Autonomic reactivity to sensory stimulation is related to consciousness level after severe traumatic brain injury

Wijnen, V.J.M.; Heutink, Matagne; Boxtel, G.J.M. van; Eilander, H.J.; Gelder, Béatrice de

doi:10.1016/j.clinph.2006.03.006

Cited by 48 publications

(37 citation statements)

References 65 publications

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“…Researchers have examined heart rate variability in children and adults who have sustained severe or catastrophic brain injuries from trauma or other causes 83 – 87. Power spectral analysis of heart rate variability diminishes in proportion to the degree of neurological injury 88.…”

Section: Resultsmentioning

confidence: 99%

Contributions of neuroimaging, balance testing, electrophysiology and blood markers to the assessment of sport-related concussion

2009

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The current status of the diagnostic tests and investigations is analysed, and potential directions for future research are provided. Currently, all tests and investigations, with the exception of clinical balance testing, remain experimental. There is accumulating research, however, that shows promise for the future clinical application of functional magnetic resonance imaging in sport concussion assessment and management.

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Section: Resultsmentioning

confidence: 99%

Contributions of neuroimaging, balance testing, electrophysiology and blood markers to the assessment of sport-related concussion

2009

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“…The occurrence of a differential SCR response to the auditory presentation of the own name might indicate that the patient was attending her or his auditory environment. It is possible that the occurrence of SCR will occur in MCS and not in VS. Stimulation-induced SCR changes have been shown to correlate with the level of consciousness in severely brain damaged patients (Wijnen, Heutink, Boxtel, Eilander, & Gelder, 2006). Studies in healthy volunteers, however, have shown enhanced autonomic arousal in response to conscious as well as nonconscious stimuli (Williams et al, 2004).…”

Section: What Does a P300 Mean?mentioning

confidence: 99%

Functional connectivity in the default network during resting state is preserved in a vegetative but not in a brain dead patient

Boly¹,

Tshibanda²,

Vanhaudenhuyse³

et al. 2009

Human Brain Mapping

301

216

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The clinical and para-clinical examination of residual self-consciousness in non-communicative severely brain damaged patients (i.e., coma, vegetative state and minimally conscious state) remains exceptionally challenging. Passive presentation of the patient's own name and own face are known to be effective attention-grabbing stimuli when clinically assessing consciousness at the patient's bedside. Event-related potential and functional neuroimaging studies using such self-referential stimuli are currently being used to disentangle the cognitive hierarchy of self-processing. We here review neuropsychological, neuropathological, electrophysiological and neuroimaging studies using the own name and own face paradigm obtained in conscious waking, sleep, pharmacological coma, pathological coma and related disorders of consciousness. Based on these results we discuss what we currently do and do not know about the functional significance of the neural network involved in ''automatic'' and ''conscious'' self-referential processing.

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“…Functional status at discharge was assessed using the NIHSS and GOS. In order to quantify the level of consciousness (LOC) at discharge more accurately, the postacute LOC score [20,21] was retrospectively assessed based on the clinical examinations documented in the patient charts. This scale describes 8 stages, ranging from coma to conscious state: (1) coma: no reaction to stimuli; (2) hyporesponsive state: occasional delayed reflex response to stimuli; (3) reflexive responsive state: mass extensor or startle responses without habituation; (4) retracting reflexive state: single limb responses to stimulation, eye movements without focusing; (5) transitional state: more definite localizing to visual, auditory or tactile stimulation; (6) inconsistent low awareness state: inconsistent reactivity to simple commands; (7) consistent low awareness state: adequate reaction to simple commands, and (8) conscious state: adequate reaction to environment, good communication is possible, profound cognitive impairments can be present.…”

Section: Methodsmentioning

confidence: 99%

EEG Power Spectrum to Predict Prognosis after Hemicraniectomy for Space-Occupying Middle Cerebral Artery Infarction

et al. 2009

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Background: Early prediction of outcome after decompressive surgery for space-occupying middle cerebral artery (MCA) infarction is needed to guide further therapy. Here we applied spectral EEG analysis to determine the prognosis early after hemicraniectomy, while the patient is still treated in the intensive care unit. Methods: Continuous EEG monitoring following hemicraniectomy was performed in 10 patients with space-occupying MCA infarction. All patients were analgosedated and mechanically ventilated. The first 6 h of monitoring after surgery were evaluated by spectral analysis. Outcome measures included Glasgow Outcome Scale (GOS), Level of Consciousness Scale (LOC) and National Institute of Health Stroke Scale (NIHSS) at discharge. Outcome after 3 months was assessed by modified Rankin Scale. Results: Six patients displayed a peak at 5–10 Hz in the EEG power spectrum. All these patients had a GOS score of 3 and an LOC score ≧7 at discharge. In contrast, the 4 patients without faster EEG activity had a GOS of 2 and LOC ≤6. GOS (r = 1, p < 0.001), LOC (r = 0.89, p = 0.001) and NIHSS (r = –0.8; p < 0.01) at discharge significantly correlated with the presence of 5- to 10-Hz activity, but not with age, time to hemicraniectomy, duration of hospital stay or baseline NIHSS scores. Outcome after 3 months significantly correlated with age (r = 0.67; p < 0.05) and the presence of faster EEG activity (r = –0.76; p < 0.01). Conclusions: Spectral analysis in the subacute phase following hemicraniectomy may represent a parameter to predict early regain of consciousness and thus the capability and potential for further rehabilitation and favorable outcome.

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Autonomic reactivity to sensory stimulation is related to consciousness level after severe traumatic brain injury

Cited by 48 publications

References 65 publications

Contributions of neuroimaging, balance testing, electrophysiology and blood markers to the assessment of sport-related concussion

Contributions of neuroimaging, balance testing, electrophysiology and blood markers to the assessment of sport-related concussion

Functional connectivity in the default network during resting state is preserved in a vegetative but not in a brain dead patient

EEG Power Spectrum to Predict Prognosis after Hemicraniectomy for Space-Occupying Middle Cerebral Artery Infarction

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