Visual processing during recovery from vegetative state to consciousness

Comparing behavioral indices to brain responses

V.J.M. Wijnen, H.J. Eilander, B. de Gelder, G.J.M. van Boxtel

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
Auditory stimulation is often used to evoke responses in unresponsive patients who have suffered severe brain injury. In order to investigate visual responses, we examined visual evoked potentials (VEPs) and behavioral responses to visual stimuli in vegetative patients during recovery to consciousness.
Methods
Behavioral responses to visual stimuli (visual localization, comprehension of written commands, and object manipulation) and flash VEPs were repeatedly examined in eleven vegetative patients every two weeks for an average period of 2.6 months, and patients’ VEPs were compared to a healthy control group. Long-term outcome of the patients was assessed 2–3 years later.
Results
Visual response scores increased during recovery to consciousness for all scales: visual localization, comprehension of written commands, and object manipulation. VEP amplitudes were smaller, and latencies were longer in the patient group relative to the controls. VEPs characteristics at first measurement were related to long-term outcome up to three years after injury.
Conclusions
Our findings show the improvement of visual responding with recovery from the vegetative state to consciousness. Elementary visual processing is present, yet according to VEP responses, poorer in vegetative and minimally conscious state than in healthy controls, and remains poorer when patients recovered to consciousness. However, initial VEPs are related to long-term outcome.
Original languageEnglish
Pages (from-to)457-469
JournalClinical Neurophysiology
Volume44
DOIs
Publication statusPublished - 2014

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Persistent Vegetative State
Visual Evoked Potentials
Consciousness
Wounds and Injuries

Cite this

@article{b08fb7726ca141499c804a74fbb5bbd5,
title = "Visual processing during recovery from vegetative state to consciousness: Comparing behavioral indices to brain responses",
abstract = "BackgroundAuditory stimulation is often used to evoke responses in unresponsive patients who have suffered severe brain injury. In order to investigate visual responses, we examined visual evoked potentials (VEPs) and behavioral responses to visual stimuli in vegetative patients during recovery to consciousness.MethodsBehavioral responses to visual stimuli (visual localization, comprehension of written commands, and object manipulation) and flash VEPs were repeatedly examined in eleven vegetative patients every two weeks for an average period of 2.6 months, and patients’ VEPs were compared to a healthy control group. Long-term outcome of the patients was assessed 2–3 years later.ResultsVisual response scores increased during recovery to consciousness for all scales: visual localization, comprehension of written commands, and object manipulation. VEP amplitudes were smaller, and latencies were longer in the patient group relative to the controls. VEPs characteristics at first measurement were related to long-term outcome up to three years after injury.ConclusionsOur findings show the improvement of visual responding with recovery from the vegetative state to consciousness. Elementary visual processing is present, yet according to VEP responses, poorer in vegetative and minimally conscious state than in healthy controls, and remains poorer when patients recovered to consciousness. However, initial VEPs are related to long-term outcome.",
author = "V.J.M. Wijnen and H.J. Eilander and {de Gelder}, B. and {van Boxtel}, G.J.M.",
year = "2014",
doi = "10.1016/j.neucli.2014.08.008",
language = "English",
volume = "44",
pages = "457--469",
journal = "Clinical Neurophysiology",
issn = "1388-2457",
publisher = "Elsevier Ireland Ltd",

}

Visual processing during recovery from vegetative state to consciousness : Comparing behavioral indices to brain responses. / Wijnen, V.J.M.; Eilander, H.J.; de Gelder, B.; van Boxtel, G.J.M.

In: Clinical Neurophysiology, Vol. 44, 2014, p. 457-469.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Visual processing during recovery from vegetative state to consciousness

T2 - Comparing behavioral indices to brain responses

AU - Wijnen, V.J.M.

AU - Eilander, H.J.

AU - de Gelder, B.

AU - van Boxtel, G.J.M.

PY - 2014

Y1 - 2014

N2 - BackgroundAuditory stimulation is often used to evoke responses in unresponsive patients who have suffered severe brain injury. In order to investigate visual responses, we examined visual evoked potentials (VEPs) and behavioral responses to visual stimuli in vegetative patients during recovery to consciousness.MethodsBehavioral responses to visual stimuli (visual localization, comprehension of written commands, and object manipulation) and flash VEPs were repeatedly examined in eleven vegetative patients every two weeks for an average period of 2.6 months, and patients’ VEPs were compared to a healthy control group. Long-term outcome of the patients was assessed 2–3 years later.ResultsVisual response scores increased during recovery to consciousness for all scales: visual localization, comprehension of written commands, and object manipulation. VEP amplitudes were smaller, and latencies were longer in the patient group relative to the controls. VEPs characteristics at first measurement were related to long-term outcome up to three years after injury.ConclusionsOur findings show the improvement of visual responding with recovery from the vegetative state to consciousness. Elementary visual processing is present, yet according to VEP responses, poorer in vegetative and minimally conscious state than in healthy controls, and remains poorer when patients recovered to consciousness. However, initial VEPs are related to long-term outcome.

AB - BackgroundAuditory stimulation is often used to evoke responses in unresponsive patients who have suffered severe brain injury. In order to investigate visual responses, we examined visual evoked potentials (VEPs) and behavioral responses to visual stimuli in vegetative patients during recovery to consciousness.MethodsBehavioral responses to visual stimuli (visual localization, comprehension of written commands, and object manipulation) and flash VEPs were repeatedly examined in eleven vegetative patients every two weeks for an average period of 2.6 months, and patients’ VEPs were compared to a healthy control group. Long-term outcome of the patients was assessed 2–3 years later.ResultsVisual response scores increased during recovery to consciousness for all scales: visual localization, comprehension of written commands, and object manipulation. VEP amplitudes were smaller, and latencies were longer in the patient group relative to the controls. VEPs characteristics at first measurement were related to long-term outcome up to three years after injury.ConclusionsOur findings show the improvement of visual responding with recovery from the vegetative state to consciousness. Elementary visual processing is present, yet according to VEP responses, poorer in vegetative and minimally conscious state than in healthy controls, and remains poorer when patients recovered to consciousness. However, initial VEPs are related to long-term outcome.

U2 - 10.1016/j.neucli.2014.08.008

DO - 10.1016/j.neucli.2014.08.008

M3 - Article

VL - 44

SP - 457

EP - 469

JO - Clinical Neurophysiology

JF - Clinical Neurophysiology

SN - 1388-2457

ER -