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Bedside EEG predicts longitudinal behavioural changes in disorders of consciousness
- Source :
- NeuroImage: Clinical, NeuroImage : Clinical, NeuroImage: Clinical, Vol 28, Iss, Pp 102372-(2020)
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Highlights • pDOC patients are assessed for 2-years longitudinally with both the CRS-R and EEG. • Theta power and alpha clustering correlated strongest with changes in CRS-R scores. • EEG combined with CRS-R improved predictive power of future CRS-R scores. • Early changes in EEG outperformed early changes in CRS-R in terms of prognostic power. • Regular and repeated bedside EEG is feasible and has clinical utility for pDOC.<br />Providing an accurate prognosis for prolonged disorder of consciousness (pDOC) patients remains a clinical challenge. Large cross-sectional studies have demonstrated the diagnostic and prognostic value of functional brain networks measured using high-density electroencephalography (hdEEG). Nonetheless, the prognostic value of these neural measures has yet to be assessed by longitudinal follow-up. We address this gap by assessing the utility of hdEEG to prognosticate long-term behavioural outcome, employing longitudinal data collected from a cohort of patients assessed systematically with resting hdEEG and the Coma Recovery Scale-Revised (CRS-R) at the bedside over a period of two years. We used canonical correlation analysis to relate clinical (including CRS-R scores combined with demographic variables) and hdEEG variables to each other. This analysis revealed that the patient’s age, and the hdEEG theta band power and alpha band connectivity, contributed most significantly to the relationship between hdEEG and clinical variables. Further, we found that hdEEG measures recorded at the time of assessment augmented clinical measures in predicting CRS-R scores at the next assessment. Moreover, the rate of hdEEG change not only predicted later changes in CRS-R scores, but also outperformed clinical measures in terms of prognostic power. Together, these findings suggest that improvements in functional brain networks precede changes in behavioural awareness in pDOC. We demonstrate here that bedside hdEEG assessments conducted at specialist nursing homes are feasible, have clinical utility, and can complement clinical knowledge and systematic behavioural assessments to inform prognosis and care.
- Subjects :
- medicine.medical_specialty
animal structures
Consciousness
Cognitive Neuroscience
Disorders of consciousness
Electroencephalography
lcsh:Computer applications to medicine. Medical informatics
lcsh:RC346-429
050105 experimental psychology
Clinical knowledge
03 medical and health sciences
Functional brain
0302 clinical medicine
Physical medicine and rehabilitation
otorhinolaryngologic diseases
medicine
Humans
0501 psychology and cognitive sciences
Radiology, Nuclear Medicine and imaging
EEG
Coma
skin and connective tissue diseases
lcsh:Neurology. Diseases of the nervous system
medicine.diagnostic_test
business.industry
05 social sciences
Regular Article
respiratory system
medicine.disease
Prognosis
Natural history studies (prognosis)
Cross-Sectional Studies
Neurology
Cohort
lcsh:R858-859.7
Consciousness Disorders
sense organs
Neurology (clinical)
medicine.symptom
Canonical correlation
Nursing homes
business
030217 neurology & neurosurgery
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- NeuroImage: Clinical, NeuroImage : Clinical, NeuroImage: Clinical, Vol 28, Iss, Pp 102372-(2020)
- Accession number :
- edsair.doi.dedup.....29f8af94f3637cdeaee8100dbcadf51e
- Full Text :
- https://doi.org/10.17863/cam.59066