Persistent Vegetative State
Conditions
Keywords
Persistent Vegetative State, minimally conscious state, Emotions, Awareness, electrodermal activity, Electroencephalography
Brief summary
After a coma, one important challenge is the detection of awareness with patients with disorders of consciousness. For some patients, the only behavioral manifestation indicative of awareness is an appropriate emotional response. Studies show that the use of a particular conditioning - with delay - appears to be an objective solution to study the conscious perception of an emotion in none-communicating people. Until now, emotions of patients suffering disorder of consciousness (DOC) have been scarcely studied. It has been proved that some awakening patients have vegetative reactions following an emotional stimulus, but the investigator can't confirm whether or not the emotional experience of the patient is conscious. The investigator's main purpose is to study emotional reactions from patients suffering a disorder of consciousness. The investigator hypothesize that some patients have preserved reflexes reaction to the emotional stimuli while others could demonstrate a conscious emotional experience. In order to answer these questions, the study is designed to record in a single session: (i) physiological vegetative reactions (electrodermal, pupillary responses and heart rate) to emotional stimuli both in DOC patients and healthy controls; (ii) a neurophysiological marker of consciousness; and (iii) physiological parameters during a trace conditioning experiment using auditory stimuli with and without emotional valence. The investigator plan to include patients vegetative patients (n=15); minimally conscious patients (n=15); acquired brain injured patients without conscious disorder (n=15) and healthy participants (n=15).
Interventions
BEHAVIORALPhysiological recording in response to different types of stimuli
In order to answer these questions, the study is designed to record in a single session: (i) physiological vegetative reactions (electrodermal, pupillary responses and heart rate) to emotional stimuli ; (ii) a neurophysiological marker of consciousness; and (iii) physiological parameters during a trace conditioning experiment using auditory stimuli with and without emotional valence.
BEHAVIORALEEG recording in response to different types of stimuli
In order to answer these questions, the study is designed to record in a single session: (i) physiological vegetative reactions (electrodermal, pupillary responses and heart rate) to emotional stimuli ; (ii) a neurophysiological marker of consciousness; and (iii) physiological parameters during a trace conditioning experiment using auditory stimuli with and without emotional valence.
Sponsors
Hospices Civils de Lyon
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
For Patients : * age between 18 and 80 * acquired brain lesion (brain injury, stroke, anoxia) with a delay since the insult superior to 1 month * level of consciousness assessed with the coma recovery scale revised (CRS-R) * patient with health insurance * informed consent signed by the patients or his representative For Healthy participants: * age between 18 and 80 * participant able to understand instructions and normal hearing * patient with health insurance * informed consent signed
Exclusion criteria
For Patients : * non controlled epilepsy * dysautonomic crisis * unstable medical state * pregnancy or breath feeding for women * Persons under guardianship, curatorship For Healthy participants: * neurological disorder * pregnancy or breath feeding for women * Persons under guardianship, curatorship or any other administrative or judicial measure of deprivation of rights or liberty
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| electrodermal response | at Day 1 | skin conductance response measured with trans-cutaneus electrodes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| pupillary response | at Day 1 | use of eye-tracker |
| heart rate modification | at day 1 | use of transcutaneous electrode |
| Variation of the intensity of different Event Related Potentials | at Day 2 | electroencephalography (EEG) The investigator will study how the intensity of different Event Related Potentials varies with different levels of sound around the auditory threshold: this will be assessed specifically for early cortical components of the auditory response such as the N1 around 100 ms after the stimulus, and for late components around 300-500 ms after the stimulus, particularly the P300. |
Countries
France
Outcome results
None listed