Caroline Schnakers1, Joseph T Giacino2, Marianne Løvstad3, Dina Habbal4, Melanie Boly4, Haibo Di5, Steve Majerus6, Steven Laureys4. 1. University Hospital of Liège, Liège, Belgium University of Liège, Liège, Belgium c.schnakers@gmail.com. 2. Spaulding Rehabilitation Hospital and Harvard Medical School, Boston, MA, USA JFK Johnson Rehabilitation Institute, Edison, NJ, USA. 3. Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway University of Oslo, Oslo, Norway. 4. University Hospital of Liège, Liège, Belgium University of Liège, Liège, Belgium. 5. Hangzhou Normal University, Hangzhou, China. 6. University of Liège, Liège, Belgium.
Abstract
BACKGROUND: Despite recent evidence suggesting that some severely brain-injured patients retain some capacity for top-down processing (covert cognition), the degree of sparing is unknown. OBJECTIVE: Top-down attentional processing was assessed in patients in minimally conscious (MCS) and vegetative states (VS) using an active event-related potential (ERP) paradigm. METHODS: A total of 26 patients were included (38 ± 12 years old, 9 traumatic, 21 patients >1 year postonset): 8 MCS+, 8 MCS-, and 10 VS patients. There were 14 healthy controls (30 ± 8 years old). The ERP paradigm included (1) a passive condition and (2) an active condition, wherein the participant was instructed to voluntarily focus attention on his/her own name. In each condition, the participant's own name was presented 100 times (ie, 4 blocks of 25 stimuli). RESULTS: In 5 MCS+ patients as well as in 3 MCS- patients and 1 VS patient, an enhanced P3 amplitude was observed in the active versus passive condition. Relative to controls, patients showed a response that was (1) widely distributed over frontoparietal areas and (2) not present in all blocks (3 of 4). In patients with covert cognition, the amplitude of the response was lower in frontocentral electrodes compared with controls but did not differ from that in the MCS+ group. CONCLUSION: The results indicate that volitional top-down attention is impaired in patients with covert cognition. Further investigation is crucially needed to better understand top-down cognitive functioning in this population because this may help refine brain-computer interface-based communication strategies.
BACKGROUND: Despite recent evidence suggesting that some severely brain-injured patients retain some capacity for top-down processing (covert cognition), the degree of sparing is unknown. OBJECTIVE: Top-down attentional processing was assessed in patients in minimally conscious (MCS) and vegetative states (VS) using an active event-related potential (ERP) paradigm. METHODS: A total of 26 patients were included (38 ± 12 years old, 9 traumatic, 21 patients >1 year postonset): 8 MCS+, 8 MCS-, and 10 VS patients. There were 14 healthy controls (30 ± 8 years old). The ERP paradigm included (1) a passive condition and (2) an active condition, wherein the participant was instructed to voluntarily focus attention on his/her own name. In each condition, the participant's own name was presented 100 times (ie, 4 blocks of 25 stimuli). RESULTS: In 5 MCS+ patients as well as in 3 MCS- patients and 1 VS patient, an enhanced P3 amplitude was observed in the active versus passive condition. Relative to controls, patients showed a response that was (1) widely distributed over frontoparietal areas and (2) not present in all blocks (3 of 4). In patients with covert cognition, the amplitude of the response was lower in frontocentral electrodes compared with controls but did not differ from that in the MCS+ group. CONCLUSION: The results indicate that volitional top-down attention is impaired in patients with covert cognition. Further investigation is crucially needed to better understand top-down cognitive functioning in this population because this may help refine brain-computer interface-based communication strategies.
Authors: John C O'Donnell; Kevin D Browne; Todd J Kilbaugh; H Isaac Chen; John Whyte; D Kacy Cullen Journal: Neurosci Biobehav Rev Date: 2018-12-11 Impact factor: 8.989
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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