Davide Rossi Sebastiano1, F Panzica1, E Visani1, F Rotondi2, V Scaioli1, M Leonardi3, D Sattin3, L D'Incerti4, E Parati5, Luigi Ferini Strambi6, S Franceschetti7. 1. Department of Neurophysiology-Epilepsy Center, C. Besta Foundation Neurological Institute, Milan, Italy. 2. Department of Neurophysiology-Epilepsy Center, C. Besta Foundation Neurological Institute, Milan, Italy; Department of Informatics, Bioengineering, Robotics and System Engineering, University of Genova, Genova, Italy. 3. Unit of Neurology, Public Health, Disability Unit, C. Besta Foundation Neurological Institute, Milan, Italy. 4. Department of Neuroradiology, C. Besta Foundation Neurological Institute, Milan, Italy. 5. Department of Cerebrovascular Diseases, C. Besta Foundation Neurological Institute, Milan, Italy. 6. Sleep Disorders Center, Università Vita-Salute San Raffaele, Milan, Italy. 7. Department of Neurophysiology-Epilepsy Center, C. Besta Foundation Neurological Institute, Milan, Italy. Electronic address: franceschetti@istituto-besta.it.
Abstract
OBJECTIVE: The aim of this study was to verify the value of multiple neurophysiological tests in classifying disorders of consciousness (DOCs) in patients in a chronic vegetative or minimal consciousness state categorised on the basis of the Coma Recovery Scale (CRS). METHODS: The study included 142 patients, all of whom underwent long (18h) EEG-polygraphic recordings including one night. The EEG was scored using the Synek scale and sleep patterns using an arbitrary scale. Absolute total power and relative EEG power were evaluated in different frequency bands. Multimodal evoked potentials (EPs), including auditory event-related potentials, were also evaluated and scored. RESULTS: The most information came from the combined multimodal EPs and sleep EEG scores. A two-step cluster analysis based on the collected information allowed a satisfactory evaluation of DOC severity. Spectral EEG properties seemed to be significantly related to DOC classes and CRS scores, but did not seem to make any significant additional contribution to DOC classification. CONCLUSIONS: Multiple electrophysiological evaluations based on EEG, sleep polygraphic recordings and multimodal EPs are helpful in assessing DOC severity and residual functioning in patients with chronic DOCs. SIGNIFICANCE: Simple electrophysiological measures that can be easily applied at patients' bedsides can significantly contribute to the recognition of DOC severity in chronic patients surviving a severe brain injury.
OBJECTIVE: The aim of this study was to verify the value of multiple neurophysiological tests in classifying disorders of consciousness (DOCs) in patients in a chronic vegetative or minimal consciousness state categorised on the basis of the Coma Recovery Scale (CRS). METHODS: The study included 142 patients, all of whom underwent long (18h) EEG-polygraphic recordings including one night. The EEG was scored using the Synek scale and sleep patterns using an arbitrary scale. Absolute total power and relative EEG power were evaluated in different frequency bands. Multimodal evoked potentials (EPs), including auditory event-related potentials, were also evaluated and scored. RESULTS: The most information came from the combined multimodal EPs and sleep EEG scores. A two-step cluster analysis based on the collected information allowed a satisfactory evaluation of DOC severity. Spectral EEG properties seemed to be significantly related to DOC classes and CRS scores, but did not seem to make any significant additional contribution to DOC classification. CONCLUSIONS: Multiple electrophysiological evaluations based on EEG, sleep polygraphic recordings and multimodal EPs are helpful in assessing DOC severity and residual functioning in patients with chronic DOCs. SIGNIFICANCE: Simple electrophysiological measures that can be easily applied at patients' bedsides can significantly contribute to the recognition of DOC severity in chronic patients surviving a severe brain injury.
Authors: Betty Wutzl; Stefan M Golaszewski; Kenji Leibnitz; Patrick B Langthaler; Alexander B Kunz; Stefan Leis; Kerstin Schwenker; Aljoscha Thomschewski; Jürgen Bergmann; Eugen Trinka Journal: Brain Sci Date: 2021-05-25