Towards a method to differentiate chronic disorder of consciousness patients' awareness: The Low-Resolution Brain Electromagnetic Tomography Analysis

Assessing residual signs of awareness in patients suffering from chronic disorders of consciousness (DOC) is a challenging issue. DOC patient behavioral assessment is often doubtful since some individuals may retain covert traces of awareness; thus, some Unresponsive Wakefulness Syndrome (UWS) patients may be misdiagnosed. The aim of our study was to explore possible differences between the source powers within poly-modal cortices to differentiate Minimally Conscious State (MCS) from UWS. To this end, we recorded an electroencephalogram (EEG) during awake resting state and performed a Low-Resolution Brain Electromagnetic Tomography (LORETA), which is a 3D source localization method allowing the visualization of the most probable neuroanatomical generators of EEG differences. MCS and UWS patients showed significant variations concerning the frontal source power of delta-band, frontal and parietal of theta, parietal and occipital of alpha, central of beta, and parietal of gamma, in correlation with the Coma Recovery Scale-Revised (CRS-R) score. The alpha-band was the most significant LORETA data correlating with the consciousness level. In addition, we observed a significant correlation between central beta-peaks and the motor abilities and a dissociation between theta and gamma bands within parietal regions. Our findings suggest that LORETA analysis may be useful in DOC differential diagnosis since distinct neurophysiological correlates in some UWS patients could be used to assess deeper the residual cerebral activity of brain areas responsible for covert awareness.