An Auditory BCI System for Assisting CRS-R Behavioral Assessment in Patients with Disorders of Consciousness.
The Coma Recovery Scale-Revised (CRS-R) is a consistent and sensitive behavioral assessment standard for disorders of consciousness (DOC) patients. However, the CRS-R has limitations due to its dependence on behavioral markers, which has led to a high rate of misdiagnosis. Brain-computer interfaces (BCIs), which directly detect brain activities without any behavioral expression, can be used to evaluate a patient's state. In this study, we explored the application of BCIs in assisting CRS-R assessments of DOC patients. Specifically, an auditory passive EEG-based BCI system with an oddball paradigm was proposed to facilitate the evaluation of one item of the auditory function scale in the CRS-R - the auditory startle. The results obtained from five healthy subjects validated the efficacy of the BCI system. Nineteen DOC patients participated in the CRS-R and BCI assessments, of which three patients exhibited no responses in the CRS-R assessment but were responsive to auditory startle in the BCI assessment. These results revealed that a proportion of DOC patients who have no behavioral responses in the CRS-R assessment can generate neural responses, which can be detected by our BCI system. Therefore, the proposed BCI may provide more sensitive results than the CRS-R and thus assist CRS-R behavioral assessments.
Center for Brain Computer Interfaces and Brain Information Processing, South China University of Technology, Guangzhou, 510640, China.
Jun
J
Xiao
Coma Research Group, Centre for Hyperbaric Oxygen and Neurorehabilitation, General Hospital of Guangzhou Military Command of People's Liberation Army, Guangzhou 510010, China.
Qiuyou
Q
Xie
Coma Research Group, Centre for Hyperbaric Oxygen and Neurorehabilitation, General Hospital of Guangzhou Military Command of People's Liberation Army, Guangzhou 510010, China.
Yanbin
Y
He
Center for Brain Computer Interfaces and Brain Information Processing, South China University of Technology, Guangzhou, 510640, China.
Tianyou
T
Yu
Center for Brain Computer Interfaces and Brain Information Processing, South China University of Technology, Guangzhou, 510640, China.
Shenglin
S
Lu
Center for Brain Computer Interfaces and Brain Information Processing, South China University of Technology, Guangzhou, 510640, China.
Ningmeng
N
Huang
Coma Research Group, Centre for Hyperbaric Oxygen and Neurorehabilitation, General Hospital of Guangzhou Military Command of People's Liberation Army, Guangzhou 510010, China.
Ronghao
R
Yu
Center for Brain Computer Interfaces and Brain Information Processing, South China University of Technology, Guangzhou, 510640, China.
Yuanqing
Y
Li
D000293:Adolescent; D000328:Adult; D000368:Aged; D058256:Brain Waves / Q000502:physiology; D062207:Brain-Computer Interfaces; D003243:Consciousness / Q000502:physiology; D003244:Consciousness Disorders / Q000175:diagnosis* / Q000473:pathology; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013216:Reflex, Startle / Q000502:physiology*; D055815:Young Adult