Quantitative EEG analysis in minimally conscious state patients during postural changes

Abstract

Mobilization and postural changes of patients with cognitive impairment are standard clinical practices useful for both psychic and physical rehabilitation process. During this process, several physiological signals, such as Electroen-cephalogram (EEG), Electrocardiogram (ECG), Photopletysmography (PPG), Respiration activity (RESP), Electrodermal activity (EDA), are monitored and processed. In this paper we investigated how quantitative EEG (qEEG) changes with postural modifications in minimally conscious state patients. This study is quite novel and no similar experimental data can be found in the current literature, therefore, although results are very encouraging, a quantitative analysis of the cortical area activated in such postural changes still needs to be deeply investigated. More specifically, this paper shows EEG power spectra and brain symmetry index modifications during a verticalization procedure, from 0 to 60 degrees, of three patients in Minimally Consciousness State (MCS) with focused region of impairment. Experimental results show a significant increase of the power in β band (12 - 30 Hz), commonly associated to human alertness process, thus suggesting that mobilization and postural changes can have beneficial effects in MCS patients.

A systematic review of head-up tilt to improve consciousness in people with a prolonged disorder of consciousness

“…The total number of participants included was 264, with 159 males and 105 females. Bartolo et al 16 had the largest sample size of 102 and Greco et al 17 the smallest with three participants. The majority of studies had 16 participants or fewer.…”

“…Taveggia et al 20 completed a change in tilt every 10 minutes from 30° to 65° and then maintained this elevation for 30-minutes. Greco et al 17 raised the tilt-table every five minutes. Riberholt et al 21 performed elevation to 30°, 60° and then 80° in 60-second intervals.…”

“…The duration of head-up tilt for single treatments was between 10 and 20 minutes. 17 , 18 , 21 Two studies did not report a specific duration. 4 , 19 For head-up tilt treatment regimes, the duration of inclination varied between 30 minutes 22 , 23 and an hour of net therapy time.…”

“…Standing was achieved via tilt-table in five studies. 18 , 19 , 21 , 23 Greco et al 17 used solely the Erigo with their participants. Three studies compared the effects of the tilt-table and Erigo 20 , 24 and one study compared the effects of the Erigo to a control group.…”

Role of Acupuncture in the Management of Severe Acquired Brain Injuries (sABIs)

“…Several nonpharmacological strategies have been utilized. Early verticalization has been shown to increase the spectral power of the EEG higher frequencies and the subject's arousal [ 7 , 8 ], probably enhancing vestibular afference on locus coeruleus, raphe, and thalamic intralaminar nuclei. Enriched environment, equipped with emotional stimuli and biographically meaningful objects, showed greater range of behavioural responses [ 9 ].…”