Event-related potentials in the odd-ball paradigm and behavioral scales for the assessment of children and adolescents with disorders of consciousness: A proof of concept study

Abstract

Objective: Quantification of signatures of conscious processing in children with disorders of consciousness (DoC) using odd-ball paradigms in multiple modalities.

Method: We review the diagnostic approaches available in the field, from clinical scales to neuroimaging methods, and concentrate upon measures derived from electroencephalographic event related potentials.

Results: Evoked potentials were recorded in five procedures, encompassing visual, auditory and tactile modalities, from ten pediatric DoC patients—six in a minimally conscious state (MCS), three in unresponsive wakefulness syndrome (UWS) and one who emerged from MCS (eMCS)—and the control group of 10 healthy children. In almost all the eMCS and MCS patients, higher amplitude of P300 was observed and the effect was statistically significant in at least one out of the five performed procedures. Additionally, signs of conscious information processing were detected in one UWS patient.

Conclusion: The presented results provide a proof of concept for the possibility of applying ERP-derived electrophysiological measures as an aid in the assessment of children and adolescents in DoC.

KEYWORDS::

• Disorders of consciousness
• unresponsive wakefulness syndrome
• minimally conscious state
• pediatric patients
• P300
• event-related potential
• electroencephalography
• oddball paradigm
• global-local

Notes

Acknowledgements

We thank the “Akogo” foundation of Ewa Błaszczyk, the staff of “The Alarm Clock Clinic,” and of course, the parents of the patients, for their collective understanding of the importance of the study and their kind cooperation. We are especially grateful to Dr. Marta Bogotko, who shared her invaluable experience with DOC children and helped with any issues arising during the recordings.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 Model hospital for children with severe brain damage, http://www.klinikabudzik.pl/en

2 http://tmsi.com

3 http://braintech.pl

4 http://psychopy.org

Additional information

Funding

This research was supported by the Polish National Science Center (UMO-2015/17/B/ST7/03784).