School of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo, 1 - 20126, Milan, Italy.
Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China; Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China; State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, China; Department of Neurosurgery, China-Japan Friendship Hospital, Beijing, China.
Neuroimage Clin. 2024;44:103698. doi: 10.1016/j.nicl.2024.103698. Epub 2024 Oct 30.
Resting state EEG in patients with disorders of consciousness (DOC) is characterized by an increase of power in the delta frequency band and a concurrent decrease in the alpha range, equivalent to a weakening or disappearance of the alpha peak. Prolongation of Intrinsic Neural Timescales (INTs) is also associated with DOCs. Together, this raises the question whether the decreased alpha peak relates to the prolonged INTs and, importantly, how that can be used for diagnosing the state of consciousness in DOC individuals. Analyzing resting state EEG recordings from both healthy subjects and DOC patients, we measure INTs through autocorrelation window (ACW) and utilize peak analysis to quantify the weakening of the alpha peak. First, we replicate previous findings of prolonged ACW in DOC patients. We then identify significantly lower alpha peak measures in DOC compared to controls. Interestingly, spectral peaks shift from the alpha to the theta range in several DOC subjects while such change is absent in healthy controls. Next, our study reveals a close relationship between ACW and alpha peak in both healthy and DOC subjects, a correlation that holds for theta peaks in DOC. Further, the prolonged ACW correlates with the state of consciousness, as quantified by the Coma Recovery Scale-Revised (CRS-R), and mediates the relationship between theta peak and CRS-R. Finally, through split analyses and machine learning, we show that ACW and alpha peak measures conjointly distinguish healthy controls and DOC patients with high accuracy (95.5%). In conclusion, we demonstrate that the prolongation of ACW, together with spectral peak measures, holds promise to serve as additional EEG biomarkers for diagnosing the state of consciousness in DOC subjects.
意识障碍(DOC)患者的静息态 EEG 以 delta 频带功率增加和 alpha 范围同时降低为特征,相当于 alpha 峰变弱或消失。固有神经时程(INTs)的延长也与 DOC 相关。这一起提出了一个问题,即 alpha 峰的降低是否与 INTs 的延长有关,重要的是,如何将其用于诊断 DOC 个体的意识状态。通过分析来自健康受试者和 DOC 患者的静息态 EEG 记录,我们通过自相关窗口(ACW)测量 INTs,并利用峰值分析来量化 alpha 峰的减弱。首先,我们复制了以前在 DOC 患者中发现的 ACW 延长的发现。然后,我们确定了 DOC 患者的 alpha 峰测量值明显低于对照组。有趣的是,在几个 DOC 受试者中,频谱峰值从 alpha 移到 theta 范围,而在健康对照组中则没有这种变化。接下来,我们的研究揭示了健康和 DOC 受试者中 ACW 和 alpha 峰之间的密切关系,这种相关性在 DOC 中的 theta 峰中也存在。此外,ACW 与意识状态密切相关,意识状态由修订后的昏迷恢复量表(CRS-R)量化,并介导 theta 峰与 CRS-R 之间的关系。最后,通过分裂分析和机器学习,我们表明 ACW 和 alpha 峰测量值共同以高精度(95.5%)区分健康对照组和 DOC 患者。总之,我们证明了 ACW 的延长以及频谱峰值测量值有望作为诊断 DOC 受试者意识状态的附加 EEG 生物标志物。