Parallel EEG-fNIRS assessments of covert cognition in behaviorally non-responsive ICU patients: A multi-task feasibility study in a case of acute motor sensory axonal neuropathy.
G Laforge, M Kolisnyk, S Novi, K Kazazian, M Ardakani, A Abdalmalak, D Debicki, T Gofton, A M Owen, L Norton
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引用次数: 0
Abstract
Background: Repeat neurological assessment is standard in cases of severe acute brain injury. However, conventional measures rely on overt behavior. Unfortunately, behavioral responses may be difficult or impossible for some patients. As a result, patients who recover consciousness before the ability to express so may go undetected. Recent studies have demonstrated the efficacy of incorporating functional neuroimaging into clinical assessment protocols. The objective of the current study is to assess the feasibility of a multi-task, multimodal bedside technique to evaluate sensory and cognitive function in behaviorally non-responsive patients.
Methods: We deployed a novel assessment paradigm to evaluate sensory and cognitive processing in one 63-year-old unresponsive patient with acute motor sensory axonal neuropathy (AMSAN). We collected parallel bedside EEG-fNIRS activity during hierarchical auditory processing, movie listening, and motor imagery.
Results: We found appropriate hemodynamic activation in the patient's middle and superior temporal gyri to simple sounds and activation in their superior temporal gyrus, left angular and precentral gyri during speech. During movie listening, the patient produced patterns of EEG and fNIRS activity that were statistically indistinguishable from healthy controls. The patient also showed appropriate fNIRS and source-localized EEG activation of motor areas during motor imagery. Upon recovering, the patient correctly recalled multiple aspects of our assessment procedures.
Conclusion: In sum, our assessment protocol effectively captures neural markers of sensory and cognitive function in behaviorally non-responsive patients. Crucially, while AMSAN is distinct from brain injury, the patient's assumed dissociation between behavior and awareness provided an ideal test case to validate our protocol.
期刊介绍：
The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field.
In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials.
Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.
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