Zhao Ying, Wang Anqi, Zhao Weiqiao, Hu Nantu, Laureys Steven, Di Haibo
International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou 311121, China.
Department of Basic Medicine, Hangzhou Normal University, Hangzhou 311121, China.
Brain Sci. 2025 Apr 4;15(4):377. doi: 10.3390/brainsci15040377.
BACKGROUND/OBJECTIVES: Disorder of consciousness (DoC) poses diagnostic challenges due to behavioral assessment limitations. This study evaluates the spectral exponent (SE)-a neurophysiological biomarker quantifying the decay slope of electroencephalography (EEG) aperiodic activity-as an objective tool for consciousness stratification and clinical behavior scores correlation.
The study involved 15 DoC patients, nine conscious brain-injured controls (BI), and 23 healthy controls (HC). Resting-state 32-channel EEG data were analyzed to compute SE across broadband (1-40 Hz) and narrowband (1-20 Hz, 20-40 Hz). Statistical frameworks included Bonferroni-corrected Kruskal-Wallis H tests, Bayesian ANOVA, and correlation analyses with CRS-R behavioral scores.
Narrowband SE (1-20 Hz) showed superior diagnostic sensitivity, differentiating DoC from controls (HC vs. DoC: < 0.0001; BI vs. DoC: = 0.0006) and MCS from VS/UWS ( = 0.0014). SE correlated positively with CRS-R index (1-20 Hz: r = 0.590, = 0.021) and visual subscale (1-20 Hz: r = 0.684, = 0.005). High-frequency (20-40 Hz) SE exhibited inconsistent results. Longitudinal tracking in an individual revealed a reduction in SE negativity, a flattening of the 1/f slope, and behavioral recovery occurring in parallel.
Narrowband SE (1-20 Hz) is a robust biomarker for consciousness quantification, overcoming behavioral assessment subjectivity. Its correlation with visual function highlights potential clinical utility. Future studies should validate SE in larger cohorts and integrate multimodal neuroimaging.
背景/目的：由于行为评估存在局限性，意识障碍（DoC）带来了诊断挑战。本研究评估频谱指数（SE）——一种量化脑电图（EEG）非周期性活动衰减斜率的神经生理学生物标志物——作为意识分层和临床行为评分相关性的客观工具。
该研究纳入了15名意识障碍患者、9名清醒的脑损伤对照者（BI）和23名健康对照者（HC）。分析静息状态下的32通道EEG数据，以计算宽带（1 - 40 Hz）和窄带（1 - 20 Hz、20 - 40 Hz）的SE。统计框架包括Bonferroni校正的Kruskal - Wallis H检验、贝叶斯方差分析以及与CRS - R行为评分的相关性分析。
窄带SE（1 - 20 Hz）显示出卓越的诊断敏感性，可区分意识障碍与对照者（HC与DoC：< 0.0001；BI与DoC：= 0.0006）以及最低意识状态（MCS）与植物状态/无反应觉醒综合征（VS/UWS）（= 0.0014）。SE与CRS - R指数呈正相关（1 - 20 Hz：r = 0.590，= 0.021）以及视觉子量表呈正相关（1 - 20 Hz：r = 0.684，= 0.005）。高频（20 - 40 Hz）SE的结果不一致。对个体的纵向跟踪显示SE负值降低、1/f斜率变平以及行为恢复同时发生。
窄带SE（1 - 20 Hz）是用于意识量化的可靠生物标志物，克服了行为评估的主观性。其与视觉功能的相关性突出了潜在的临床应用价值。未来的研究应在更大的队列中验证SE，并整合多模态神经影像学。
