Task-based EEG and fMRI paradigms in a multimodal clinical diagnostic framework for disorders of consciousness.
| Autor: | Lo CCH; School of Biomedical Sciences, and Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China., Woo PYM; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China., Cheung VCK; School of Biomedical Sciences, and Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China. |
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| Jazyk: | angličtina |
| Zdroj: | Reviews in the neurosciences [Rev Neurosci] 2024 May 29; Vol. 35 (7), pp. 775-787. Date of Electronic Publication: 2024 May 29 (Print Publication: 2024). |
| DOI: | 10.1515/revneuro-2023-0159 |
| Abstrakt: | Disorders of consciousness (DoC) are generally diagnosed by clinical assessment, which is a predominantly motor-driven process and accounts for up to 40 % of non-communication being misdiagnosed as unresponsive wakefulness syndrome (UWS) (previously known as prolonged/persistent vegetative state). Given the consequences of misdiagnosis, a more reliable and objective multimodal protocol to diagnosing DoC is needed, but has not been produced due to concerns regarding their interpretation and reliability. Of the techniques commonly used to detect consciousness in DoC, task-based paradigms (active paradigms) produce the most unequivocal result when findings are positive. It is well-established that command following (CF) reliably reflects preserved consciousness. Task-based electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) can detect motor-independent CF and reveal preserved covert consciousness in up to 14 % of UWS patients. Accordingly, to improve the diagnostic accuracy of DoC, we propose a practical multimodal clinical decision framework centered on task-based EEG and fMRI, and complemented by measures like transcranial magnetic stimulation (TMS-EEG). (© 2024 the author(s), published by De Gruyter, Berlin/Boston.) |
| Databáze: | MEDLINE |
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