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Electrophysiological and Neuroimaging Studies � During Resting State and Sensory Stimulation in Disorders of Consciousness: A Review

Jain, R and Ramakrishnan, AG (2020) Electrophysiological and Neuroimaging Studies � During Resting State and Sensory Stimulation in Disorders of Consciousness: A Review. In: Frontiers in Neuroscience, 14 .

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Official URL: https://dx.doi.org/10.3389/fnins.2020.555093


A severe brain injury may lead to a disorder of consciousness (DOC) such as coma, vegetative state (VS), minimally conscious state (MCS) or locked-in syndrome (LIS). Till date, the diagnosis of DOC relies only on clinical evaluation or subjective scoring systems such as Glasgow coma scale, which fails to detect subtle changes and thereby results in diagnostic errors. The high rate of misdiagnosis and inability to predict the recovery of consciousness for DOC patients have created a huge research interest in the assessment of consciousness. Researchers have explored the use of various stimulation and neuroimaging techniques to improve the diagnosis. In this article, we present the important findings of resting-state as well as sensory stimulation methods and highlight the stimuli proven to be successful in the assessment of consciousness. Primarily, we review the literature based on (a) application/non-use of stimuli (i.e., sensory stimulation/resting state-based), (b) type of stimulation used (i.e., auditory, visual, tactile, olfactory, or mental-imagery), (c) electrophysiological signal used (EEG/ERP, fMRI, PET, EMG, SCL, or ECG). Among the sensory stimulation methods, auditory stimulation has been extensively used, since it is easier to conduct for these patients. Olfactory and tactile stimulation have been less explored and need further research. Emotionally charged stimuli such as subject�s own name or narratives in a familiar voice or subject�s own face/family pictures or music result in stronger responses than neutral stimuli. Studies based on resting state analysis have employed measures like complexity, power spectral features, entropy and functional connectivity patterns to distinguish between the VS and MCS patients. Resting-state EEG and fMRI are the state-of-the-art techniques and have a huge potential in predicting the recovery of coma patients. Further, EMG and mental-imagery based studies attempt to obtain volitional responses from the VS patients and thus could detect their command-following capability. This may provide an effective means to communicate with these patients. Recent studies have employed fMRI and PET to understand the brain-activation patterns corresponding to the mental imagery. This review promotes our knowledge about the techniques used for the diagnosis of patients with DOC and attempts to provide ideas for future research. © Copyright © 2020 Jain and Ramakrishnan.

Item Type: Journal Article
Publication: Frontiers in Neuroscience
Publisher: Frontiers Media S.A.
Additional Information: Copyright to this article belongs to Frontiers Media S.A.
Keywords: auditory response; auditory stimulation; brain electrophysiology; consciousness disorder; electroencephalography; electromyography; emotionality; event related potential; functional connectivity; functional magnetic resonance imaging; human; neuroimaging; positron emission tomography; resting state network; Review; sensory stimulation; smelling; tactile stimulation
Department/Centre: Division of Electrical Sciences > Electrical Engineering
Date Deposited: 15 Dec 2020 09:30
Last Modified: 15 Dec 2020 09:30
URI: http://eprints.iisc.ac.in/id/eprint/66823

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