Detecting consciousness in a total locked-in syndrome: an active event-related paradigm.
Total locked-in syndrome is characterized by tetraplegia, anarthria and paralysis of eye motility. In this study, consciousness was detected in a 21-year-old woman who presented a total locked-in syndrome after a basilar artery thrombosis (49 days post-injury) using an active event-related paradigm. The patient was presented sequences of names containing the patient's own name and other names. The patient was instructed to count her own name or to count another target name. Similar to 4 age- and gender-matched healthy controls, the P3 response recorded for the voluntarily counted own name was larger than while passively listening. This P3 response was observed 14 days before the first behavioral signs of consciousness. This study shows that our active event-related paradigm allowed to identify voluntary brain activity in a patient who would behaviorally be diagnosed as comatose.
Schnakers
Caroline
C
Coma Science Group, Cyclotron Research Centre, Sart Tilman, B30, University of Liège, 4000 Liège, Belgium. steven.laureys@ulg.ac.be
Perrin
Fabien
F
Schabus
Manuel
M
Hustinx
Roland
R
Majerus
Steve
S
Moonen
Gustave
G
Boly
Melanie
M
Vanhaudenhuyse
Audrey
A
Bruno
Marie-Aurelie
MA
Laureys
Steven
S
D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D003128:Coma / Q000175:diagnosis* / Q000209:etiology*; D003243:Consciousness / Q000502:physiology*; D004185:Disability Evaluation; D004569:Electroencephalography / Q000379:methods; D018913:Event-Related Potentials, P300 / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011379:Prognosis; D011782:Quadriplegia / Q000150:complications* / Q000473:pathology / Q000503:physiopathology*; D020127:Recovery of Function / Q000502:physiology; D012680:Sensitivity and Specificity; D014715:Vertebrobasilar Insufficiency / Q000150:complications; D014836:Volition / Q000502:physiology; D055815:Young Adult