EEG and ANS markers of attention response in vegetative state: Different responses to own vs. other names.

Covert measures of information-processing are valuable tools to support assessment of patients' disorders of consciousness because of their potential in revealing what seem to be hidden. Those measures allow to overcome some limitations of traditional behavioural methods, which are often biased by difficulties in detecting reliable patients' responses. Therefore, we aimed at exploring patterns of psychophysiological responses (electroencephalography - EEG, skin conductance level - SCL, skin conductance response - SCR, heart rate - HR) marking potentially-preserved processing of personally-relevant stimuli in a sample of VS patients. In particular, we compared the processing of own vs. other names due to the intrinsic salience, relevance, and familiarity of such stimuli. Analysis of electroencephalography, skin conductance and heart rate modulations highlighted a consistent pattern of increased skin conductance and heart rate measures in response to patients' own name with respect to other names. Further, we observed increased delta and decreased alpha activity over frontal areas in response to their own name with respect to other names. Own-name stimuli might preserve their peculiar qualification even after severe brain damage and might call on residual attention orientation and preferred coding resources, suggesting the existence of partly preserved information-processing pathways that extends beyond basic auditory sensory processing.

EEG and autonomic responses to nociceptive stimulation in disorders of consciousness.

Since behavioral responses to external stimuli of patients presenting disorders of consciousness (DoC) are often difficult to qualify, covert physiological correlates of responsivity are deemed as potentially valuable tools to help assessment procedures. While noxious stimuli seem good candidates to explore DoC patients' responsivity, autonomic and electrophysiological correlates of pain detection in DoC patients are still debated. This research aims at investigating autonomic and cortical activation as covert measure of residual somatosensory and nociceptive processes in patients in vegetative state. Twenty-one patients received touch- and pain-related stimulations while autonomic and cortical measures were recorded, with minimal stress for them. Results showed an increased frontal and parietal activation in response to both touch and pain stimuli. Pain-related stimulation was however associated with greater delta parietal response, lower left frontal activation, and increased electrodermal and heart rate measures. Present findings suggest that both somatic stimulations could induce measurable central responses, which might mirror basic attention orientation and perceptual processes. Nonetheless, the nociceptive stimulation in particular seemed to induce a more consistent and informative pattern of covert response even if we used a mild pain-induction procedure.