Spataro Rossella, Xu Yiyan, Xu Ren, Mandalà Giorgio, Allison Brendan Z, Ortner Rupert, Heilinger Alexander, La Bella Vincenzo, Guger Christoph
IRCCS Centro Neurolesi Bonino Pulejo, Palermo, Italy.
ALS Clinical Research Center, University of Palermo, Palermo, Italy.
Front Neurosci. 2022 Aug 11;16:959339. doi: 10.3389/fnins.2022.959339. eCollection 2022.
Clinical assessment of consciousness relies on behavioural assessments, which have several limitations. Hence, disorder of consciousness (DOC) patients are often misdiagnosed. In this work, we aimed to compare the repetitive assessment of consciousness performed with a clinical behavioural and a Brain-Computer Interface (BCI) approach.
For 7 weeks, sixteen DOC patients participated in weekly evaluations using both the Coma Recovery Scale-Revised (CRS-R) and a vibrotactile P300 BCI paradigm. To use the BCI, patients had to perform an active mental task that required detecting specific stimuli while ignoring other stimuli. We analysed the reliability and the efficacy in the detection of command following resulting from the two methodologies.
Over repetitive administrations, the BCI paradigm detected command following before the CRS-R in seven patients. Four clinically unresponsive patients consistently showed command following during the BCI assessments.
Brain-Computer Interface active paradigms might contribute to the evaluation of the level of consciousness, increasing the diagnostic precision of the clinical bedside approach.
The integration of different diagnostic methods leads to a better knowledge and care for the DOC.
意识的临床评估依赖于行为评估，而行为评估存在若干局限性。因此，意识障碍（DOC）患者常常被误诊。在本研究中，我们旨在比较采用临床行为方法和脑机接口（BCI）方法对意识进行的重复性评估。
16名DOC患者在7周内每周接受使用昏迷恢复量表修订版（CRS-R）和振动触觉P300脑机接口范式的评估。为了使用脑机接口，患者必须执行一项主动思维任务，即检测特定刺激同时忽略其他刺激。我们分析了两种方法在检测对指令的跟随方面的可靠性和有效性。
在多次重复评估中，脑机接口范式在7名患者中比CRS-R更早检测到对指令的跟随。4名临床无反应的患者在脑机接口评估期间始终表现出对指令的跟随。
脑机接口主动范式可能有助于意识水平的评估，提高临床床边评估方法的诊断准确性。
不同诊断方法的整合有助于更好地了解和护理DOC患者。
