Bispectral index monitoring correlates with the level of consciousness in brain injured patients

Consciousness transiently fades away during deep sleep, more stably under anesthesia, and sometimes permanently due to brain injury. The development of an index to quantify the level of consciousness across these different states is regarded as a key problem both in basic and clinical neuroscience. We argue that this problem is ill-defined since such an index would not exhaust all the relevant information about a given state of consciousness. While the level of consciousness can be taken to describe the actual brain state, a complete characterization should also include its potential behavior against external perturbations. We developed and analyzed whole-brain computational models to show that the stability of conscious states provides information complementary to their similarity to conscious wakefulness. Our work leads to a novel methodological framework to sort out different brain states by their stability and reversibility, and illustrates its usefulness to dissociate between physiological (sleep), pathological (brain-injured patients), and pharmacologically-induced (anesthesia) loss of consciousness.

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Perturbations in dynamical models of whole-brain activity dissociate between the level and stability of consciousness

10.1101/2020.07.02.185157 ◽

2020 ◽

Cited By ~ 1

Author(s):

Yonatan Sanz Perl ◽

Carla Pallavicini ◽

Ignacio Pérez Ipiña ◽

Athena Demertzi ◽

Vincent Bonhomme ◽

...

Keyword(s):

Computational Models ◽

Brain Activity ◽

Relevant Information ◽

Complete Characterization ◽

Brain State ◽

Whole Brain ◽

Brain Injured ◽

Level Of Consciousness ◽

The Stability ◽

Injured Patients

AbstractConsciousness transiently fades away during deep sleep, more stably under anesthesia, and sometimes permanently due to brain injury. The development of an index to quantify the level of consciousness across these different states is regarded as a key problem both in basic and clinical neuroscience. We argue that this problem is ill-defined since such an index would not exhaust all the relevant information about a given state of consciousness. While the level of consciousness can be taken to describe the actual brain state, a complete characterization should also include its potential behavior against external perturbations. We developed and analyzed whole-brain computational models to show that the stability of conscious states provides information complementary to their similarity to conscious wakefulness. Our work leads to a novel methodological framework to sort out different brain states by their stability and reversibility, and illustrates its usefulness to dissociate between physiological (sleep), pathological (brain-injured patients), and pharmacologically-induced (anesthesia) loss of consciousness.

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Bispectral index monitoring to assess the level of consciousness in patients with brain injury

Korean Journal of Anesthesiology ◽

10.4097/kjae.2009.57.2.185 ◽

2009 ◽

Vol 57 (2) ◽

pp. 185 ◽

Cited By ~ 1

Author(s):

Jae Heung Cho ◽

Soon Ho Cheong ◽

Hyun Sik Kim ◽

Se Hoon Kim ◽

Kwang Rae Cho ◽

...

Keyword(s):

Brain Injury ◽

Bispectral Index ◽

Bispectral Index Monitoring ◽

Level Of Consciousness

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Use of Cerebral State Index Monitoring to Detect Purposeful Movement in Unsedated Brain-injured Patients

Journal of International Medical Research ◽

10.1177/147323000903700312 ◽

2009 ◽

Vol 37 (3) ◽

pp. 689-696 ◽

Cited By ~ 2

Author(s):

Q Wang ◽

M Xu ◽

Y-N Lei ◽

G-N Wang ◽

J-X Zhou

Keyword(s):

External Stimulation ◽

Prediction Probability ◽

Brain Injured ◽

Level Of Consciousness ◽

Before And After ◽

High Prediction ◽

State Index ◽

Set Up ◽

Injured Patients ◽

External Stimuli

To test whether the cerebral state index (CSI) can be used as a measurement of the level of consciousness in unsedated brain-injured patients, 21 brain-injured adults were prospectively assessed in 77 separate sessions. After CSI monitoring was set up, the patient's motor responses to verbal and/or painful stimuli were assessed. CSI values were recorded before and after external stimulation. Purposeful movement in response to external stimuli was defined as command obeying and pain localization. Mean maximal CSI values increased significantly after external stimulation: from 71 to 89 and 49 to 62 in patients exhibiting purposeful and non-purposeful movements, respectively. The CSI value showed a high prediction probability (PK < 0.8) for detecting purposeful movement to external stimuli, especially after external stimulation (PK < 0.9). These results suggest that CSI monitoring might be a valid method for detecting purposeful movement in response to external stimuli in unsedated brain-injured patients.

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