Disorder of Consciousness
Conditions
Keywords
EEG;DOC;auditory
Brief summary
In recent years, promoting wakening attempts in patients with disorders of consciousness are increasing, but there are a lack of objective indicators to evaluate the efficacy and further researches on the brain mechanism during the wakening processing. So, the study first assessed the cerebral response during emotional acoustic stimuli with quantitative EEG and ERP(Event-related potential), and next, the investigators explored the relationship between brain activation and patients' recovery.
Detailed description
Auditory stimuli have potential beneficial effects on cognitive functions and consciousness in patients with disorders of consciousness (DOC)，especially the emotional sound; however, precise and accurate quantitative indices to estimate cerebral activation to different auditory stimuli remain scarce. In this study, investigators assessed the response of different brain regions to three acoustic stimuli using quantitative electroencephalography (QEEG) and ERP(Event-related potential),and further investigated the predictive value of QEEG in the prognosis of DOC.
Interventions
DEVICEmusic,name,and noise sound
A 5-minute baseline silence was followed by the presentation of three contrasting auditory stimuli(music,name,and noise), with a 2-minute washout silence separating each stimulus
Sponsors
First Affiliated Hospital of Zhejiang University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
Brain-damaged patients : Inclusion Criteria: 1. Disorders of consciousness (Traumatic brain injury, stroke or anoxic encephalopathy) 2. Coma diagnosis (Plum and Posner, 1966), vegetative state (Task Force, 1994) or minimally conscious state (Giacino, Ashwal et al. 2002) 3. Lack of autonomic crisis since one week minimum 4. Medical condition considered stable 5. Patients who do not present hearing loss. Peaks I and II of Brainstem Auditory Evoked Potentials (BAEP) will be normal.
Exclusion criteria
1. hearing Problem 2. Uncontrolled Epilepsy 3. Autonomic crises 4. Medical unstable state 5. Pregnant or likely to be (interrogation data) or breastfeeding woman Healthy participants : Inclusion Criteria: 1. Subjects with normal hearing 2. Absence of neurological disorder 3. Subjects able to understand the experimental instructions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Glasgow Outcome Scale (GOS) | In one year | A GOS value of \<3 was considered as a bad recovery, while a GOS value of ≥3 was considered as a good recovery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| quantitative electroencephalography | 30 minutes before the auditory stimualtion and 30 minutes after each stimulation | The power spectrum was divided into four bandwidths,an increase of delta and theta activity usually reflects encephalopathy and/or structural lesions, interpreted as poor outcome predictor of DOC. The power of α and β is related to the chance of recovery. |
Other
| Measure | Time frame | Description |
|---|---|---|
| N1,P300,LPP | From 200 msec before the stimuli onset to 1000ms after the auditory stimulation | The event-related potential waveforms uncover voluntary responses to external stimuli that could assist in detecting signs of consciousness to reduce the risk of misdiagnosis. |
Outcome results
None listed