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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
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Automated EEG entropy measurements in coma, vegetative state/unresponsive wakefulness syndrome and minimally conscious state.

Authors: Gosseries, Olivia; Schnakers, Caroline; LEDOUX, Didier; Vanhaudenhuyse, Audrey; Bruno, Marie-Aurélie; Demertzi, Athina; Noirhomme, Quentin; +6 Authors

Automated EEG entropy measurements in coma, vegetative state/unresponsive wakefulness syndrome and minimally conscious state.

Abstract

Monitoring the level of consciousness in brain-injured patients with disorders of consciousness is crucial as it provides diagnostic and prognostic information. Behavioral assessment remains the gold standard for assessing consciousness but previous studies have shown a high rate of misdiagnosis. This study aimed to investigate the usefulness of electroencephalography (EEG) entropy measurements in differentiating unconscious (coma or vegetative) from minimally conscious patients. Left fronto-temporal EEG recordings (10-minute resting state epochs) were prospectively obtained in 56 patients and 16 age-matched healthy volunteers. Patients were assessed in the acute (≤1 month post-injury; n=29) or chronic (>1 month post-injury; n=27) stage. The etiology was traumatic in 23 patients. Automated online EEG entropy calculations (providing an arbitrary value ranging from 0 to 91) were compared with behavioral assessments (Coma Recovery Scale-Revised) and outcome. EEG entropy correlated with Coma Recovery Scale total scores (r=0.49). Mean EEG entropy values were higher in minimally conscious (73±19; mean and standard deviation) than in vegetative/unresponsive wakefulness syndrome patients (45±28). Receiver operating characteristic analysis revealed an entropy cut-off value of 52 differentiating acute unconscious from minimally conscious patients (sensitivity 89% and specificity 90%). In chronic patients, entropy measurements offered no reliable diagnostic information. EEG entropy measurements did not allow prediction of outcome. User-independent time-frequency balanced spectral EEG entropy measurements seem to constitute an interesting diagnostic - albeit not prognostic - tool for assessing neural network complexity in disorders of consciousness in the acute setting. Future studies are needed before using this tool in routine clinical practice, and these should seek to improve automated EEG quantification paradigms in order to reduce the remaining false negative and false positive findings.

Countries
Belgium, Italy
Keywords

Adult, Male, Time Factors, Consciousness, Entropy, Persistent Vegetative State -- physiopathology, Consciousness -- classification, Sciences de la santé humaine, Severity of Illness Index, vegetative state, Diagnosis, Differential, Coma -- physiopathology, Neurologie, 616, Diagnosis, Unresponsive wakefulness syndrome, Humans, Prospective Studies, Wakefulness, Human health sciences, Coma, Minimally conscious state, Aged, Vegetative state, Brain Injuries -- complications, Consciousness Disorders -- diagnosis -- etiology -- physiopathology, Persistent Vegetative State, EEG entropy, Brain -- physiopathology, Brain, Electroencephalography, Sciences bio-médicales et agricoles, Eeg entropy, Middle Aged, Prognosis, minimally conscious state, Neurology, Brain Injuries, Case-Control Studies, Differential, Consciousness Disorders, 616.8 Malattie del sistema nervoso e disturbi mentali (Classificare qui la Neuropsichiatria, Female, la Neurologia)

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
89
Top 10%
Top 10%
Top 10%
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