ComAlive · Diagnosis, prediction, communication and rehabilitation for patients with disorders of consciousness

Diagnosis, prediction, communication and rehabilitation for patients with disorders of consciousness

Comalive project aimed to contribute to the research on diagnosis, communication and rehabilitation of the disorders of consciousness (DOC). DOC are neurological conditions in which awareness and responsivity to environmental stimuli are compromised. The DOCs include the Coma, characterised by closed eyes and no volitional responses to commands or sensory stimulation. When eye-opening appears, without other changes in responsivity, the Unresponsive Wakefulness Syndrome (UWS) is recognised. Consistent voluntary reactions to external stimuli characterise the Minimal Conscious State (MCS). The Complete Locked-in Syndrome (CLIS) is contiguous to the DOC. The affected patients present anarthria and quadriplegia, with impossible verbal language and voluntary movements. Consequently, they can’t communicate by any means with the external environment, despite preserving intact cognitive functioning, according to the evidence of preservation of cortical circuits (Fig. 1). The bedside diagnosis of the DOCs and CLIS represents a challenge even for expert physicians. It has been estimated that up to 43 % of clinically diagnosed UWS preserve a minimal consciousness, which can’t be recognised because of motor impairment, attention fluctuations, severe hypertonus and other clinical characteristics. The diagnostic precision of the DOC has relevant ethical implications. UWS patients don’t have access to life-prolonging treatments and rehabilitation programs in most countries due to a reduced possibility of recovery. From these premises arises the need for instrumental support to the clinical diagnosis to detect covert awareness in patients unresponsive at the bedside. For this purpose, we applied EEG-based brain-computer interface (BCI) paradigms to record non-invasively the cortical activity and directly measure the execution of mental tasks. Besides the diagnostic application, we explored the potential use of these devices to establish communication with these vulnerable patients, possibly directed to collecting their needs and wishes. Finally, we studied the potential role of EEG-based BCIs on the rehabilitation of DOC. Key scientific objectives of Comalive included: I. Use of EEG-based brain-computer interfaces for diagnosis, prediction and communication with patients with disorders of consciousness II. Use of EEG-based brain-computer interfaces for rehabilitation of patients with disorders of consciousness

Текст от CORDIS, на английски · Данни: CORDIS, © Европейски съюз