Prognosis for patients with cognitive motor dissociation identified by brain-computer interface

Jiahui Pan, Qiuyou Xie, Pengmin Qin, Yan Chen, Yanbin He, Haiyun Huang, Fei Wang, Xiaoxiao Ni, Andrzej Cichocki, Ronghao Yu, Yuanqing Li

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

Cognitive motor dissociation describes a subset of patients with disorders of consciousness who show neuroimaging evidence of consciousness but no detectable command-following behaviours. Although essential for family counselling, decision-making, and the design of rehabilitation programmes, the prognosis for patients with cognitive motor dissociation remains under-investigated. The current study included 78 patients with disorders of consciousness who showed no detectable command-following behaviours. These patients included 45 patients with unresponsive wakefulness syndrome and 33 patients in a minimally conscious state, as diagnosed using the Coma Recovery Scale-Revised. Each patient underwent an EEG-based brain-computer interface experiment, in which he or she was instructed to perform an item-selection task (i.e. select a photograph or a number from two candidates). Patients who achieved statistically significant brain-computer interface accuracies were identified as cognitive motor dissociation. Two evaluations using the Coma Recovery Scale-Revised, one before the experiment and the other 3 months later, were carried out to measure the patients' behavioural improvements. Among the 78 patients with disorders of consciousness, our results showed that within the unresponsive wakefulness syndrome patient group, 15 of 18 patients with cognitive motor dissociation (83.33%) regained consciousness, while only five of the other 27 unresponsive wakefulness syndrome patients without significant brain-computer interface accuracies (18.52%) regained consciousness. Furthermore, within the minimally conscious state patient group, 14 of 16 patients with cognitive motor dissociation (87.5%) showed improvements in their Coma Recovery Scale-Revised scores, whereas only four of the other 17 minimally conscious state patients without significant brain-computer interface accuracies (23.53%) had improved Coma Recovery Scale-Revised scores. Our results suggest that patients with cognitive motor dissociation have a better outcome than other patients. Our findings extend current knowledge of the prognosis for patients with cognitive motor dissociation and have important implications for brain-computer interface-based clinical diagnosis and prognosis for patients with disorders of consciousness.

Original languageEnglish
Pages (from-to)1177-1189
Number of pages13
JournalBrain
Volume143
Issue number3
DOIs
Publication statusPublished - Mar 1 2020
Externally publishedYes

Keywords

  • Brain-computer interface
  • Cognitive motor dissociation
  • Disorders of consciousness
  • Prognosis
  • Unresponsive wakefulness syndrome

ASJC Scopus subject areas

  • Clinical Neurology

Fingerprint

Dive into the research topics of 'Prognosis for patients with cognitive motor dissociation identified by brain-computer interface'. Together they form a unique fingerprint.

Cite this