Cognitive processes in disorders of consciousness as revealed by EEG time–frequency analyses

ObjectiveAlthough behavioral evaluation of awareness in disorders of consciousness is difficult it remains the clinical standard. We believe that the refinement of EEG and analyses techniques would improve our characterization of those patients.MethodsWe focused on cognitive processing in a sample of 12 control subjects, eight vegetative-state patients, and 13 patients in the minimally consciousness state using EEG. We used an ‘active paradigm’ which asks subjects to follow instructions, specifically to actively count own or other names as compared to passively listening to them. EEG data was then analyzed using an advanced EEG analysis technique.ResultsResults revealed that all groups exhibit a stronger theta-synchronization to their own names when forced to count them. We also observed a delay in theta power in response to targets relative to non-targets when participants were instructed to count their own name.ConclusionActive paradigms are able to induce a different oscillatory activity compared to passive paradigms. Differences between controls and the pathologic groups are prominent in the theta- and alpha-band.SignificanceTime–frequency analyses allow to focus on distinct cognitive processes in patients with disorders of consciousness and thereby contribute to a refined understanding of severely brain-injured patients.

► Oscillatory analyses are suggested for testing cognition in patients with disorders of consciousness.
► Time–frequency analysis examines cognitive processes reflected by different oscillations.
► Actively counting a name induces strong event-related synchronization of theta oscillations.