Changes in Standard Electroencephalograms Parallel Consciousness Improvements in Patients With Unresponsive Wakefulness Syndrome

被引:21
作者
Bagnato, Sergio [1 ,2 ]
Boccagni, Cristina [1 ,2 ]
Prestandrea, Caterina [1 ,2 ]
Fingelkurts, Alexander A. [3 ]
Fingelkurts, Andrew A. [3 ]
Galardi, Giuseppe [1 ,2 ]
机构
[1] Giuseppe Giglio Fdn, Rehabil Dept, Unit Neurophysiol, Cefalu, PA, Italy
[2] Giuseppe Giglio Fdn, Rehabil Dept, Unit Severe Acquired Brain Injuries, Cefalu, PA, Italy
[3] BM Sci, Brain & Mind Technol Res Ctr, Espoo, Finland
来源
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION | 2017年 / 98卷 / 04期
关键词
Consciousness disorders; Electroencephalography; Prognosis; Rehabilitation; EEG; DISORDERS; RECOVERY; PREDICTORS;
D O I
10.1016/j.apmr.2016.09.132
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Objective: To identify changes in the standard electroencephalograms (EEGs) of patients with unresponsive wakefulness syndrome (UWS) who did or did not recover consciousness 6 months after admission to a rehabilitation department. Design: Prospective cohort study. Setting: Unit for severe acquired brain injuries. Participants: Consecutive patients with UWS (N=28). Interventions: Not applicable. Main Outcome Measures: EEG amplitude (reduced or normal), dominant frequency (alpha, theta, or delta), and reactivity (absent or present) were scored at admission and 6 months later. The cumulative Amplitude-Frequency-Reactivity score was evaluated. Clinical assessments were made using the Coma Recovery Scale-Revised. Results: Sixteen (57.1%) of the 28 patients with UWS recovered consciousness after 6 months, while 12 patients (42.9%) did not recover consciousness. EEG improvements occurred in 14 patients with consciousness recovery (87.5%) and 2 patients without consciousness recovery (16.7%) only. Improvements in EEG dominant frequency (from the theta to the alpha band or from the delta to the theta band), reappearance of EEG reactivity, and Amplitude-Frequency-Reactivity score increase (P<.01) differentiated patients with consciousness improvement from those without consciousness improvement. Six months after admission for rehabilitation, patients with EEG improvements showed higher Coma Recovery Scale-Revised scores than did those without EEG changes (P<.01). Conclusions: Most patients who emerge from UWS demonstrate improvement in basic EEG characteristics over time. EEG changes in patients with UWS may aid in the timely recognition of patients transitioning into a minimally conscious state. (C) 2016 by the American Congress of Rehabilitation Medicine
引用
收藏
页码:665 / 672
页数:8
相关论文
共 33 条
[1]   Trait anxiety impact on the EEG theta band power changes during appraisal of threatening and pleasant visual stimuli [J].
Aftanas, LI ;
Pavlov, SV ;
Reva, NV ;
Varlamov, AA .
INTERNATIONAL JOURNAL OF PSYCHOPHYSIOLOGY, 2003, 50 (03) :205-212
[2]  
[Anonymous], 2013, PROL DIS CONSC NAT C
[3]   Prospective Cohort Study Evaluating the Prognostic Value of Simple EEG Parameters in Postanoxic Coma [J].
Azabou, Eric ;
Fischer, Catherine ;
Mauguiere, Francois ;
Vaugier, Isabelle ;
Annane, Djillali ;
Sharshar, Tarek ;
Lofaso, Frederic .
CLINICAL EEG AND NEUROSCIENCE, 2016, 47 (01) :75-82
[4]   Prognostic value of standard EEG in traumatic and non-traumatic disorders of consciousness following coma [J].
Bagnato, S. ;
Boccagni, C. ;
Prestandrea, C. ;
Sant'Angelo, A. ;
Castiglione, A. ;
Galardi, G. .
CLINICAL NEUROPHYSIOLOGY, 2010, 121 (03) :274-280
[5]  
Bagnato S., 2016, J NEUROTRAUM
[6]   EEG epileptiform abnormalities at admission to a rehabilitation department predict the risk of seizures in disorders of consciousness following a coma [J].
Bagnato, Sergio ;
Boccagni, Cristina ;
Sant'Angelo, Antonino ;
Prestandrea, Caterina ;
Virgilio, Vittorio ;
Galardi, Giuseppe .
EPILEPSY & BEHAVIOR, 2016, 56 :83-87
[7]   EEG predictors of outcome in patients with disorders of consciousness admitted for intensive rehabilitation [J].
Bagnato, Sergio ;
Boccagni, Cristina ;
Sant'Angelo, Antonino ;
Prestandrea, Caterina ;
Mazzilli, Roberta ;
Galardi, Giuseppe .
CLINICAL NEUROPHYSIOLOGY, 2015, 126 (05) :959-966
[8]   Emerging from an unresponsive wakefulness syndrome: Brain plasticity has to cross a threshold level [J].
Bagnato, Sergio ;
Boccagni, Cristina ;
St'Angelo, Antonino ;
Fingelkurts, Alexander A. ;
Fingelkurts, Andrew A. ;
Galardi, Giuseppe .
NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS, 2013, 37 (10) :2721-2736
[9]   Interpreting EEG alpha activity [J].
Bazanova, O. M. ;
Vernon, D. .
NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS, 2014, 44 :94-110
[10]   Usefulness of Standard EEG in Predicting the Outcome of Patients With Disorders of Consciousness After Anoxic Coma [J].
Boccagni, Cristina ;
Bagnato, Sergio ;
Sant'Angelo, Antonino ;
Prestandrea, Caterina ;
Galardi, Giuseppe .
JOURNAL OF CLINICAL NEUROPHYSIOLOGY, 2011, 28 (05) :489-492