Prognostic Value of Resting-State Electroencephalography Structure in Disentangling Vegetative and Minimally Conscious States

Abstract

The result of this preliminary study demonstrates that structural strategy of EEG analysis is better suited for providing prognosis of consciousness recovery than existing methods of clinical assessment and of conventional EEG. Our results may be a starting point for developing reliable prognosticators in patients who are in a vegetative state, with the potential to improve their day-to-day management, quality of life, and access to early interventions.

Long-Term (Six Years) Clinical Outcome Discrimination of Patients in the Vegetative State Could be Achieved Based on the Operational Architectonics EEG Analysis: A Pilot Feasibility Study

“…To confirm the results presented in this article, future prospective studies with a larger group of patients for each state are warranted. Nevertheless, the preliminary results of the present study are strengthened by the fact that the characterizations of the states (VS/UWS, MCS and E-MCS) in terms of EEG operational architectonics revealed in the present study coincide precisely with our previous EEG studies of DOC patients [ 21 , 23 , 29 , 35 ]. Moreover, in trend analysis (linear regression) that has been used in the present study as a main statistical method, the observations (or units of analysis) relate to time periods (years, months, days) and not to individuals [ 62 ].…”

“…Phase shifts were eliminated by forward and backward filtering. The mentioned frequency bands were chosen based on our previous studies involving DOC patients [ 21 , 23 , 29 , 35 ] due to a fact that only these frequency oscillations have shown dynamics consistent with the analytical consciousness model [ 20 ]. According to this model (Fig.…”

“…Foremost, OA methodology was able to reliably discriminate (at the group level) between patients in VS/UWS and MCS independent of brain damage etiology, thus indicating that OA EEG parameters capture consciousness phenomenon itself rather than physiological parameters of brain damage [ 35 ]. Further, OA EEG parameters registered 3 months post-injury (in patients in VS/UWS) were able to reliably predict consciousness recovery 6 months post-injury [ 23 ].…”

Recommendations for Electroencephalography Monitoring in Neurocritical Care Units

“…Patients with higher approximate entropy often partially recovered consciousness (Evidence Class Ib). In 2013, a prospective study[23] including 14 VS patients in Europe showed that patients with decreased network connectivity (using linear EEG analysis) were prone to poor outcomes (Evidence Class Ib).…”

Silencing The Brain May Be Better Than Stimulating it. The GABA Effect

“…The degree of EEG abnormality usually reflects the severity of brain damage: grade I predicts an excellent prognosis for recovery of consciousness whereas grades IV and V are usually associated with a permanent VS or death. Similarly, a bilateral absence of somatosensory evoked cortical responses (N20) [28], as well as breakdown of EEG functional connectivity [29] are highly predictive of failure to regain consciousness and suggest a condition of permanent unconsciousness. [28,29].…”