Article (Scientific journals)
Auditory and somatosensory p3 are complementary for the assessment of patients with disorders of consciousness
Annen, Jitka; Mertel, I.; Xu, R. et al.
2020In Brain Sciences, 10 (10), p. 1-14
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Keywords :
Auditory evoked potentials; Disorders of consciousness; Multisensory stimulation; P3; Vibrotactile
Abstract :
[en] The evaluation of the level of consciousness in patients with disorders of consciousness (DOC) is primarily based on behavioural assessments. Patients with unresponsive wakefulness syndrome (UWS) do not show any sign of awareness of their environment, while minimally conscious state (MCS) patients show reproducible but fluctuating signs of awareness. Some patients, although with remaining cognitive abilities, are not able to exhibit overt voluntary responses at the bedside and may be misdiagnosed as UWS. Several studies investigated functional neuroimaging and neurophysiology as an additional tool to evaluate the level of consciousness and to detect covert command following in DOC. Most of these studies are based on auditory stimulation, neglecting patients suffering from decreased or absent hearing abilities. In the present study, we aim to assess the response to a P3-based paradigm in 40 patients with DOC and 12 healthy participants using auditory (AEP) and vibrotactile (VTP) stimulation. To this end, an EEG-based brain-computer interface was used at DOC patient’s bedside. We compared the significance of the P3 performance (i.e., the interpretation of significance of the evoked P3 response) as obtained by ‘direct processing’ (i.e., theoretical-based significance threshold) and ‘offline processing’ (i.e., permutation-based single subject level threshold). We evaluated whether the P3 performances were dependent on clinical variables such as diagnosis (UWS and MCS), aetiology and time since injury. Last we tested the dependency of AEP and VTP performances at the single subject level. Direct processing tends to overestimate P3 performance. We did not find any difference in the presence of a P3 performance according to the level of consciousness (UWS vs. MCS) or the aetiology (traumatic vs. non-traumatic brain injury). The performance achieved at the AEP paradigm was independent from what was achieved at the VTP paradigm, indicating that some patients performed better on the AEP task while others performed better on the VTP task. Our results support the importance of using multimodal approaches in the assessment of DOC patients in order to optimise the evaluation of patient’s abilities. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Research center :
CHU de Liège-Centre du Cerveau² - ULiège
Disciplines :
Author, co-author :
Annen, Jitka  ;  Université de Liège - ULiège > GIGA Consciousness-Coma Science Group
Mertel, I.;  Schoen Klinik Bad Aibling, Bad Aibling, 83043, Germany, Department of Clinical Psychology, University of Tuebingen, Tuebingen, 72074, Germany
Xu, R.;  Guger Technologies OG, Graz, 8020, Austria
Chatelle, Camille ;  GIGA Consciousness, Coma Science Group, University of Liege, Liege, 4000, Belgium, Centre du Cerveau (C2), University Hospital Liege, Liege, 4000, Belgium, Laboratory for NeuroImaging of Coma and Consciousness, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, 02114 MA, United States
Lesenfants, Damien ;  Université de Liège - ULiège > Service administratif de la Fac. (FPLSE)
Ortner, R.;  g.tec Medical Engineering, Barcelona, 08038, Spain
Bonin, Estelle  ;  Université de Liège - ULiège > GIGA Consciousness-Coma Science Group
Guger, C.;  Guger Technologies OG, Graz, 8020, Austria, g.tec Medical Engineering GmbH, Schiedlberg, 4521, Austria
Laureys, Steven  ;  Université de Liège - ULiège > GIGA Consciousness-Coma Science Group
Muller, Friedemann
Language :
Title :
Auditory and somatosensory p3 are complementary for the assessment of patients with disorders of consciousness
Publication date :
Journal title :
Brain Sciences
Publisher :
Volume :
Issue :
Pages :
Peer reviewed :
Peer Reviewed verified by ORBi
European Projects :
H2020 - 945539 - HBP SGA3 - Human Brain Project Specific Grant Agreement 3
Funders :
CHU Liège - Centre Hospitalier Universitaire de Liège [BE]
ULiège - Université de Liège [BE]
F.R.S.-FNRS - Fonds de la Recherche Scientifique [BE]
ESA - European Space Agency [FR]
BELSPO - Politique scientifique fédérale [BE]
FERB - Fondazione Europea Ricerca Biomedica [IT]
Bial Foundation [PT]
MSF - Mind Science Foundation [US-TX] [US-TX]
CE - Commission Européenne [BE]
the fund Generet
FRB - Fondation Roi Baudouin [BE]
DOCMA project [EU-H2020-MSCA–RISE–778234]
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