EEG分形维数预测最低意识患者的高水平行为反应。

IF 3.7 3区 医学 Q2 ENGINEERING, BIOMEDICAL Journal of neural engineering Pub Date : 2023-08-25 DOI:10.1088/1741-2552/aceaac
Piergiuseppe Liuzzi, Bahia Hakiki, Francesca Draghi, Anna Maria Romoli, Rachele Burali, Maenia Scarpino, Francesca Cecchi, Antonello Grippo, Andrea Mannini
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引用次数: 0

摘要

目标。脑损伤患者可能进入一种最小或不一致的意识状态,称为最小意识状态(MCS)。这些患者可能(MCS+)或可能(MCS-)表现出高水平的行为反应,两组保留了两种本质上不同的康复路径和预期结果。在这项前瞻性观察研究中,68例MCS患者(MCS-: 30;女性:31例)(中位[IQR]年龄69 [20];发病后时间83[28])。在入院接受强化康复治疗时,按照国际准则进行30分钟静息状态闭眼记录和意识诊断。计算每个通道时间序列的多重分形奇异谱宽度(MSS),并输入针对MCS±的鉴别诊断的嵌套交叉验证的可解释机器学习模型。主要的结果。额叶MSS宽度(p< 0.05),以及左侧中央颞叶网络的MSS宽度(C3:p= 0.018, T3:p= 0.017;T5:p= 0.003)在MCS+组中显著升高。结果发现,表现最好的解决方案是k近邻模型,其聚合测试准确率为75.5%(100次执行的中位数[IQR] AuROC为0.88[0.02])。同时,Shapley值最高的电极是Fz和Cz,前5个特征中有4个属于前额-中央网络。MCS+是一种常见的疾病,其预后明显优于MCS-。左中央颞叶网络的高分形结果与MCS+患者的语言功能相关的神经网络一致。使用基于脑电图的可解释算法来补充意识的鉴别诊断可以改善康复途径和与护理人员的沟通。
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EEG fractal dimensions predict high-level behavioral responses in minimally conscious patients.

Objective.Brain-injured patients may enter a state of minimal or inconsistent awareness termed minimally conscious state (MCS). Such patient may (MCS+) or may not (MCS-) exhibit high-level behavioral responses, and the two groups retain two inherently different rehabilitative paths and expected outcomes. We hypothesized that brain complexity may be treated as a proxy of high-level cognition and thus could be used as a neural correlate of consciousness.Approach.In this prospective observational study, 68 MCS patients (MCS-: 30; women: 31) were included (median [IQR] age 69 [20]; time post-onset 83 [28]). At admission to intensive rehabilitation, 30 min resting-state closed-eyes recordings were performed together with consciousness diagnosis following international guidelines. The width of the multifractal singularity spectrum (MSS) was computed for each channel time series and entered nested cross-validated interpretable machine learning models targeting the differential diagnosis of MCS±.Main results.Frontal MSS widths (p< 0.05), as well as the ones deriving from the left centro-temporal network (C3:p= 0.018, T3:p= 0.017; T5:p= 0.003) were found to be significantly higher in the MCS+ cohort. The best performing solution was found to be the K-nearest neighbor model with an aggregated test accuracy of 75.5% (median [IQR] AuROC for 100 executions 0.88 [0.02]). Coherently, the electrodes with highest Shapley values were found to be Fz and Cz, with four out the first five ranked features belonging to the fronto-central network.Significance.MCS+ is a frequent condition associated with a notably better prognosis than the MCS-. High fractality in the left centro-temporal network results coherent with neurological networks involved in the language function, proper of MCS+ patients. Using EEG-based interpretable algorithm to complement differential diagnosis of consciousness may improve rehabilitation pathways and communications with caregivers.

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来源期刊
Journal of neural engineering
Journal of neural engineering 工程技术-工程:生物医学
CiteScore
7.80
自引率
12.50%
发文量
319
审稿时长
4.2 months
期刊介绍: The goal of Journal of Neural Engineering (JNE) is to act as a forum for the interdisciplinary field of neural engineering where neuroscientists, neurobiologists and engineers can publish their work in one periodical that bridges the gap between neuroscience and engineering. The journal publishes articles in the field of neural engineering at the molecular, cellular and systems levels. The scope of the journal encompasses experimental, computational, theoretical, clinical and applied aspects of: Innovative neurotechnology; Brain-machine (computer) interface; Neural interfacing; Bioelectronic medicines; Neuromodulation; Neural prostheses; Neural control; Neuro-rehabilitation; Neurorobotics; Optical neural engineering; Neural circuits: artificial & biological; Neuromorphic engineering; Neural tissue regeneration; Neural signal processing; Theoretical and computational neuroscience; Systems neuroscience; Translational neuroscience; Neuroimaging.
期刊最新文献
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