The Clinical Diagnostic Utility of Electrophysiological Techniques in Assessment of Patients With Disorders of Consciousness Following Acquired Brain Injury: A Systematic Review

Abstract

We are still far from establishing precise recommendations for standardized electrophysiological diagnostic procedures in DoC, but electrophysiological methods may add supplemental diagnostic information of covert cognition in some patients with DoC.

Multicentre registry of brain-injured patients with disorder of consciousness: rationale and preliminary data

“…Instead, fields related to data not routinely collected in the rehabilitation unit setting (Estraneo et al, 2013) are not mandatory notwithstanding their possible diagnostic (e.g. ERP, Hauger et al, 2017) or prognostic value (SEP, Estraneo et al, 2013). Indeed, there is currently a lack of national/international guidelines/recommendations about diagnostic and prognostic procedures for DoC patients , and in a scenario frequently characterised by a dearth of equipment and human resources (Sattin et al, 2017), some potentially useful neurophysiological or neuroimaging examinations are not routinely carried out in rehabilitation units.…”

Motor Attempt EEG Paradigm as a Diagnostic Tool for Disorders of Consciousness

“…CMD encompasses patients that, due to a complete absence of meaningful motor output, would be classified as UWS or marginal MCS based on clinical criteria, but nevertheless exhibit command-following behavior evident in brain signal responses [7]. Although functional brain imaging like Positron Emission Tomography (PET) [8] and functional Magnetic Resonance Imaging (fMRI) have provided the first breakthroughs [9] and are still preferred for their high spatial resolution, electroencephalography (EEG)-based assessment of consciousness offers a number of practical advantages (portability, low price, less contraindications), thus holding great promise for bedside detection of awareness [10]- [12].…”

Assessment and Intervention with Patients with Severe Disorders of Consciousness

“…Evidence of P300 responses and mismatch negativity has been generally considered a signal of the patient's potential abilities in terms of awareness/consciousness with relevant implications for his or her recovery process (Blume et al 2015;Fischer et al 2010;Lugo et al 2016;Risetti et al 2013;Vanhaudenhuyse et al 2008;Wijnen et al 2007). In a partial revision of this view, recent literature cautions about the reliability and predictive value of P300 and mismatch negativity (Hauger et al 2017) and emphasizes the advantages of using multiple/different measures to improve the representativeness of the findings (Sergent et al 2017).…”

“…Those procedures indicate diverse types of emphasis and theoretical backgrounds, which have clear implications (a) for the role of the assessment (for deciding whether the functioning level of the patient should be determined prior to the intervention) and (b) for the role of the patient within the intervention program set up for him or her (Hauger et al 2015(Hauger et al , 2017Lancioni et al 2014a). The goal of this paper is to reflect on both assessment and intervention by providing a brief account of main assessment and intervention procedures, drawing general considerations about their usability and potential, and envisaging possible lines of progress in those areas.…”