TY  - JOUR
AU  - Zilio, Federico
AU  - Gomez-Pilar, Javier
AU  - Chaudhary, Ujwal
AU  - Fogel, Stuart
AU  - Fomina, Tatiana
AU  - Synofzik, Matthis
AU  - Schöls, Ludger
AU  - Cao, Shumei
AU  - Zhang, Jun
AU  - Huang, Zirui
AU  - Birbaumer, Niels
AU  - Northoff, Georg
TI  - Altered brain dynamics index levels of arousal in complete locked-in syndrome.
JO  - Communications biology
VL  - 6
IS  - 1
SN  - 2399-3642
CY  - London
PB  - Springer Nature
M1  - DZNE-2023-00736
SP  - 757
PY  - 2023
AB  - Complete locked-in syndrome (CLIS) resulting from late-stage amyotrophic lateral sclerosis (ALS) is characterised by loss of motor function and eye movements. The absence of behavioural indicators of consciousness makes the search for neuronal correlates as possible biomarkers clinically and ethically urgent. EEG-based measures of brain dynamics such as power-law exponent (PLE) and Lempel-Ziv complexity (LZC) have been shown to have explanatory power for consciousness and may provide such neuronal indices for patients with CLIS. Here, we validated PLE and LZC (calculated in a dynamic way) as benchmarks of a wide range of arousal states across different reference states of consciousness (e.g., awake, sleep stages, ketamine, sevoflurane). We show a tendency toward high PLE and low LZC, with high intra-subject fluctuations and inter-subject variability in a cohort of CLIS patients with values graded along different arousal states as in our reference data sets. In conclusion, changes in brain dynamics indicate altered arousal in CLIS. Specifically, PLE and LZC are potentially relevant biomarkers to identify or diagnose the arousal level in CLIS and to determine the optimal time point for treatment, including communication attempts.
KW  - Humans
KW  - Locked-In Syndrome
KW  - Electroencephalography: methods
KW  - Brain: physiology
KW  - Wakefulness
KW  - Biomarkers
KW  - Biomarkers (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:37474587
C2  - pmc:PMC10359418
DO  - DOI:10.1038/s42003-023-05109-1
UR  - https://pub.dzne.de/record/259235
ER  -