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Assessment of Neural Dynamics in Severe Traumatic Brain Injured Patients with Disorders of Consciousness
Casey S. Gilmore, Ph.D.Defense and Veterans Brain Injury Center
Minneapolis VA Medical Center
Collaborators
•Giuseppe Pellizzer, Ph.D.
•Michelle Peterson, DPT, NCS
•Brian Fay, Ph.D.
•Charidimos Tzagarakis, M.D., Ph.D.
Consciousness
Disorders of Consciousness
Arousal
Awareness
Coma Vegetative State
Minimally Conscious
StateConsciousness
Adapted from Laureys et al. 2004
Emergence from Altered Consciousness
Interactive communication
Functional object use
Sense of self in the environment
Challenges
Objective Assessment of Levels of Consciousness
EEG Assessment of Levels of Consciousness
Power in Frequency Bands Functional Connectivity
Hargrove et al, 2012www.neurosky.com
Event Related Potential (ERP)
commons.wikimedia.org
Multidimensional classification of neural dynamics in Disorders of Consciousness
Evaluate the neural dynamics of DOC patients
Monitor changes of these neural dynamics across time
Assess the prognostic value of EEG-based measures
Preliminary Data
Minneapolis VA Emerging Consciousness Program
2 patients in Minimally Conscious State (MCS)•21 and 31 year old males•Motor Vehicle Accidents
2 healthy controls
Resting State EEG
Differences in Power profiles between MCS and Controls
Power profiles after Emergence from MCS (MCS+)
Functional Connectivity lower in MCS, but higher after Emergence (MCS+)
Conclusions & Future Directions
Analysis of neural oscillatory activity with EEG can provide a sound basis for evaluating the level of consciousness of an individual, and monitoring changes in that level over time.
This project will assess the effectiveness of several measures of brain activity in relation to the level of consciousness as measured by the clinical scales, and to their value as prognostic markers.
A multidimensional approach of different measures reflecting neural activity will be used to increase effectiveness of short-term and long-term evaluation of patients.
The development of an EEG assessment protocol would provide VA, and other, sites with advanced methodology to serve severely brain injured patients and their families.
Contact: [email protected]
