Brain-heart interactions reveal consciousness in non-communicating patients

[en] Objective: We here aimed at characterizing heart–brain interactions in patients with disorders of consciousness. We tested how this information impacts data-driven classification between unresponsive and minimally conscious patients. Methods: A cohort of 127 patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS; n570) and minimally conscious state (MCS; n557) were presented with the local–global auditory oddball paradigm, which dis- tinguishes 2 levels of processing: short-term deviation of local auditory regularities and global long-term rule viola- tions. In addition to previously validated markers of consciousness extracted from electroencephalograms (EEG), we computed autonomic cardiac markers, such as heart rate (HR) and HR variability (HRV), and cardiac cycle phase shifts triggered by the processing of the auditory stimuli. Results: HR and HRV were similar in patients across groups. The cardiac cycle was not sensitive to the processing of local regularities in either the VS/UWS or MCS patients. In contrast, global regularities induced a phase shift of the cardiac cycle exclusively in the MCS group. The interval between the auditory stimulation and the following R peak was significantly shortened in MCS when the auditory rule was violated. When the information for the cardiac cycle modulations and other consciousness-related EEG markers were combined, single patient classification performance was enhanced compared to classification with solely EEG markers. Interpretation: Our work shows a link between residual cognitive processing and the modulation of autonomic somatic markers. These results open a new window to evaluate patients with disorders of consciousness via the embodied paradigm, according to which body–brain functions contribute to a holistic approach to conscious processing.

Disciplines :

Neurology

Author, co-author :

Raimondo, Federico

Rohaut, Benjamin

Demertzi, Athina ; Université de Liège - ULiège > Centre de recherches du cyclotron

Valente, Melanie

Engemann, Denis

Salti, Moti

Fernandez Slezak, Diego

Naccache, Lionel

Sitt, Jacobo Diego

Language :

English

Title :

Brain-heart interactions reveal consciousness in non-communicating patients

Publication date :

2017

Journal title :

Annals of Neurology

ISSN :

0364-5134

eISSN :

1531-8249

Publisher :

Wiley Liss, Inc., New York, United States - New York

Volume :

Issue :

Pages :

578-591

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 04 December 2017

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