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Large scale screening of neural signatures of consciousness in patients in a vegetative or minimally conscious state

Jacobo Diego Sitt, Jean-Remi King, Imen El Karoui, Benjamin Rohaut, Frederic Faugeras, Alexandre Gramfort, Laurent Cohen, Mariano Sigman, Stanislas Dehaene, Lionel Naccache
DOI: http://dx.doi.org/10.1093/brain/awu141 2258-2270 First published online: 11 June 2014

Summary

In recent years, numerous electrophysiological signatures of consciousness have been proposed. Here, we perform a systematic analysis of these electroencephalography markers by quantifying their efficiency in differentiating patients in a vegetative state from those in a minimally conscious or conscious state. Capitalizing on a review of previous experiments and current theories, we identify a series of measures that can be organized into four dimensions: (i) event-related potentials versus ongoing electroencephalography activity; (ii) local dynamics versus inter-electrode information exchange; (iii) spectral patterns versus information complexity; and (iv) average versus fluctuations over the recording session. We analysed a large set of 181 high-density electroencephalography recordings acquired in a 30 minutes protocol. We show that low-frequency power, electroencephalography complexity, and information exchange constitute the most reliable signatures of the conscious state. When combined, these measures synergize to allow an automatic classification of patients’ state of consciousness.

  • consciousness
  • vegetative state
  • unresponsive wakefulness syndrome
  • minimally conscious state
  • EEG
  • Abbreviations
    AUC
    area under the curve
    CRS-R
    Coma Recovery Scale Revised
    CS
    conscious state
    MCS
    minimally conscious state
    VS
    vegetative state
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