Cortical response to the natural speech envelope correlates with neuroimaging evidence of cognition in severe brain injury
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Recent studies identify severely brain-injured patients with limited or no behavioral responses who successfully perform functional magnetic resonance imaging (fMRI) or electroencephalogram (EEG) mental imagery tasks [1, 2, 3, 4, 5]. Such tasks are cognitively demanding [1]; accordingly, recent studies support that fMRI command following in brain-injured patients associates with preserved cerebral metabolism and preserved sleep-wake EEG [5, 6]. We investigated the use of an EEG response that tracks the natural speech envelope (NSE) of spoken language [7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22] in healthy controls and brain-injured patients (vegetative state to emergence from minimally conscious state). As audition is typically preserved after brain injury, auditory paradigms may be preferred in searching for covert cognitive function [23, 24, 25]. NSE measures are obtained by cross-correlating EEG with the NSE. We compared NSE latencies and amplitudes with and without consideration of fMRI assessments. NSE latencies showed significant and progressive delay across diagnostic categories. Patients who could carry out fMRI-based mental imagery tasks showed no statistically significant difference in NSE latencies relative to healthy controls; this subgroup included patients without behavioral command following. The NSE may stratify patients with severe brain injuries and identify those patients demonstrating “cognitive motor dissociation” (CMD) [26] who show only covert evidence of command following utilizing neuroimaging or electrophysiological methods that demand high levels of cognitive function. Thus, the NSE is a passive measure that may provide a useful screening tool to improve detection of covert cognition with fMRI or other methods and improve stratification of patients with disorders of consciousness in research studies.
Date Issued
2018-12-03
Date Acceptance
2018-10-28
Citation
Current Biology, 2018, 28 (23), pp.3833-3839.E3
ISSN
0960-9822
Publisher
Elsevier
Start Page
3833
End Page
3839.E3
Journal / Book Title
Current Biology
Volume
28
Issue
23
Copyright Statement
© 2018 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor
Engineering & Physical Science Research Council (E
Wellcome Trust
Identifier
https://www.cell.com/current-biology/fulltext/S0960-9822(18)31458-1?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0960982218314581%3Fshowall%3Dtrue
Grant Number
EP/M026728/1
108295/Z/15/Z
Subjects
Science & Technology
Life Sciences & Biomedicine
Biochemistry & Molecular Biology
Biology
Cell Biology
Life Sciences & Biomedicine - Other Topics
EVENT-RELATED POTENTIALS
AUDITORY-EVOKED POTENTIALS
MINIMALLY CONSCIOUS STATE
MISMATCH NEGATIVITY
VEGETATIVE STATE
OWN NAME
NEURAL ENTRAINMENT
DISORDERS
COMA
AWARENESS
EEG
cognitive motor dissociation
coma
disorders of consciousness
fMRI
minimally conscious state
speech envelope
speech perception
traumatic brain injury
vegetative state
Adolescent
Adult
Brain Injuries
Cognition
Electroencephalography
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Neuroimaging
Speech
Young Adult
Humans
Brain Injuries
Magnetic Resonance Imaging
Electroencephalography
Speech
Cognition
Adolescent
Adult
Middle Aged
Female
Male
Young Adult
Neuroimaging
06 Biological Sciences
11 Medical and Health Sciences
17 Psychology and Cognitive Sciences
Developmental Biology
Publication Status
Published
Date Publish Online
2018-11-21