The Application Of Quantitative EEG Features In The Diagnosis And Prognostic Evaluation Of Prolong Disorders Of Consciousness

Objective:To Analyze the quantitative electroencephalogram(QEEG)features of patients with prolong disorders of consciousness(pDOC),explore the correlation between QEEG features and the degree of consciousness disorders,and the predictive value of short-term consciousness outcomes in pDOC patients.This provides a basis for early clinical evaluation of the degree of consciousness disorders and prognosis in pDOC patients.Methods:Patients with vegetative/unresponsive arousal syndrome(VS/UWS)or minimal state of consciousness(MCS)who were hospitalized in the Department of Rehabilitation Medicine of the First Affiliated Hospital of Nanchang University 28 days after brain injury were included.Clinical data were collected at the beginning of the study,including: age,sex,etiology,course of disease,QEEG parameters(Amplitude-integrated EEG(a EEG),relative alpha variability(RAV),spectral entropy(SE),relative band power(RBP).According to the diagnosis of CRS-R(Coma Recovery Scale-Revised)within 24 hours of admission,the patients were divided into Vegetative State(VS)group,Minimally Conscious State minus(MCS-)group,and Minimally conscious state plus(MCS+).The QEEG characteristics of the three groups of patients were analyzed,and the correlation between QEEG characteristics and CRS-R scale scores,as well as the correlation between QEEG characteristics and consciousness levels,was analyzed;The patients were followed up for a period of 4 weeks,and were divided into an improved consciousness group and an unimproved consciousness group by comparing the CRS-R diagnostic results at the 4th week and within 24 hours of admission.The correlation between variables and consciousness improvement was analyzed using single factor analysis,multivariate logistic regression analysis,and stepwise regression analysis.The predictive efficacy of variables on consciousness improvement was analyzed using the subject’s work characteristic curve.Results:1.90 people were included in the study,including 51 males and 39 females,with an average age of(55.97 ± 14.41)years and an average time from onset to admission of(39.37 ± 20.27)days.There were 41 cases of cerebrovascular diseases,44 cases of traumatic brain injury,and 5 cases of ischemic hypoxic encephalopathy.Among them,there were 53 VS patients,22 MCS-patients,and 15 MCS+patients.2.SE,RAV grading,and alpha relative band energy were positively correlated with CRS-R scores.among the 3 groups of patients with different impairments of consciousness,RAV and SE were statistically significantly different between the 3groups(P < 0.05),with the highest proportion of patients with RAV grade Ⅱ in the VS group;predominantly RAV grade Ⅳ in the MCS-group;and the highest proportion of patients with normal RAV grade Ⅳ in the MCS+ group.The SE values were different for different states of consciousness.a EEG grading was negatively correlated with the level of consciousness,and RAV grading was positively correlated with the level of consciousness.3.By comparing the CRS-R diagnostic outcomes at week 4 of admission and within 24 h of admission,the final consciousness improved in 42 patients(46%)and did not improve in 48 patients(54%).Univariate analysis showed that CRS-R score at admission,state of consciousness at admission,RAV grade,alpha relative band energy,and SE were factors associated with improved consciousness,with statistically significant differences(P < 0.05),and multifactorial logistic regression analysis showed that only CRS-R score(95% CI: 1.052 to 1.645,OR = 1.315),RAV grade(95% CI: 1.222 to 15.541,OR=4.359),and alpha relative band energy(95% CI:1.146 to 2.552,OR=1.711)were correlates of improvement in consciousness in patients with chronic disorders of consciousness,and in stepwise regression analysis,CRS-R score at admission,RAV grade,and alpha relative band energy had a strong correlation with improvement in consciousness,and the area under the curve(AUC)of alpha relative band energy,RAV grading,and CRS-R score to predict improvement in consciousness were 0.851(95% CI 0.771-0.930,P<0.05),0.781(95% CI0.682-0.880,P<0.05),and 0.767(95% CI 0.671-0.864,P< 0.05).Conclusion:Quantitative EEG features can characterize different levels of consciousness in patients with prolong disorders of consciousness,and RAV grading is most closely related to the level of consciousness in patients with prolong disorders of consciousness;quantitative EEG features have some predictive ability for improvement of consciousness in patients with prolong disorders of consciousness,and alpha relative band energy is most closely related to improvement of consciousness with the highest online prediction accuracy;therefore,quantitative EEG features are closely related to the diagnosis and prognosis of prolong disorders of consciousness.