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EEG ultradian rhythmicity differences in disorders of consciousness during wakefulness

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Abstract

Temporal fluctuations of cognitively-mediated behaviors in minimally conscious state (MCS) have been linked to changes of awareness, but the time-pattern of these variations remains ill-described. We analyzed 4-h EEG recordings from 12 patients with disorders of consciousness (6 MCS and 6 vegetative state/unresponsive wakefulness syndrome, VS/UWS). Relative powers (delta, theta, alpha, beta1 and beta2 bands) and spectral entropy were estimated (Fz, Cz and Pz derivations). Spectral entropy time-courses were then analyzed. MCS patients had higher theta and alpha and lower delta power when compared to VS/UWS. They showed higher spectral entropy mean value and higher time variability. MCS patients were characterized by spectral entropy fluctuations with periodicities of 70 min (range 57–80 min). Notably, these periodicities closely resemble those described in awake healthy subjects, which were hypothesized to be related to fluctuation in vigilance/attention. No significant periodicity was observed for VS/UWS. The spectral entropy periodicity found in MCS patients could reflect the fluctuation of awareness responsible for the inconsistency of MCS manifestation of cognitively-mediated behaviors. The presence of a 70 min periodicity in spectral entropy could permit clinicians to better choose their time-window when performing a clinical assessment of consciousness. It could also permit to monitor fluctuations in cognitive performance (i.e., response to command) during complementary testing by passive or active electrophysiological or functional neuroimaging paradigms or in resting state conditions.

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Acknowledgments

No external funding was used for the study.

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    Authors and Affiliations

    1. Coma Science Group, GIGA-Research B34, University and University Hospital of Liége, Avenue de l’Hôpital 1, B-4000, Liége, Belgium

      Andrea Piarulli, Aurore Thibaut, Olivia Gosseries & Steven Laureys

    2. Perceptual Robotics Laboratory, TECIP Institute, Scuola Superiore Sant’Anna, Via Alamanni 13D, 56010, Pisa, Italy

      Andrea Piarulli & Massimo Bergamasco

    3. Innovation and Research Management, University Hospital of Toulouse (Hôtel-Dieu Saint-Jacques), 31059, Toulouse, France

      Victor Cologan

    4. Department of Psychiatry and Psychology, University of Wisconsin, Madison, WI, 53706, USA

      Olivia Gosseries

    Authors
    1. Andrea Piarulli
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    2. Massimo Bergamasco
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    3. Aurore Thibaut
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    4. Victor Cologan
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    5. Olivia Gosseries
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    6. Steven Laureys
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    Correspondence to Andrea Piarulli.

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    None of the authors have potential conflicts of interest to be disclosed.

    Ethical standards

    The study was approved by the Ethics Committee of the Faculty of Medicine of the University of Liège. Written informed consent forms were received from the patients' legal representatives. The study was conducted in agreement with the Declaration of Helsinki 1964 and its later amendments.

    Additional information

    O. Gosseries and S. Laureys contributed equally to this work.

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    Piarulli, A., Bergamasco, M., Thibaut, A. et al. EEG ultradian rhythmicity differences in disorders of consciousness during wakefulness. J Neurol 263, 1746–1760 (2016). https://doi.org/10.1007/s00415-016-8196-y

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    • DOI: https://doi.org/10.1007/s00415-016-8196-y

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