Neural detection of complex sound sequences in the absence of consciousness.
The neural response to a violation of sequences of identical sounds is a typical example of the brain's sensitivity to auditory regularities. Previous literature interprets this effect as a pre-attentive and unconscious processing of sensory stimuli. By contrast, a violation to auditory global regularities, i.e. based on repeating groups of sounds, is typically detectable when subjects can consciously perceive them. Here, we challenge the notion that global detection implies consciousness by testing the neural response to global violations in a group of 24 patients with post-anoxic coma (three females, age range 45-87 years), treated with mild therapeutic hypothermia and sedation. By applying a decoding analysis to electroencephalographic responses to standard versus deviant sound sequences, we found above-chance decoding performance in 10 of 24 patients (Wilcoxon signed-rank test, P < 0.001), despite five of them being mildly hypothermic, sedated and unarousable. Furthermore, consistently with previous findings based on the mismatch negativity the progression of this decoding performance was informative of patients' chances of awakening (78% predictive of awakening). Our results show for the first time that detection of global regularities at neural level exists despite a deeply unconscious state.
1 Centre for Biomedical Imaging (CIBM), Department of Radiology, Lausanne, University Hospital and University of Lausanne, CH-1011 Lausanne, Switzerland 2 Laboratoire de Recherche en Neuroimagerie (LREN), Department of Clinical Neurosciences, Lausanne University and University Hospital, Lausanne, CH-1011, Switzerland.
Athina
A
Tzovara
3 Department of Clinical Neurosciences, University Hospital, Lausanne, CH-1011, Switzerland.
Alexandre
A
Simonin
4 Department of Intensive Care Medicine, CH-1011, Lausanne University Hospital, Switzerland.
Mauro
M
Oddo
3 Department of Clinical Neurosciences, University Hospital, Lausanne, CH-1011, Switzerland.
Andrea O
AO
Rossetti
1 Centre for Biomedical Imaging (CIBM), Department of Radiology, Lausanne, University Hospital and University of Lausanne, CH-1011 Lausanne, Switzerland 2 Laboratoire de Recherche en Neuroimagerie (LREN), Department of Clinical Neurosciences, Lausanne University and University Hospital, Lausanne, CH-1011, Switzerland Marzia.De-Lucia@chuv.ch.
Marzia
M
De Lucia
D000161:Acoustic Stimulation / Q000379:methods; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology*; D001307:Auditory Perception / Q000502:physiology*; D003243:Consciousness / Q000502:physiology*; D004569:Electroencephalography / Q000379:methods; D005072:Evoked Potentials, Auditory / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013016:Sound
EEG; auditory system; coma; consciousness; hypothermia