Information processing in patients in vegetative and minimally conscious states

Ruben G L Real; Sandra Veser; Helena Erlbeck; Monica Risetti; Dominik Vogel; Friedemann Müller; Boris Kotchoubey; Donatella Mattia; Andrea Kübler

doi:10.1016/j.clinph.2015.07.020

Information processing in patients in vegetative and minimally conscious states

Clin Neurophysiol. 2016 Feb;127(2):1395-1402. doi: 10.1016/j.clinph.2015.07.020. Epub 2015 Aug 7.

Authors

Ruben G L Real¹, Sandra Veser², Helena Erlbeck³, Monica Risetti⁴, Dominik Vogel⁵, Friedemann Müller⁵, Boris Kotchoubey², Donatella Mattia⁴, Andrea Kübler³

Affiliations

¹ Institute of Psychology, University of Würzburg, Germany. Electronic address: ruben.real@uni-wuerzburg.de.
² Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany.
³ Institute of Psychology, University of Würzburg, Germany.
⁴ IRCCS, Fondazione Santa Lucia, Rome, Italy.
⁵ Schön Clinics for Neurological Rehabilitation, Bad Aibling, Germany.

PMID: 26315366
DOI: 10.1016/j.clinph.2015.07.020

Abstract

Objective: Evaluation of a short two-tone oddball paradigm to discriminate between the vegetative state (VS) and minimal consciousness state (MCS) in a sample of patients with severe disorders of consciousness (DOC).

Method: EEG was recorded from 45 DOC patients and 14 healthy participants while listening to an auditory oddball paradigm presented in a passive - just listen - and an active - count the odd tones - condition. In patients, the experiment was repeated after a minimum of one week.

Results: Prevalence of the P300 was higher in healthy participants (71%) than in patients, but did not discriminate between VS (T1: ∼10%; T2: ∼11%) and MCS (T1: ∼13%; T2: 25%) patients.

Conclusion: Results cast doubt on whether this simple auditory stimulation paradigm, which requires cognitive action from the listener, is sensitive enough to discriminate between patients with DOC.

Significance: The sensitivity of the P300 ERP obtained in a short two-tone oddball paradigm presented in a passive and an active condition appears to be too low for routine application in a clinical setting aiming at distinguishing between VS and MCS patients.

Keywords: DOC; EEG; Minimally conscious state; P300; Vegetative state.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Acoustic Stimulation / methods*
Adult
Aged
Electroencephalography / methods*
Event-Related Potentials, P300 / physiology*
Female
Humans
Male
Mental Processes / physiology*
Middle Aged
Persistent Vegetative State / diagnosis*
Persistent Vegetative State / physiopathology*