RESEARCH ARTICLE


Long-Term (Six Years) Clinical Outcome Discrimination of Patients in the Vegetative State Could be Achieved Based on the Operational Architectonics EEG Analysis: A Pilot Feasibility Study



Andrew A. Fingelkurtsa, *, Alexander A. Fingelkurtsa, Sergio Bagnatob, c, Cristina Boccagnib, c, Giuseppe Galardib, c
a BM-Science, Brain and Mind Technologies Research Centre, Espoo, Finland
b Neurorehabilitation Unit, Rehabilitation Department, Fondazione Istituto “San Raffaele - G. Giglio”, Cefalù (PA), Italy
c Neurophysiology Unit, Rehabilitation Department, Fondazione Istituto “San Raffaele - G. Giglio”, Cefalù (PA), Italy


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© Fingelkurts et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the BM-Science - Brain and Mind Technologies Research Centre, P.O. Box 77, FI-02601, Espoo, Finland; Tel: +358 9 5414506; Fax: +358 9 5414507; E-mail: andrew.fingelkurts@bm-science.com; Url: www.bm-science.com/team/fingelkurts.html


Abstract

Electroencephalogram (EEG) recordings are increasingly used to evaluate patients with disorders of consciousness (DOC) or assess their prognosis outcome in the short-term perspective. However, there is a lack of information concerning the effectiveness of EEG in classifying long-term (many years) outcome in chronic DOC patients. Here we tested whether EEG operational architectonics parameters (geared towards consciousness phenomenon detection rather than neurophysiological processes) could be useful for distinguishing a very long-term (6 years) clinical outcome of DOC patients whose EEGs were registered within 3 months post-injury. The obtained results suggest that EEG recorded at third month after sustaining brain damage, may contain useful information on the long-term outcome of patients in vegetative state: it could discriminate patients who remain in a persistent vegetative state from patients who reach a minimally conscious state or even recover a full consciousness in a long-term perspective (6 years) post-injury. These findings, if confirmed in further studies, may be pivotal for long-term planning of clinical care, rehabilitative programs, medical-legal decisions concerning the patients, and policy makers.

Keywords: Brain operations, consciousness, EEG-a and b-rhythms, functional connectivity, minimally conscious state (MCS), neuronal assemblies, operational synchrony, synchronization, unconsciousness, vegetative state (VS).