fMRI + EEG used to detect consciousness in ICU patients

MGH’s  Brian Edlow and colleagues have completed a small study showing the efficacy of using fMRI and EEG in ICU TBI patients to detect consciousness.  Previous research has suggested that up to 40% of conscious patients are misclassified as unconscious.

The goal is to create a more informed care plan, and earlier interventions that could improve outcomes.

16 patients with severe traumatic brain injury at MGH’s ICU were studied. At the start, 8 patients could respond to language, 3 were classified as minimally conscious with no language response, 3 were classified as vegetative, and 2 were in a coma. The study also included a healthy control group 16.

f MRI scans were performed as soon as the subjects were stable. EEG readings were usually taken within 24 hours after the fMRI scan.  Tests were designed to detect a mismatch between their ability to imagine performing a task and their ability to physically express themselves (cognitive motor dissociation.)

Through the study, researchers detected evidence of consciousness in 4 of the 8 patients who were unable to respond to language in bedside exams, including the 3 classified as vegetative. (It was also noted that 25% of the healthy controls had no detectable brain response in a hand-squeeze imagery test.)

The subjects were also exposed to brief recordings of spoken language and music during both fMRI and EEG to detect activity in certain brain regions. Higher-order cortex activity was seen in 2 additional subjects. While higher-order cortical activity doesn’t prove that a patient is conscious, finding a response in those structures could have implications for a patient’s eventual recovery.

A 19 electrode EEG device was used for the study.

Brain health company Neurosteer is attempting to gather similar neural activity data with its continuous, mobile, 3 electrode, EEG wearable.  The company’s CEO, Nathan Intrator, will present this work at ApplySci’s Wearable Tech + Digital Health + Neurotech conference, on September 19th at the MIT Media Lab.

Join ApplySci at Wearable Tech + Digital Health + NeuroTech Boston on September 19, 2017 at the MIT Media Lab – featuring  Joi Ito – Ed Boyden – Roz Picard – George Church – Nathan Intrator –  Tom Insel – John Rogers – Jamshid Ghajar – Phillip Alvelda – Michael Weintraub – Nancy Brown – Steve Kraus – Bill Geary – Mary Lou Jepsen

Registration rates increase Friday, August 18th.


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