Progression of auditory discrimination based on neural decoding predicts awakening from coma
- Tzovara, Athina Electroencephalography Brain Mapping Core, Centre for Biomedical Imaging (CIBM), Lausanne University Hospital and University of Lausanne, Switzerland - Department of Radiology, Lausanne University Hospital and University of Lausanne, Switzerland
- Rossetti, Andrea O. Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Switzerland
- Spierer, Lucas Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Switzerland - Department of Medicine, Neurology Unit, Faculty of Sciences, University of Fribourg, Switzerland
- Grivel, Jeremy Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Switzerland
- Murray, Micah M. Electroencephalography Brain Mapping Core, Centre for Biomedical Imaging (CIBM), Lausanne University Hospital and University of Lausanne, Switzerland - Department of Radiology, Lausanne University Hospital and University of Lausanne, Switzerland - Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Switzerland
- Oddo, Mauro Department of Intensive Care Medicine, Lausanne University Hospital and University of Lausanne, Switzerland
- De Lucia, Marzia Electroencephalography Brain Mapping Core, Centre for Biomedical Imaging (CIBM), Lausanne University Hospital and University of Lausanne, Switzerland - Department of Radiology, Lausanne University Hospital and University of Lausanne, Switzerland
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12.11.2012
Published in:
- Brain. - 2013, vol. 136, no. 1, p. 81-89
English
Auditory evoked potentials are informative of intact cortical functions of comatose patients. The integrity of auditory functions evaluated using mismatch negativity paradigms has been associated with their chances of survival. However, because auditory discrimination is assessed at various delays after coma onset, it is still unclear whether this impairment depends on the time of the recording. We hypothesized that impairment in auditory discrimination capabilities is indicative of coma progression, rather than of the comatose state itself and that rudimentary auditory discrimination remains intact during acute stages of coma. We studied 30 post-anoxic comatose patients resuscitated from cardiac arrest and five healthy, age- matched controls. Using a mismatch negativity paradigm, we performed two electroencephalography recordings with a standard 19-channel clinical montage: the first within 24 h after coma onset and under mild therapeutic hypothermia, and the second after 1 day and under normothermic conditions. We analysed electroencephalography responses based on a multivariate decoding algorithm that automatically quantifies neural discrimination at the single patient level. Results showed high average decoding accuracy in discriminating sounds both for control subjects and comatose patients. Importantly, accurate decoding was largely independent of patients’ chance of survival. However, the progression of auditory discrimination between the first and second recordings was informative of a patient’s chance of survival. A deterioration of auditory discrimination was observed in all non- survivors (equivalent to 100% positive predictive value for survivors). We show, for the first time, evidence of intact auditory processing even in comatose patients who do not survive and that progression of sound discrimination over time is informative of a patient’s chance of survival. Tracking auditory discrimination in comatose patients could provide new insight to the chance of awakening in a quantitative and automatic fashion during early stages of coma.
- Faculty
- Faculté des sciences et de médecine
- Department
- Médecine 3ème année
- Language
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- English
- Classification
- Biological sciences
- License
- License undefined
- Identifiers
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- RERO DOC 31063
- DOI 10.1093/brain/aws264
- Persistent URL
- https://folia.unifr.ch/unifr/documents/302664
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