Spatio-temporal analysis of EEG features during consciousness recovery in patients with disorders of consciousness

Lei, Ling; Liu, Kehong; Yang, Yong; Doubliez, Alice; Hu, Xiaohua; Xu, Ying; Zhou, Yixing

doi:10.1016/j.clinph.2021.08.027

Cited by 9 publications

(8 citation statements)

References 69 publications

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“…One of the most promising is Lempel-Ziv complexity (LZc; Lempel and Ziv, 1976 ) which specifically quantifies the rate at which non-redundant patterns appear in an EEG signal in time ( Boncompte et al, 2021 ). LZc has exhibited strong dependence on different states of consciousness, showing high values during wakefulness, and low values when consciousness is lost due to a variety of anesthetics ( Zhang et al, 2001 ), during non-REM sleep ( Massimini et al, 2005 ) and in disorders of consciousness ( Lei et al, 2022 ). Another information-based EEG measure that shows a strong relation with states of consciousness is permutation entropy (PE).…”

Section: Introductionmentioning

confidence: 99%

The effect of age on electroencephalogram measures of anesthesia hypnosis: A comparison of BIS, Alpha Power, Lempel-Ziv complexity and permutation entropy during propofol induction

Biggs

Boncompte

Pedemonte

et al. 2022

Front. Aging Neurosci.

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BackgroundImproving anesthesia administration for elderly population is of particular importance because they undergo considerably more surgical procedures and are at the most risk of suffering from anesthesia-related complications. Intraoperative brain monitors electroencephalogram (EEG) have proved useful in the general population, however, in elderly subjects this is contentious. Probably because these monitors do not account for the natural differences in EEG signals between young and older patients. In this study we attempted to systematically characterize the age-dependence of different EEG measures of anesthesia hypnosis.MethodsWe recorded EEG from 30 patients with a wide age range (19–99 years old) and analyzed four different proposed indexes of depth of hypnosis before, during and after loss of behavioral response due to slow propofol infusion during anesthetic induction. We analyzed Bispectral Index (BIS), Alpha Power and two entropy-related EEG measures, Lempel-Ziv complexity (LZc), and permutation entropy (PE) using mixed-effect analysis of variances (ANOVAs). We evaluated their possible age biases and their trajectories during propofol induction.ResultsAll measures were dependent on anesthesia stages. BIS, LZc, and PE presented lower values at increasing anesthetic dosage. Inversely, Alpha Power increased with increasing propofol at low doses, however this relation was reversed at greater effect-site propofol concentrations. Significant group differences between elderly patients (>65 years) and young patients were observed for BIS, Alpha Power, and LZc, but not for PE.ConclusionBIS, Alpha Power, and LZc show important age-related biases during slow propofol induction. These should be considered when interpreting and designing EEG monitors for clinical settings. Interestingly, PE did not present significant age differences, which makes it a promising candidate as an age-independent measure of hypnotic depth to be used in future monitor development.

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Section: Introductionmentioning

confidence: 99%

The effect of age on electroencephalogram measures of anesthesia hypnosis: A comparison of BIS, Alpha Power, Lempel-Ziv complexity and permutation entropy during propofol induction

Biggs

Boncompte

Pedemonte

et al. 2022

Front. Aging Neurosci.

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“…In particular, patients with MCS were characterized by more complex interactions between the activity of brain regions (Lee et al, 2019a ), and by higher variability and periodicity of spectral entropy over time (Piarulli et al, 2016 ). As shown by Lei et al ( 2022 ) in the longitudinal scheme, different entropy measures (Approximate Entropy, Sample Entropy, and Lempel-Ziv complexity) increased non-monotonically with the inflection point when the patients transferred from UWS to MCS. These results suggest that the transition from unconscious to conscious is not a linear phenomenon.…”

Section: Signal Complexity In Patients With Docmentioning

confidence: 81%

“…In turn, patients with MCS were usually characterized by stronger activity in higher bands (θ, α, β) and weaker in the δ band compared with UWS (Lechinger et al, 2013 ; Sitt et al, 2014 ; Naro et al, 2016 , 2018 ; Lei et al, 2022 ). Thibaut et al ( 2021 ) showed similar differences between patients with MCS* and UWS.…”

Section: Spectral Characteristics Of Eeg In Docmentioning

confidence: 99%

Brain Activity Characteristics of Patients With Disorders of Consciousness in the EEG Resting State Paradigm: A Review

Duszyk-Bogorodzka

Zieleniewska

Jankowiak-Siuda

2022

Front. Syst. Neurosci.

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The assessment of the level of consciousness in disorders of consciousness (DoC) is still one of the most challenging problems in contemporary medicine. Nevertheless, based on the multitude of studies conducted over the last 20 years on resting states based on electroencephalography (EEG) in DoC, it is possible to outline the brain activity profiles related to both patients without preserved consciousness and minimally conscious ones. In the case of patients without preserved consciousness, the dominance of low, mostly delta, frequency, and the marginalization of the higher frequencies were observed, both in terms of the global power of brain activity and in functional connectivity patterns. In turn, the minimally conscious patients revealed the opposite brain activity pattern—the characteristics of higher frequency bands were preserved both in global power and in functional long-distance connections. In this short review, we summarize the state of the art of EEG-based research in the resting state paradigm, in the context of providing potential support to the traditional clinical assessment of the level of consciousness.

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“…Since the recovery of consciousness is not only a dynamic process but also one that involves interaction among various regions of the brain ( Lei et al, 2022 ), the improvement of the brain functional network precedes the change in behavioral signs of awareness in DOC patients ( Bareham et al, 2020 ). It is speculated that HBO therapy restored the function of some brain cells and enhanced the connections among different brain regions.…”

Section: Discussionmentioning

confidence: 99%

“…However, the current clinical misdiagnosis rate of MCS as UWS/ VS is 41% ( Schnakers et al, 2009 ; Ye et al, 2020 ). When the patient’s level of consciousness shifts from UWS/ VS to MCS, there is an inflection point in electroencephalography (EEG) features ( Lei et al, 2022 ). An increasing number of studies have confirmed the role of hyperbaric oxygen (HBO) therapy in the process of awakening in patients with DOC ( Ye et al, 2020 ; Porcaro et al, 2022 ), and quantitative EEG (qEEG) can be applied to evaluate the effect of the HBO therapy course or intervention time on the curative effect of patients with cerebral resuscitation ( Ye et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

EEG microstate changes during hyperbaric oxygen therapy in patients with chronic disorders of consciousness

Wang

et al. 2023

Front. Neurosci.

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Hyperbaric oxygen (HBO) therapy is an effective treatment for patients with disorders of consciousness (DOC). In this study, real-time electroencephalogram (EEG) recordings were obtained from patients with DOC during HBO therapy. EEG microstate indicators including mean microstate duration (MMD), ratio of total time covered (RTT), global explained variance (GEV), transition probability, mean occurrence, and mean global field power (GFP) were compared before and during HBO therapy. The results showed that the duration of microstate C in all patients with DOC increased after 20 min of HBO therapy (p < 0.05). Further statistical analysis found that the duration of microstate C was longer in the higher CRS-R group (≥8, 17 cases) than in the lower group (<8, 24 cases) during HBO treatment. In the higher CRS-R group, the transition probabilities from microstate A to microstate C and from microstate C to microstate A also increased significantly compared with the probability before treatment (p < 0.05). Microstate C is generally considered to be related to a salience network; an increase in the transition probability between microstate A and microstate C indicates increased information exchange between the auditory network and the salience network. The results of this study show that HBO therapy has a specific activating effect on attention and cognitive control in patients and causes increased activity in the primary sensory cortex (temporal lobe and occipital lobe). This study demonstrates that real-time EEG detection and analysis during HBO is a clinically feasible method for assessing brain function in patients with DOC. During HBO therapy, some EEG microstate indicators show significant changes related to the state of consciousness in patients with chronic DOC. This will be complementary to important electrophysiological indicators for assessing consciousness and may also provide an objective foundation for the precise treatment of patients with DOC.

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Spatio-temporal analysis of EEG features during consciousness recovery in patients with disorders of consciousness

Cited by 9 publications

References 69 publications

The effect of age on electroencephalogram measures of anesthesia hypnosis: A comparison of BIS, Alpha Power, Lempel-Ziv complexity and permutation entropy during propofol induction

The effect of age on electroencephalogram measures of anesthesia hypnosis: A comparison of BIS, Alpha Power, Lempel-Ziv complexity and permutation entropy during propofol induction

Brain Activity Characteristics of Patients With Disorders of Consciousness in the EEG Resting State Paradigm: A Review

EEG microstate changes during hyperbaric oxygen therapy in patients with chronic disorders of consciousness

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