Electroencephalographic differences between waking and sleeping periods in patients with prolonged disorders of consciousness at different levels of consciousness
ObjectiveThis study aimed to explore differences in sleep electroencephalogram (EEG) patterns in individuals with prolonged disorders of consciousness, utilizing polysomnography (PSG) to assist in distinguishing between the vegetative state (VS)/unresponsive wakefulness syndrome (UWS) and the minima...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-02-01
|
| Series: | Frontiers in Human Neuroscience |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnhum.2025.1521355/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850197503199150080 |
|---|---|
| author | Keke Li Man Li Wanqing Liu Wanqing Liu Yanzhi Wu Fang Li Jingwei Xie Jingwei Xie Jingwei Xie Shaolong Zhou Shaolong Zhou Shaolong Zhou Sen Wang Yongkun Guo Yongkun Guo Yongkun Guo Jiahui Pan Xinjun Wang Xinjun Wang Xinjun Wang Xinjun Wang |
| author_facet | Keke Li Man Li Wanqing Liu Wanqing Liu Yanzhi Wu Fang Li Jingwei Xie Jingwei Xie Jingwei Xie Shaolong Zhou Shaolong Zhou Shaolong Zhou Sen Wang Yongkun Guo Yongkun Guo Yongkun Guo Jiahui Pan Xinjun Wang Xinjun Wang Xinjun Wang Xinjun Wang |
| author_sort | Keke Li |
| collection | DOAJ |
| description | ObjectiveThis study aimed to explore differences in sleep electroencephalogram (EEG) patterns in individuals with prolonged disorders of consciousness, utilizing polysomnography (PSG) to assist in distinguishing between the vegetative state (VS)/unresponsive wakefulness syndrome (UWS) and the minimally conscious state (MCS), thereby reducing misdiagnosis rates and enhancing the quality of medical treatment.MethodsA total of 40 patients with prolonged disorders of consciousness (pDOC; 27 patients in the VS/UWS and 13 in the MCS) underwent polysomnography. We analyzed differential EEG indices between VS/UWS and MCS groups and performed correlation analyses between these indices and the Coma Recovery Scale-Revised (CRS-R) scores. The diagnostic accuracy of the differential indices was evaluated using receiver operating characteristic (ROC) curves.Results1. The fractal dimension (Higuchi’s fractal dimension (HFD)) of patients in the MCS tended to be higher than that of patients in the VS/UWS across all phases, with a significant difference only in the waking phase (p < 0.05). The HFD in the waking phase was positively correlated with the CRS-R score and exhibited the highest diagnostic accuracy at 88.3%. The Teager–Kaiser energy operator (TKEO) also showed higher levels in patients in the MCS compared to those in the VS/UWS, significantly so in the NREM2 phase (p < 0.05), with a positive correlation with the CRS-R score and diagnostic accuracy of 75.2%. The δ-band power spectral density [PSD(δ)] in the patients in the MCS was lower than that in those in the VS/UWS, significantly so in the waking phase (p < 0.05), and it was negatively correlated with the CRS-R score, with diagnostic accuracy of 71.5%.ConclusionPolysomnography for the VS/UWS and MCS revealed significant differences, aiding in distinguishing between the two patient categories and reducing misdiagnosis rates. Notably, the HFD and PSD(δ) showed significantly better performance during wakefulness compared to sleep, while the TKEO was more prominent in the NREM2 stage. Notably, the HFD exhibited a robust correlation with the CRS-R scores, the highest diagnostic accuracy, and immense promise in the clinical diagnosis of prolonged disorders of consciousness. |
| format | Article |
| id | doaj-art-80419f282297449da00cd15aed61c4e0 |
| institution | OA Journals |
| issn | 1662-5161 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Human Neuroscience |
| spelling | doaj-art-80419f282297449da00cd15aed61c4e02025-08-20T02:13:07ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612025-02-011910.3389/fnhum.2025.15213551521355Electroencephalographic differences between waking and sleeping periods in patients with prolonged disorders of consciousness at different levels of consciousnessKeke Li0Man Li1Wanqing Liu2Wanqing Liu3Yanzhi Wu4Fang Li5Jingwei Xie6Jingwei Xie7Jingwei Xie8Shaolong Zhou9Shaolong Zhou10Shaolong Zhou11Sen Wang12Yongkun Guo13Yongkun Guo14Yongkun Guo15Jiahui Pan16Xinjun Wang17Xinjun Wang18Xinjun Wang19Xinjun Wang20Department of Neurosurgery, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaSchool of Automation Science and Engineering, South China University of Technology, Guangzhou, ChinaDepartment of Neurosurgery, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Neurosurgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Neurosurgery, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Neurosurgery, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Neurosurgery, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaHenan Engineering Research Center for Prevention and Treatment of Brain Injuries, Zhengzhou, ChinaHenan Key Laboratory of Brain Science and Brain Computer Interface Technology, Zhengzhou, ChinaDepartment of Neurosurgery, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaHenan Engineering Research Center for Prevention and Treatment of Brain Injuries, Zhengzhou, ChinaHenan Key Laboratory of Brain Science and Brain Computer Interface Technology, Zhengzhou, ChinaDepartment of Neurosurgery, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Neurosurgery, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaHenan Engineering Research Center for Prevention and Treatment of Brain Injuries, Zhengzhou, ChinaHenan Key Laboratory of Brain Science and Brain Computer Interface Technology, Zhengzhou, ChinaSchool of Software, South China Normal University, Nanhai Software Technology Park, Foshan, Guangdong Province, ChinaDepartment of Neurosurgery, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaDepartment of Neurosurgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaHenan Engineering Research Center for Prevention and Treatment of Brain Injuries, Zhengzhou, ChinaHenan Key Laboratory of Brain Science and Brain Computer Interface Technology, Zhengzhou, ChinaObjectiveThis study aimed to explore differences in sleep electroencephalogram (EEG) patterns in individuals with prolonged disorders of consciousness, utilizing polysomnography (PSG) to assist in distinguishing between the vegetative state (VS)/unresponsive wakefulness syndrome (UWS) and the minimally conscious state (MCS), thereby reducing misdiagnosis rates and enhancing the quality of medical treatment.MethodsA total of 40 patients with prolonged disorders of consciousness (pDOC; 27 patients in the VS/UWS and 13 in the MCS) underwent polysomnography. We analyzed differential EEG indices between VS/UWS and MCS groups and performed correlation analyses between these indices and the Coma Recovery Scale-Revised (CRS-R) scores. The diagnostic accuracy of the differential indices was evaluated using receiver operating characteristic (ROC) curves.Results1. The fractal dimension (Higuchi’s fractal dimension (HFD)) of patients in the MCS tended to be higher than that of patients in the VS/UWS across all phases, with a significant difference only in the waking phase (p < 0.05). The HFD in the waking phase was positively correlated with the CRS-R score and exhibited the highest diagnostic accuracy at 88.3%. The Teager–Kaiser energy operator (TKEO) also showed higher levels in patients in the MCS compared to those in the VS/UWS, significantly so in the NREM2 phase (p < 0.05), with a positive correlation with the CRS-R score and diagnostic accuracy of 75.2%. The δ-band power spectral density [PSD(δ)] in the patients in the MCS was lower than that in those in the VS/UWS, significantly so in the waking phase (p < 0.05), and it was negatively correlated with the CRS-R score, with diagnostic accuracy of 71.5%.ConclusionPolysomnography for the VS/UWS and MCS revealed significant differences, aiding in distinguishing between the two patient categories and reducing misdiagnosis rates. Notably, the HFD and PSD(δ) showed significantly better performance during wakefulness compared to sleep, while the TKEO was more prominent in the NREM2 stage. Notably, the HFD exhibited a robust correlation with the CRS-R scores, the highest diagnostic accuracy, and immense promise in the clinical diagnosis of prolonged disorders of consciousness.https://www.frontiersin.org/articles/10.3389/fnhum.2025.1521355/fullpolysomnographyprolonged disorders of consciousnessCRS-Rfractal dimensionTeager–Kaiser energy operator |
| spellingShingle | Keke Li Man Li Wanqing Liu Wanqing Liu Yanzhi Wu Fang Li Jingwei Xie Jingwei Xie Jingwei Xie Shaolong Zhou Shaolong Zhou Shaolong Zhou Sen Wang Yongkun Guo Yongkun Guo Yongkun Guo Jiahui Pan Xinjun Wang Xinjun Wang Xinjun Wang Xinjun Wang Electroencephalographic differences between waking and sleeping periods in patients with prolonged disorders of consciousness at different levels of consciousness Frontiers in Human Neuroscience polysomnography prolonged disorders of consciousness CRS-R fractal dimension Teager–Kaiser energy operator |
| title | Electroencephalographic differences between waking and sleeping periods in patients with prolonged disorders of consciousness at different levels of consciousness |
| title_full | Electroencephalographic differences between waking and sleeping periods in patients with prolonged disorders of consciousness at different levels of consciousness |
| title_fullStr | Electroencephalographic differences between waking and sleeping periods in patients with prolonged disorders of consciousness at different levels of consciousness |
| title_full_unstemmed | Electroencephalographic differences between waking and sleeping periods in patients with prolonged disorders of consciousness at different levels of consciousness |
| title_short | Electroencephalographic differences between waking and sleeping periods in patients with prolonged disorders of consciousness at different levels of consciousness |
| title_sort | electroencephalographic differences between waking and sleeping periods in patients with prolonged disorders of consciousness at different levels of consciousness |
| topic | polysomnography prolonged disorders of consciousness CRS-R fractal dimension Teager–Kaiser energy operator |
| url | https://www.frontiersin.org/articles/10.3389/fnhum.2025.1521355/full |
| work_keys_str_mv | AT kekeli electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT manli electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT wanqingliu electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT wanqingliu electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT yanzhiwu electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT fangli electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT jingweixie electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT jingweixie electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT jingweixie electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT shaolongzhou electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT shaolongzhou electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT shaolongzhou electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT senwang electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT yongkunguo electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT yongkunguo electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT yongkunguo electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT jiahuipan electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT xinjunwang electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT xinjunwang electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT xinjunwang electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness AT xinjunwang electroencephalographicdifferencesbetweenwakingandsleepingperiodsinpatientswithprolongeddisordersofconsciousnessatdifferentlevelsofconsciousness |