Significance of multiple neurophysiological measures in patients with chronic disorders of consciousness

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Abstract

Objective: The aim of this study was to verify the value of multiple neurophysiological tests in classifying disorders of consciousness (DOCs) in patients in a chronic vegetative or minimal consciousness state categorised on the basis of the Coma Recovery Scale (CRS). Methods: The study included 142 patients, all of whom underwent long (18. h) EEG-polygraphic recordings including one night. The EEG was scored using the Synek scale and sleep patterns using an arbitrary scale. Absolute total power and relative EEG power were evaluated in different frequency bands. Multimodal evoked potentials (EPs), including auditory event-related potentials, were also evaluated and scored. Results: The most information came from the combined multimodal EPs and sleep EEG scores. A two-step cluster analysis based on the collected information allowed a satisfactory evaluation of DOC severity. Spectral EEG properties seemed to be significantly related to DOC classes and CRS scores, but did not seem to make any significant additional contribution to DOC classification. Conclusions: Multiple electrophysiological evaluations based on EEG, sleep polygraphic recordings and multimodal EPs are helpful in assessing DOC severity and residual functioning in patients with chronic DOCs. Significance: Simple electrophysiological measures that can be easily applied at patients' bedsides can significantly contribute to the recognition of DOC severity in chronic patients surviving a severe brain injury.

Original languageEnglish
Pages (from-to)558-564
Number of pages7
JournalClinical Neurophysiology
Volume126
Issue number3
DOIs
Publication statusPublished - Mar 1 2015

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Consciousness Disorders
Electroencephalography
Evoked Potentials
Sleep
Coma
Auditory Evoked Potentials
Consciousness
Brain Injuries
Cluster Analysis

Keywords

  • Cluster analysis
  • Disorders of consciousness
  • EEG
  • Evoked potentials
  • Relative power
  • Sleep score

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Physiology (medical)
  • Sensory Systems
  • Medicine(all)

Cite this

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title = "Significance of multiple neurophysiological measures in patients with chronic disorders of consciousness",
abstract = "Objective: The aim of this study was to verify the value of multiple neurophysiological tests in classifying disorders of consciousness (DOCs) in patients in a chronic vegetative or minimal consciousness state categorised on the basis of the Coma Recovery Scale (CRS). Methods: The study included 142 patients, all of whom underwent long (18. h) EEG-polygraphic recordings including one night. The EEG was scored using the Synek scale and sleep patterns using an arbitrary scale. Absolute total power and relative EEG power were evaluated in different frequency bands. Multimodal evoked potentials (EPs), including auditory event-related potentials, were also evaluated and scored. Results: The most information came from the combined multimodal EPs and sleep EEG scores. A two-step cluster analysis based on the collected information allowed a satisfactory evaluation of DOC severity. Spectral EEG properties seemed to be significantly related to DOC classes and CRS scores, but did not seem to make any significant additional contribution to DOC classification. Conclusions: Multiple electrophysiological evaluations based on EEG, sleep polygraphic recordings and multimodal EPs are helpful in assessing DOC severity and residual functioning in patients with chronic DOCs. Significance: Simple electrophysiological measures that can be easily applied at patients' bedsides can significantly contribute to the recognition of DOC severity in chronic patients surviving a severe brain injury.",
keywords = "Cluster analysis, Disorders of consciousness, EEG, Evoked potentials, Relative power, Sleep score",
author = "{Rossi Sebastiano}, Davide and F. Panzica and E. Visani and F. Rotondi and V. Scaioli and M. Leonardi and D. Sattin and L. D'Incerti and E. Parati and {Ferini Strambi}, Luigi and S. Franceschetti",
year = "2015",
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T1 - Significance of multiple neurophysiological measures in patients with chronic disorders of consciousness

AU - Rossi Sebastiano, Davide

AU - Panzica, F.

AU - Visani, E.

AU - Rotondi, F.

AU - Scaioli, V.

AU - Leonardi, M.

AU - Sattin, D.

AU - D'Incerti, L.

AU - Parati, E.

AU - Ferini Strambi, Luigi

AU - Franceschetti, S.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Objective: The aim of this study was to verify the value of multiple neurophysiological tests in classifying disorders of consciousness (DOCs) in patients in a chronic vegetative or minimal consciousness state categorised on the basis of the Coma Recovery Scale (CRS). Methods: The study included 142 patients, all of whom underwent long (18. h) EEG-polygraphic recordings including one night. The EEG was scored using the Synek scale and sleep patterns using an arbitrary scale. Absolute total power and relative EEG power were evaluated in different frequency bands. Multimodal evoked potentials (EPs), including auditory event-related potentials, were also evaluated and scored. Results: The most information came from the combined multimodal EPs and sleep EEG scores. A two-step cluster analysis based on the collected information allowed a satisfactory evaluation of DOC severity. Spectral EEG properties seemed to be significantly related to DOC classes and CRS scores, but did not seem to make any significant additional contribution to DOC classification. Conclusions: Multiple electrophysiological evaluations based on EEG, sleep polygraphic recordings and multimodal EPs are helpful in assessing DOC severity and residual functioning in patients with chronic DOCs. Significance: Simple electrophysiological measures that can be easily applied at patients' bedsides can significantly contribute to the recognition of DOC severity in chronic patients surviving a severe brain injury.

AB - Objective: The aim of this study was to verify the value of multiple neurophysiological tests in classifying disorders of consciousness (DOCs) in patients in a chronic vegetative or minimal consciousness state categorised on the basis of the Coma Recovery Scale (CRS). Methods: The study included 142 patients, all of whom underwent long (18. h) EEG-polygraphic recordings including one night. The EEG was scored using the Synek scale and sleep patterns using an arbitrary scale. Absolute total power and relative EEG power were evaluated in different frequency bands. Multimodal evoked potentials (EPs), including auditory event-related potentials, were also evaluated and scored. Results: The most information came from the combined multimodal EPs and sleep EEG scores. A two-step cluster analysis based on the collected information allowed a satisfactory evaluation of DOC severity. Spectral EEG properties seemed to be significantly related to DOC classes and CRS scores, but did not seem to make any significant additional contribution to DOC classification. Conclusions: Multiple electrophysiological evaluations based on EEG, sleep polygraphic recordings and multimodal EPs are helpful in assessing DOC severity and residual functioning in patients with chronic DOCs. Significance: Simple electrophysiological measures that can be easily applied at patients' bedsides can significantly contribute to the recognition of DOC severity in chronic patients surviving a severe brain injury.

KW - Cluster analysis

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KW - Evoked potentials

KW - Relative power

KW - Sleep score

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