title: Audiomotor Integration in Minimally Conscious State: Proof of Concept!
abstract: Patients suffering from chronic disorders of consciousness (DOC) are characterized by profound unawareness and an impairment of large-scale cortical and subcortical connectivity. In this study, we applied an electrophysiological approach aimed at identifying the residual audiomotor connectivity patterns that are thought to be linked to awareness. We measured some markers of audiomotor integration (AMI) in 20 patients affected by DOC, before and after the application of a repetitive transcranial magnetic stimulation protocol (rTMS) delivered over the left primary motor area (M1), paired to a transauricular alternating current stimulation. Our protocol induced potentiating of the electrophysiological markers of AMI and M1 excitability, paired to a clinical improvement, in all of the patients with minimally conscious state (MCS) but in none of those suffering from unresponsive wakefulness syndrome (UWS). Our protocol could be a promising approach to potentiate the functional connectivity within large-scale audiomotor networks, thus allowing clinicians to differentiate patients affected by MCS from UWS, besides the clinical assessment.
authors.affiliation: IRCCS Centro Neurolesi "Bonino-Pulejo", Contrada Casazza, SS113, 98124 Messina, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Naro
authors.affiliation: IRCCS Centro Neurolesi "Bonino-Pulejo", Contrada Casazza, SS113, 98124 Messina, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Leo
authors.affiliation: IRCCS Centro Neurolesi "Bonino-Pulejo", Contrada Casazza, SS113, 98124 Messina, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Cannavò
authors.affiliation: IRCCS Centro Neurolesi "Bonino-Pulejo", Contrada Casazza, SS113, 98124 Messina, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Buda
authors.affiliation: Otorhinolaryngoiatry Unit, University of Messina, Messina, Italy.
authors.forename: Rocco
authors.initials: R
authors.lastname: Bruno
authors.affiliation: Otorhinolaryngoiatry Unit, University of Messina, Messina, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Salviera
authors.affiliation: IRCCS Centro Neurolesi "Bonino-Pulejo", Contrada Casazza, SS113, 98124 Messina, Italy.
authors.forename: Placido
authors.initials: P
authors.lastname: Bramanti
authors.affiliation: IRCCS Centro Neurolesi "Bonino-Pulejo", Contrada Casazza, SS113, 98124 Messina, Italy.
authors.forename: Rocco Salvatore
authors.initials: RS
authors.lastname: Calabrò
mesh_terms: D000328:Adult; D000368:Aged; D001307:Auditory Perception; D003213:Conditioning, Psychological; D005072:Evoked Potentials, Auditory; D019054:Evoked Potentials, Motor; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology; D009068:Movement; D009434:Neural Pathways; D018458:Persistent Vegetative State / Q000523:psychology*; D050781:Transcranial Magnetic Stimulation; D014851:Wakefulness; D055815:Young Adult