galanaud D, Puybasset L, Bolgert F, Sergent C, Cohen L, Dehaene S, et al. Probing consciousness with event-related potentials in the vegetative state. Neurology. 2011;77(3):264–8.
Barr J, Fraser GL, Puntillo K, Ely EW, Gélinas C, Dasta JF, Davidson JE, Devlin JW, Kress JP, Jofe AM, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit: Executive summary. Am J Health-Syst Pharmacy. 2013;70(1):53–8.
Luyt C-E, Galanaud D, Perlbarg V, Vanhaudenhuyse A, Stevens RD, Gupta R, Besancenot H, Krainik A, Audibert G, Combes A, et al. Diffusion tensor imaging to predict long-term outcome after cardiac arrest: a bicentric pilot study. Anesthesiology. 2012;117(6):1311–21.
Faugeras F, Rohaut B, Weiss N, Bekinschtein T, Galanaud D, Puybasset L, Bolgert F, Sergent C, Cohen L, Dehaene S, et al. Event related potentials elicited by violations of auditory regularities in patients with impaired consciousness. Neuropsychologia. 2012;50(3):403–18.
Sitt JD, King JR, El Karoui I, Rohaut B, Faugeras F, Gramfort A, Cohen L, Sigman M, Dehaene S, Naccache L., Large scale screening of neural signatures of consciousness in patients in a vegetative or minimally conscious state. Brain. 2014;137(8):2258–70.
Engemann D, Raimondo F, King J-R, Jas M, Gramfort A, Dehaene S, Naccache L, Sitt J., Automated measurement and prediction of consciousness in vegetative and minimally conscious patients. ICML Workshop on Statistics, Machine Learning and Neuroscience (Stamlins 2015). 2015.
King JR, Sitt JD, Faugeras F, Rohaut B, El Karoui I, Cohen L, Naccache L, Dehaene S., Information sharing in the brain indexes consciousness in noncommunicative patients. Curr Biol. 2013;23(19):1914–9.
Giacino JT, Kalmar K, Whyte J., The JFK coma recovery scale-revised: Measurement characteristics and diagnostic utility. Arch Phys Med Rehabil. 2004;85(12):2020–9.
Dehaene S, Changeux JP, Naccache L, Sackur J, Sergent C., Conscious, preconscious, and subliminal processing: a testable taxonomy. Trends Cognit Sci. 2006;10(5):204–11.
Wang Z, Bovik AC, Sheikh HR, Simoncelli EP., Image quality assessment: From error visibility to structural similarity. IEEE Trans Image Process. 2004;13(4):600–12.
Gramfort A, Luessi M, Larson E, Engemann DA, Strohmeier D, Brodbeck C, Goj R, Jas M, Brooks T, Parkkonen L, et al. MEG and EEG data analysis with MNE-Python. Frontiers in Neuroscience. 2013;7:267.
Gramfort A, Luessi M, Larson E, Engemann DA, Strohmeier D, Brodbeck C, Parkkonen L, Hämäläinen MS., MNE software for processing MEG and EEG data. NeuroImage. 2014;86:446–60.
Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D., The CARE Guidelines: Consensus-based Clinical Case Reporting Guideline Development. Global Adv Health Med. 2013;2(5):38–43.
Carrai R, Grippo A, Fossi S, Campolo MC, Lanzo G, Pinto F, Amantini A., Transient post-traumatic locked-in syndrome: A case report and a literature review. Neurophysiol Clin. 2009;39(2).
Schnakers C, Perrin F, Schabus M, Hustinx R, Majerus S, Moonen G, Boly M, Vanhaudenhuyse A, Bruno M-A, Laureys S., Detecting consciousness in a total locked-in syndrome: an active event-related paradigm. Neurocase. 2009;15(4):271–7.
John ER, Halper JP, Lowe RS, Merkin H, Defina P, Prichep LS., Source imaging of QEEG as a method to detect awareness in a person in vegetative state. Brain injury. 2011;25(4):426–32.
Pistoia F, Carolei A, Iacoviello D, Petracca A, Sacco S, Sarà M, Spezialetti M, Placidi G., EEG-detected olfactory imagery to reveal covert consciousness in minimally conscious state. Brain Inj. 2015;29(13–14):1729–35.
Aslaksen PM, Vangberg TR, Schäfer C., Probing for consciousness after severe brain injury by functional magnetic resonance imaging (fMRI). J Neurol. 2012;259(3):576–8.
Rosanova M, Gosseries O, Casarotto S, Boly M, Casali AG, Bruno MA, Mariotti M, Boveroux P, Tononi G, Laureys S, et al. Recovery of cortical effective connectivity and recovery of consciousness in vegetative patients. Brain. 2012;135(4):1308–20.