BCI Performance and Brain Metabolism Profile in Severely Brain-Injured Patients Without Response to Command at Bedside.
Front Neurosci 2018;
12:370. [PMID:
29910708 PMCID:
PMC5992287 DOI:
10.3389/fnins.2018.00370]
[Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 05/14/2018] [Indexed: 12/24/2022] Open
Abstract
Detection and interpretation of signs of “covert command following” in patients with disorders of consciousness (DOC) remains a challenge for clinicians. In this study, we used a tactile P3-based BCI in 12 patients without behavioral command following, attempting to establish “covert command following.” These results were then confronted to cerebral metabolism preservation as measured with glucose PET (FDG-PET). One patient showed “covert command following” (i.e., above-threshold BCI performance) during the active tactile paradigm. This patient also showed a higher cerebral glucose metabolism within the language network (presumably required for command following) when compared with the other patients without “covert command-following” but having a cerebral glucose metabolism indicative of minimally conscious state. Our results suggest that the P3-based BCI might probe “covert command following” in patients without behavioral response to command and therefore could be a valuable addition in the clinical assessment of patients with DOC.
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