TY - JOUR
T1 - Intrinsic network reactivity differentiates levels of consciousness in comatose patients
AU - Khanmohammadi, Sina
AU - Laurido-Soto, Osvaldo
AU - Eisenman, Lawrence N.
AU - Kummer, Terrance T.
AU - Ching, Shi Nung
N1 - Publisher Copyright:
© 2018 International Federation of Clinical Neurophysiology
PY - 2018/11
Y1 - 2018/11
N2 - Objective: We devise a data-driven framework to assess the level of consciousness in etiologically heterogeneous comatose patients using intrinsic dynamical changes of resting-state Electroencephalogram (EEG) signals. Methods: EEG signals were collected from 54 comatose patients (GCS ⩽ 8) and 20 control patients (GCS > 8). We analyzed the EEG signals using a new technique, termed Intrinsic Network Reactivity Index (INRI), that aims to assess the overall lability of brain dynamics without the use of extrinsic stimulation. The proposed technique uses three sigma EEG events as a trigger for ensuing changes to the directional derivative of signals across the EEG montage. Results: The INRI had a positive relationship with GCS and was significantly different between various levels of consciousness. In comparison, classical band-limited power analysis did not show any specific patterns correlated to GCS. Conclusions: These findings suggest that reaching low variance EEG activation patterns becomes progressively harder as the level of consciousness of patients deteriorate, and provide a quantitative index based on passive measurements that characterize this change. Significance: Our results emphasize the role of intrinsic brain dynamics in assessing the level of consciousness in coma patients and the possibility of employing simple electrophysiological measures to recognize the severity of disorders of consciousness (DOC).
AB - Objective: We devise a data-driven framework to assess the level of consciousness in etiologically heterogeneous comatose patients using intrinsic dynamical changes of resting-state Electroencephalogram (EEG) signals. Methods: EEG signals were collected from 54 comatose patients (GCS ⩽ 8) and 20 control patients (GCS > 8). We analyzed the EEG signals using a new technique, termed Intrinsic Network Reactivity Index (INRI), that aims to assess the overall lability of brain dynamics without the use of extrinsic stimulation. The proposed technique uses three sigma EEG events as a trigger for ensuing changes to the directional derivative of signals across the EEG montage. Results: The INRI had a positive relationship with GCS and was significantly different between various levels of consciousness. In comparison, classical band-limited power analysis did not show any specific patterns correlated to GCS. Conclusions: These findings suggest that reaching low variance EEG activation patterns becomes progressively harder as the level of consciousness of patients deteriorate, and provide a quantitative index based on passive measurements that characterize this change. Significance: Our results emphasize the role of intrinsic brain dynamics in assessing the level of consciousness in coma patients and the possibility of employing simple electrophysiological measures to recognize the severity of disorders of consciousness (DOC).
KW - Coma
KW - Consciousness
KW - Electroencephalography
KW - Intrinsic Network Reactivity Index (INRI)
KW - Intrinsic dynamics
KW - Traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=85053456674&partnerID=8YFLogxK
U2 - 10.1016/j.clinph.2018.08.004
DO - 10.1016/j.clinph.2018.08.004
M3 - Article
C2 - 30240976
AN - SCOPUS:85053456674
SN - 1388-2457
VL - 129
SP - 2296
EP - 2305
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
IS - 11
ER -