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Electrophysiology and Disorders of Consciousness

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Coma and Disorders of Consciousness

Abstract

Electroencephalography offers different insights into brain activity useful in the study of disorders of consciousness. In this paper we focus on three aspects of electroencephalography, namely standard clinical assessments, event related potentials (ERP) and quantitative electroencephalography (qEEG). Standard clinical assessments provide qualitative information on background electrical activity and can spot paroxystic activity and therefore guide treatment.

Event related potentials (ERP) reflect the time course of the information flow following a stimuli, it is therefore useful in the evaluation of auditory, visual and emotive pathways. Finally qEEG consists of the extraction of objective parameters such as band power, connectivity values, or entropy measurements, that can lead to computer based prognostic/diagnostic statements.

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References

  1. Guideline seven: a proposal for standard montages to be used in clinical EEG. American Electroencephalographic Society. J Clin Neurophysiol. 1994;11:30–6. (http://www.ncbi.nlm.nih.gov/pubmed/8195414)

  2. Krauss GL, Fisher RS, editors. The Johns Hopkins atlas of digital EEG: an interactive training guide. Baltimore: The Johns Hopkins University Press; 2006.

    Google Scholar 

  3. Brenner RP. The interpretation of the EEG in stupor and coma. Neurologist. 2005;11:271–84.

    Article  PubMed  Google Scholar 

  4. Young GB, et al. Initial assessment and management of the patient with impaired alertness. In: Young GB, editor. Coma and impaired consciousness. New York: McGraw-Hill; 1998. p. 97–103.

    Google Scholar 

  5. Posner JB, Saper CB, Schiff ND, Plum F. Plum and Posner’s diagnosis of stupor and coma. New York: Oxford University Press; 2007.

    Google Scholar 

  6. Young GB, McLachlan RS, Kreeft JH, Demelo JD. An electroencephalographic classification for coma. Can J Neurol Sci. 1997;24:320–5.

    PubMed  CAS  Google Scholar 

  7. Synek VM. Prognostically important EEG coma patterns in diffuse anoxic and traumatic encephalopathies in adults. J Clin Neurophysiol. 1988;5:161–74.

    Article  PubMed  CAS  Google Scholar 

  8. Westmoreland BF, Klass DW, Sharbrough FW, Reagan TJ. Alpha-coma. Electroencephalographic, clinical, pathologic, and etiologic correlations. Arch Neurol. 1975;32:713–8.

    Article  PubMed  CAS  Google Scholar 

  9. Kaplan PW. The clinical features, diagnosis, and prognosis of nonconvulsive status epilepticus. Neurologist. 2005;11:348–61.

    Article  PubMed  Google Scholar 

  10. Vanhaudenhuyse A, Laureys S, Perrin F. Cognitive event-related potentials in comatose and post-comatose states. Neurocrit Care. 2007;8:262–70.

    Article  Google Scholar 

  11. Guerit JM. Evoked potentials in severe brain injury. Prog Brain Res. 2005;150:415–26.

    Article  PubMed  Google Scholar 

  12. Amantini A, Grippo A, Fossi S, et al. Prediction of ‘awakening’ and outcome in prolonged acute coma from severe traumatic brain injury: evidence for validity of short latency SEPs. Clin Neurophysiol. 2005;116:229–35.

    Article  PubMed  Google Scholar 

  13. Fischer C, Luaute J, Nemoz C, et al. Improved prediction of awakening or nonawakening from severe anoxic coma using tree-based classification analysis. Crit Care Med. 2006;34:1520–4.

    Article  PubMed  Google Scholar 

  14. Lew HL, Dikmen S, Slimp J, et al. Use of somatosensory-evoked potentials and cognitive event-related potentials in predicting outcomes of patients with severe traumatic brain injury. Am J Phys Med Rehabil. 2003;82:53–61; quiz 62–4, 80.

    Article  PubMed  Google Scholar 

  15. Robinson LR, Micklesen PJ, Tirschwell DL, Lew HL. Predictive value of somatosensory evoked potentials for awakening from coma. Crit Care Med. 2003;31:960–7.

    Article  PubMed  Google Scholar 

  16. de Sousa LC, Colli BO, Piza MR, et al. Auditory brainstem response: prognostic value in patients with a score of 3 on the Glasgow Coma Scale. Otol Neurotol. 2007;28:426–8.

    PubMed  Google Scholar 

  17. Haupt WF, Pawlik G, Thiel A. Initial and serial evoked potentials in cerebrovascular critical care patients. J Clin Neurophysiol. 2006;23:389–94.

    Article  PubMed  Google Scholar 

  18. Laureys S, Perrin F, Schnakers C, et al. Residual cognitive function in comatose, vegetative and minimally conscious states. Curr Opin Neurol. 2005;18:726–33.

    Article  PubMed  Google Scholar 

  19. Fischer C, Luaute J, Adeleine P, Morlet D. Predictive value of sensory and cognitive evoked potentials for awakening from coma. Neurology. 2004;63:669–73.

    Article  PubMed  Google Scholar 

  20. Glass I, Sazbon L, Groswasser Z. Mapping “cognitive” event-related potentials in prolonged postcoma unawareness state. Clin Electroencephalogr. 1998;29:19–30.

    PubMed  CAS  Google Scholar 

  21. Guerit JM, Verougstraete D, de Tourtchaninoff M, et al. ERPs obtained with the auditory oddball paradigm in coma and altered states of consciousness: clinical relationships, prognostic value, and origin of components. Clin Neurophysiol. 1999;110:1260–9.

    Article  PubMed  CAS  Google Scholar 

  22. Mutschler V, Chaumeil CG, Marcoux L, et al. Auditory P300 in subjects in a post-anoxic coma. Preliminary data. Neurophysiol Clin. 1996;26:158–63.

    Article  PubMed  CAS  Google Scholar 

  23. Naccache L, Puybasset L, Gaillard R, et al. Auditory mismatch negativity is a good predictor of awakening in comatose patients: a fast and reliable procedure. Clin Neurophysiol. 2005;116:988–9.

    Article  PubMed  Google Scholar 

  24. Daltrozzo J, Wioland N, Mutschler V, Kotchoubey B. Predicting coma and other low responsive patients outcome using event-related brain potentials: a meta-analysis. Clin Neurophysiol. 2007;118:606–14.

    Article  PubMed  CAS  Google Scholar 

  25. Kotchoubey B, Lang S, Mezger G, et al. Information processing in severe disorders of consciousness: vegetative state and minimally conscious state. Clin Neurophysiol. 2005;116:2441–53.

    Article  PubMed  CAS  Google Scholar 

  26. Wijnen VJ, van Boxtel GJ, Eilander HJ, de Gelder B. Mismatch negativity predicts recovery from the vegetative state. Clin Neurophysiol. 2007;118:597–605.

    Article  PubMed  CAS  Google Scholar 

  27. Munte TF, Heinze HJ. Brain potentials reveal deficits of language processing after closed head injury. Arch Neurol. 1994;51:482–93.

    Article  PubMed  CAS  Google Scholar 

  28. Granovsky Y, Sprecher E, Hemli J, Yarnitsky D. P300 and stress in mild head injury patients. Electroencephalogr Clin Neurophysiol. 1998;108:554–9.

    Article  PubMed  CAS  Google Scholar 

  29. Pegado F, Bekinschtein T, Chausson N, et al. Probing the lifetimes of auditory novelty detection processes. Neuropsychologia. 2010;48:3145–54.

    Article  PubMed  Google Scholar 

  30. Perrin F, Schnakers C, Schabus M, et al. Brain response to one’s own name in vegetative state, minimally conscious state, and locked-in syndrome. Arch Neurol. 2006;63:562–9.

    Article  PubMed  Google Scholar 

  31. Schnakers C, Perrin F, Schabus M, et al. Voluntary brain processing in disorders of consciousness. Neurology. 2008;71:1614–20.

    Article  PubMed  CAS  Google Scholar 

  32. Fischer C, Dailler F, Morlet D. Novelty P3 elicited by the subject’s own name in comatose patients. Clin Neurophysiol. 2008;119:2224–30.

    Article  PubMed  Google Scholar 

  33. Vanhaudenhuyse A, Laureys S, Perrin F. Cognitive event-related potentials in comatose and post-comatose states. Neurocrit Care. 2008;8:262–70.

    Article  PubMed  Google Scholar 

  34. Kotchoubey B. Event-related potential measures of consciousness: two equations with three unknowns. Prog Brain Res. 2005;150:427–44.

    Article  PubMed  Google Scholar 

  35. Fischer C, Luaute J, Morlet D. Event-related potentials (MMN and novelty P3) in permanent vegetative or minimally conscious states. Clin Neurophysiol. 2010;121:1032–42.

    Article  PubMed  Google Scholar 

  36. Kubler A, Kotchoubey B. Brain-computer interfaces in the continuum of consciousness. Curr Opin Neurol. 2007;20:643–9.

    Article  PubMed  Google Scholar 

  37. Leon-Carrion J, Martin-Rodriguez JF, Damas-Lopez J, et al. Brain function in the minimally conscious state: a quantitative neurophysiological study. Clin Neurophysiol. 2008;119:1506–14.

    Article  PubMed  CAS  Google Scholar 

  38. Lehembre R, Bruno MA, Vanhaudenhuyse A, et al. Resting state EEG study of comatose patients: a connectivity and frequency analysis to find differences between vegetative and minimally conscious states. Funct Neurol 2012 (in press).

    Google Scholar 

  39. Johansen JW, Sebel PS. Development and clinical application of electroencephalographic bispectrum monitoring. Anesthesiology. 2000;93:1336–44.

    Article  PubMed  CAS  Google Scholar 

  40. Noirhomme Q, Boly M, Bonhomme V, et al. Bispectral index correlates with regional cerebral blood flow during sleep in distinct cortical and subcortical structures in humans. Arch Ital Biol. 2009;147:51–7.

    PubMed  CAS  Google Scholar 

  41. Schnakers C, Ledoux D, Majerus S, et al. Diagnostic and prognostic use of bispectral index in coma, vegetative state and related disorders. Brain Inj. 2008;22:926–31.

    Article  PubMed  CAS  Google Scholar 

  42. Gosseries O, Schnakers C, Ledoux D, et al. Automated EEG entropy measurements in coma, vegetative state/unresponsive wakefulness syndrome and minimally conscious state. Funct Neurol. 2011;26(1):25–30.

    PubMed  Google Scholar 

  43. Viertio-Oja H, Maja V, Sarkela M, et al. Description of the entropy algorithm as applied in the datex-ohmeda S/5 entropy module. Acta Anaesthesiol Scand. 2004;48:154–61.

    Article  PubMed  CAS  Google Scholar 

  44. Pereda E, Quiroga RQ, Bhattacharya J. Nonlinear multivariate analysis of neurophysiological signals. Prog Neurobiol. 2005;77:1–37.

    Article  PubMed  Google Scholar 

  45. Laureys S. The neural correlate of (un)awareness: lessons from the vegetative state. Trends Cogn Sci. 2005;9:556–9.

    Article  PubMed  Google Scholar 

  46. Davey MP, Victor JD, Schiff ND. Power spectra and coherence in the EEG of a vegetative patient with severe asymmetric brain damage. Clin Neurophysiol. 2000;111:1949–54.

    Article  PubMed  CAS  Google Scholar 

  47. Schiff N. Large scale brain dynamics and connectivity in the minimally conscious state. In: Handbook of brain connectivity. New York: Springer; 2007. p. 505–20.

    Chapter  Google Scholar 

  48. Pollonini L, Pophale S, Situ N, et al. Information communication networks in severe traumatic brain injury. Brain Topogr. 2010;23:221–6.

    Article  PubMed  Google Scholar 

  49. Stam CJ. Nonlinear dynamical analysis of EEG and MEG: review of an emerging field. Clin Neurophysiol. 2005;116:2266–301.

    Article  PubMed  CAS  Google Scholar 

  50. Michel CM, Murray MM, Lantz G, et al. EEG source imaging. Clin Neurophysiol. 2004;115:2195–222.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Coma Science Group, Cyclotron Research Centre, University of Liège, Allée du 6 Août 8, Sart Tilman B30, 4000, Liège, Belgium

    Quentin Noirhomme Ph.D. & Rémy Lehembre M.Sc.

Authors
  1. Quentin Noirhomme Ph.D.
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  2. Rémy Lehembre M.Sc.
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Correspondence to Quentin Noirhomme Ph.D. .

Editor information

Editors and Affiliations

  1. , Cyclotron Research Centre, University of Liège, Allée du 6 août 8, Liège, B-4000, Belgium

    Caroline Schnakers

  2. , Cyclotron Research Centre, University of Liège, Allée du 6 août 8, Liège, 4000, Belgium

    Steven Laureys

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© 2012 Springer-Verlag London

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Noirhomme, Q., Lehembre, R. (2012). Electrophysiology and Disorders of Consciousness. In: Schnakers, C., Laureys, S. (eds) Coma and Disorders of Consciousness. Springer, London. https://doi.org/10.1007/978-1-4471-2440-5_6

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  • DOI: https://doi.org/10.1007/978-1-4471-2440-5_6

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  • Online ISBN: 978-1-4471-2440-5

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