In recent years, numerous electrophysiological signatures of consciousness have been proposed. Here, we perform a systematic analysis of these electroencephalography markers by quantifying their efficiency in differentiating patients in a vegetative state from those in a minimally conscious or conscious state. Capitalizing on a review of previous experiments and current theories, we identify a series of measures that can be organized into four dimensions: (i) event-related potentials versus ongoing electroencephalography activity; (ii) local dynamics versus inter-electrode information exchange; (iii) spectral patterns versus information complexity; and (iv) average versus fluctuations over the recording session. We analysed a large set of 181 high-density electroencephalography recordings acquired in a 30 minutes protocol. We show that low-frequency power, electroencephalography complexity, and information exchange constitute the most reliable signatures of the conscious state. When combined, these measures synergize to allow an automatic classification of patients' state of consciousness.
Neuronal theories of conscious access tentatively relate conscious perception to the integration and global broadcasting of information across distant cortical and thalamic areas. Experiments contrasting visible and invisible stimuli support this view and suggest that global neuronal communication may be detectable using scalp electroencephalography (EEG). However, whether global information sharing across brain areas also provides a specific signature of conscious state in awake but noncommunicating patients remains an active topic of research. We designed a novel measure termed "weighted symbolic mutual information" (wSMI) and applied it to 181 high-density EEG recordings of awake patients recovering from coma and diagnosed in various states of consciousness. The results demonstrate that this measure of information sharing systematically increases with consciousness state, particularly across distant sites. This effect sharply distinguishes patients in vegetative state (VS), minimally conscious state (MCS), and conscious state (CS) and is observed regardless of etiology and delay since insult. The present findings support distributed theories of conscious processing and open up the possibility of an automatic detection of conscious states, which may be particularly important for the diagnosis of awake but noncommunicating patients.
Campbell, B. C.V. et al. (2019) Penumbral imaging and functional outcome in patients with anterior circulation ischaemic stroke treated with endovascular thrombectomy versus medical therapy: a meta-analysis of individual patient-level data.ABSTRACT Background: CT-perfusion (CTP) and MRI may assist patient selection for endovascular thrombectomy. We aimed to establish whether imaging assessments of ischaemic core and penumbra volumes were associated with functional outcomes and treatment effect.
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