Evidence of persisting cognitive impairment in a case series of patients with locked-in syndrome

Rousseaux, M.; Castelnot, Emilie; Rigaux, Pascal; Kozlowski, Odile; Danze, F.

doi:10.1136/jnnp.2007.128686

Cited by 29 publications

(20 citation statements)

References 20 publications

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“…Only four of the 10 patients performed the tasks within normal limits. Rousseaux, Castelnot, Rigaux, Kozlowski & Danze [14] describe persistent moderate and selective cognitive impairment in 16 patients with LIS (nine patients with LIS resulting from brainstem stroke and seven patients with frontal or frontotemporal lesions). They noted impairments in auditory recognition (associative level), oral comprehension of complex sentences, delayed visuospatial memory, mental calculation and problem solving.…”

Section: Introductionmentioning

confidence: 99%

A clinical screening protocol for the RSVP Keyboard brain–computer interface

Fried-Oken¹,

Mooney²,

Peters³

et al. 2013

Disability and Rehabilitation: Assistive Technology

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Purpose To propose a screening protocol that identifies requisite sensory, motor, cognitive, and communication skills for people with locked-in syndrome (PLIS) to use the RSVP Keyboard™ brain-computer interface (BCI). Method A multidisciplinary clinical team of seven individuals representing five disciplines identified requisite skills for the BCI. They chose questions and subtests from existing standardized instruments for auditory comprehension, reading, and spelling;modified them to accommodate nonverbal response modalities; and developed novel tasks to screen visual perception, sustained visual attention, and working memory. Questions were included about sensory skills, positioning, pain interference, and medications. The result is a compilation of questions, adapted subtests and original tasks designed for this new BCI system. It was administered to 12 PLIS and six healthy controls. Results Administration required one hour or less. Yes/no choices and eye gaze were adequate response modes for PLIS. Healthy controls and 9 PLIS were 100% accurate on all tasks; three PLIS missed single items. Conclusions The RSVP BCI screening protocol is a brief, repeatable technique for patients with different levels of LIS to identify the presence/absence of skills for BCI use. Widespread adoption of screening methods should be a clinical goal and will help standardize BCI implementation for research and intervention.

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Section: Introductionmentioning

confidence: 99%

A clinical screening protocol for the RSVP Keyboard brain–computer interface

Fried-Oken¹,

Mooney²,

Peters³

et al. 2013

Disability and Rehabilitation: Assistive Technology

View full text Add to dashboard Cite

show abstract

“…Similarly, LIS patients performed substantially worse in this not-so-easy paradigm. A possible explanation for the bad performance of LIS patients could be related to the presence of a mild cognitive impairment, which has been described in LIS patients [16], affecting the performance of the task. Other factors could be a limited training time with the experimental setup.…”

Section: Discussionmentioning

confidence: 98%

Performance of a tactile P300 speller for healthy people and severely disabled patients

Ortner

Lugo

Prückl

et al. 2013

2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

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P300 based Brain-Computer Interfaces (BCIs) for communication are well known since many years. Most of them use visual stimuli to elicit evoked potentials because it is easy to integrate a high number of different classes into the paradigm. Nevertheless, a BCI that depends on visual stimuli is sometimes not feasible due to the presence of visual impairment in patients with severe brain injuries. In this case, it could be possible to use auditory or somatosensory stimulation. In this publication a vibrotactile P300 based BCI is introduced. Two different approaches were tested: a first approach using two stimulators and a second one that utilizes three stimulators for emitting the stimuli. The two paradigms were tested on 16 users: A group of ten healthy users and a second group comprising of 6 patients suffering Locked-In Syndrome. The control accuracy was calculated for both groups and both approaches, proving the feasibility of the device, not only for healthy people but also in severely disabled patients. In a second step we evaluated the influence of the number of stimuli on the accuracy. It was shown that in many cases the maximum accuracy was already reached with a small number of stimuli, this could be used in future tests to speed up the Information transfer rate.

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“…In chronic LIS patients previous studies have shown deficits in short and long term memory, in sustained auditory attention (Schnakers et al, 2008a) and in auditory recognition, oral comprehension of complex sentences, delayed visuo-spatial memory, mental calculation and problem solving (Rousseaux et al, 2009). In both studies, the presence of deficits was related to more extended lesions (thalamic or hemispheric).…”

Section: Discussionmentioning

confidence: 99%

Cognitive Processing in Non-Communicative Patients: What Can Event-Related Potentials Tell Us?

Lugo

Quitadamo

Bianchi

et al. 2016

Front. Hum. Neurosci.

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Event-related potentials (ERP) have been proposed to improve the differential diagnosis of non-responsive patients. We investigated the potential of the P300 as a reliable marker of conscious processing in patients with locked-in syndrome (LIS). Eleven chronic LIS patients and 10 healthy subjects (HS) listened to a complex-tone auditory oddball paradigm, first in a passive condition (listen to the sounds) and then in an active condition (counting the deviant tones). Seven out of nine HS displayed a P300 waveform in the passive condition and all in the active condition. HS showed statistically significant changes in peak and area amplitude between conditions. Three out of seven LIS patients showed the P3 waveform in the passive condition and five of seven in the active condition. No changes in peak amplitude and only a significant difference at one electrode in area amplitude were observed in this group between conditions. We conclude that, in spite of keeping full consciousness and intact or nearly intact cortical functions, compared to HS, LIS patients present less reliable results when testing with ERP, specifically in the passive condition. We thus strongly recommend applying ERP paradigms in an active condition when evaluating consciousness in non-responsive patients.

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Evidence of persisting cognitive impairment in a case series of patients with locked-in syndrome

Abstract: Moderate and selective cognitive disorders can be observed in LIS patients. Systematic assessment is needed, because of their possible consequences for communication and rehabilitation protocols.

Cited by 29 publications

References 20 publications

A clinical screening protocol for the RSVP Keyboard brain–computer interface

A clinical screening protocol for the RSVP Keyboard brain–computer interface

Performance of a tactile P300 speller for healthy people and severely disabled patients

Cognitive Processing in Non-Communicative Patients: What Can Event-Related Potentials Tell Us?

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