Reanalysis of “Bedside detection of awareness in the vegetative state: a cohort study”

Goldfine, Andrew M.; Bardin, Jonathan C.; Noirhomme, Quentin; Fins, Joseph J.; Schiff, Nicholas D.; Victor, Jonathan D.

doi:10.1016/s0140-6736(13)60125-7

Cited by 84 publications

(83 citation statements)

References 13 publications

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“…128 Other studies have used motor imagery to detect command-related EEG changes in MCS 129 and some rare VS cases 130 in the absence of overt motor behaviour. An independent re-analysis of the data from the latter study, 131 however, identified statistical flaws and failed to reproduce the initial findings, illustrating the challenge of developing reliable statistical classifiers of ERP data in DOC. Indeed, in the absence of a gold standard for measuring consciousness, 19,83 active functional neuroimaging or neurophysiological tools must strike a balance between avoidance of false-positive and false-negative errors.…”

Section: Electrophysiologymentioning

confidence: 95%

Disorders of consciousness after acquired brain injury: the state of the science

et al. 2014

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| The concept of consciousness continues to defy definition and elude the grasp of philosophical and scientific efforts to formulate a testable construct that maps to human experience. Severe acquired brain injury results in the dissolution of consciousness, providing a natural model from which key insights about consciousness may be drawn. In the clinical setting, neurologists and neurorehabilitation specialists are called on to discern the level of consciousness in patients who are unable to communicate through word or gesture, and to project outcomes and recommend approaches to treatment. Standards of care are not available to guide clinical decision-making for this population, often leading to inconsistent, inaccurate and inappropriate care. In this Review, we describe the state of the science with regard to clinical management of patients with prolonged disorders of consciousness. We review consciousness-altering pathophysiological mechanisms, specific clinical syndromes, and novel diagnostic and prognostic applications of advanced neuroimaging and electrophysiological procedures. We conclude with a provocative discussion of bioethical and medicolegal issues that are unique to this population and have a profound impact on care, as well as raising questions of broad societal interest.

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Section: Electrophysiologymentioning

confidence: 95%

Disorders of consciousness after acquired brain injury: the state of the science

et al. 2014

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“…These dependencies are lower for block designs ( Figure 4B) but can still be observed (e.g., Goldfine et al, 2013). The safest solution is to perform a cross-validation across independent fMRI measurement periods (runs) for both trialbased and block-based experiments (Mumford et al, 2014).…”

Section: Analyzing Patterned Fmri Signalsmentioning

confidence: 99%

A Primer on Pattern-Based Approaches to fMRI: Principles, Pitfalls, and Perspectives

Haynes

2015

Neuron

396

307

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Human fMRI signals exhibit a spatial patterning that contains detailed information about a person's mental states. Using classifiers it is possible to access this information and study brain processes at the level of individual mental representations. The precise link between fMRI signals and neural population signals still needs to be unraveled. Also, the interpretation of classification studies needs to be handled with care. Nonetheless, pattern-based analyses make it possible to investigate human representational spaces in unprecedented ways, especially when combined with computational modeling.

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“…The motor imagery task they employed, which the authors claim to have developed as 'novel', involves imagination of hand and foot movement and has in fact been used for over two decades in both basic research and in clinical research involving brain-computer interfaces in patients with motor and neuromuscular disorders (Kalcher et al, 1996;McFarland et al, 1997McFarland et al, , 2000Müller-Putz et al, 2005;Neuper et al, 2003;Penny et al, 2000;Pfurtscheller et al, 1993Pfurtscheller et al, , 2000Scherer et al, 2004;Wolpaw et al, 1991; for reviews see e.g., Neuper and Pfurtscheller, 1999;Neuper et al, 2006a,b;Wolpaw et al, 2002). Recently, a debate has arisen over the statistical methods employed by Cruse et al in a re-analysis of the study's data by Goldfine et al (2013) which suggests that Cruse et al's methods violate statistical assumptions and are biased towards falsely identifying awareness in VS patients. However Cruse et al's (2013) rebuttal argues that Goldfine and colleagues' methods are unsuitable for the data and equally error-prone in the opposite direction, making detection of awareness unlikely not only in patients, but also in a majority of healthy controls.…”

Section: Detection Of Awarenessmentioning

confidence: 99%

Finding a way in: A review and practical evaluation of fMRI and EEG for detection and assessment in disorders of consciousness

Harrison

Connolly

2013

Neuroscience & Biobehavioral Reviews

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Diagnoses and assessments of cognitive function in disorders of consciousness (DOC) are notoriously prone to error due to their reliance on behavioural measures. As a result, researchers have turned to functional neuroimaging and electrophysiological techniques with the goal of developing more effective methods of detecting awareness and assessing cognition in these patients. This article reviews functional magnetic resonance imaging (fMRI) and electroenchphalography (EEG)-based studies of cognition and consciousness in DOC, including assessment of basic sensory, perceptual, language, and emotional processing; studies for detection of conscious awareness; paradigms for the establishment of communication in the absence of behaviour; and functional connectivity studies. The advantages and limitations of fMRI and EEG-based measures are examined as research and clinical tools in this population and an explanation offered for the rediscovery of the unique advantages of EEG in the study of DOC.

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Reanalysis of “Bedside detection of awareness in the vegetative state: a cohort study”

Cited by 84 publications

References 13 publications

Disorders of consciousness after acquired brain injury: the state of the science

Disorders of consciousness after acquired brain injury: the state of the science

A Primer on Pattern-Based Approaches to fMRI: Principles, Pitfalls, and Perspectives

Finding a way in: A review and practical evaluation of fMRI and EEG for detection and assessment in disorders of consciousness

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