Clinical and advanced neurophysiology in the prognostic and diagnostic evaluation of disorders of consciousness: review of an IFCN-endorsed expert group. Issue 11 (November 2020)

• Record Type: Journal Article
• Authors: Comanducci, A.; Boly, M.; Claassen, J.; De Lucia, M.; Gibson, R.M.; Juan, E.; Laureys, S.; Naccache, L.; Owen, A.M.; Rosanova, M.; Rossetti, A.O.; Schnakers, C.; Sitt, J.D.; Schiff, N.D.; Massimini, M.
• Is Part Of: Clinical neurophysiology. Volume 131:Issue 11(2020:Nov.)
• Page Start: 2736
• Page End: 2765
• Publication Date: 2020-11
• Subjects: disorders of consciousness -- EEG -- evoked potentials -- event-related potentials -- vegetative state -- minimally conscious state -- coma; α alpha -- β beta -- δ delta -- γ gamma -- θ theta -- AAN American Academy of Neurology -- BCI Brain-Computer Interface -- CI confidence intervals -- CMD cognitive motor dissociation -- CPC cerebral performance category -- CRS-R Coma-Recovery Scale-revised -- cEEG continuous electroencephalography -- CSD cortical spread depolarization -- DoC disorders of consciousness -- EAN European Academy of Neurology -- EEG electroencephalography -- EMCS emergence from minimally conscious state -- EP evoked potential -- ERD event-related desynchronization -- ERP event-related potential -- ERSP event-related spectral perturbation -- GOS Glasgow Outcome Scale -- GOS-E Glasgow Outcome Scale Extended -- FDG-PET fluorodeoxyglucose positron emission tomography -- fMRI functional magnetic resonance imaging -- FPR false positive rate -- HIE hypoxic-ischemic encephalopathy -- HMD higher-order cortex motor dissociation -- ICU intensive care unit -- IIC ictal-interictal continuum -- K Kolmogorov complexity -- LIS locked-in syndrome -- LFP local field potential -- MCS minimally conscious state -- ML machine learning -- MMN mismatch negativity -- NCSz non-convulsive seizures -- NCSE non-convulsive status epilepticus -- NREM non-rapid eye movement -- OPJ occipito-parietal junction -- PCI perturbational complexity index -- PHG parahippocampal gyrus -- PLF phase locking factor -- PMC premotor cortex -- PPV positive predictive value -- PSD power spectral density -- qEEG quantitative EEG -- REM rapid eye movement -- SAH subarachnoid hemorrhage -- SEP somatosensory evoked potential -- SIRPIDs stimulus-induced rhythmic, periodic, or ictal discharges -- SMA supplementary motor area -- SPES single pulse electrical stimulation -- TEP TMS-evoked potential -- TBI traumatic brain injury -- TMS transcranial magnetic stimulation -- TMS/EEG TMS combined with EEG -- TTM targeted temperature management -- UWS unresponsive wakefulness syndrome -- VS vegetative state -- wSMI weighted symbolic mutual information; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2020.07.015
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: We provide an overview of EEG-based techniques in the prognostic and diagnostic assessment of DoC. We highlight bridging principles between conventional and investigational approaches. We share expert opinions and considerations on the technical and conceptual caveats. Abstract: The analysis of spontaneous EEG activity and evoked potentials is a cornerstone of the instrumental evaluation of patients with disorders of consciousness (DoC). The past few years have witnessed an unprecedented surge in EEG-related research applied to the prediction and detection of recovery of consciousness after severe brain injury, opening up the prospect that new concepts and tools may be available at the bedside. This paper provides a comprehensive, critical overview of both consolidated and investigational electrophysiological techniques for the prognostic and diagnostic assessment of DoC. We describe conventional clinical EEG approaches, then focus on evoked and event-related potentials, and finally we analyze the potential of novel research findings. In doing so, we (i) draw a distinction between acute, prolonged and chronic phases of DoC, (ii) attempt to relate both clinical and research findings to the underlying neuronal processes and (iii) discuss technical and conceptual caveats. The primary aim of this narrative review is to bridge the gap between standard and emerging electrophysiological measures for the detection and prediction of recovery of consciousness. The ultimate scope is to provide a reference and common ground for academic researchers active in the field of neurophysiology and clinicians engaged in intensive care unit and rehabilitation.