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<p>Consciousness assessment in disorders of consciousness (DoC) patients remains clinically challenging. Dynamic brain activities responsive to sensory stimulations have been suggested to contain consciousness-related information. However, primary sensory processing can occur unconsciously, necessitating evaluation of residual higher-order cognitive functions for effective assessment. In this study, we introduced a movie-viewing paradigm incorporating a scrambled version to control for primary sensory processing and applied electroencephalography (EEG) microstate analysis to capture higher-order neural dynamics. By comparing 23 DoC patients with 23 healthy individuals and 12 conscious brain-injured patients, we found significant abnormalities in microstate D in DoC patients. Healthy individuals and conscious brain-injured patients showed enhanced D-related parameters during intact movie-viewing compared to the scrambled condition. Conversely, DoC patients displayed a significant decrease in Duration, Coverage, Occurrence, and Transition Probabilities of microstate D during intact movie-viewing. Additionally, K-nearest neighbors classifier showed that the differences in microstate features between the intact and scrambled movie-viewing yielded the best classification outcome (AUC = 0.83), in which microstate D parameters serve as the most important features. Our results suggested that EEG microstates during naturalistic movie-viewing, especially microstate D, have the potential to serve as a novel, objective indicator for characterizing and diagnosing the state of consciousness.&#xa0;</p> Graphical Abstract <p></p>

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Characterizing consciousness states: EEG microstate dynamics in patients with disorders of consciousness during naturalistic movie-viewing

  • 期刊论文

  • 发表日期：

    2025年7月30日

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  • Xiyuan Lei,
  • Anqi Wang,
  • Kexu Zhang,
  • Siyang Liu,
  • Ying Zhao,
  • Steven Laureys,
  • Shanbao Tong,
  • Haibo Di,
  • Nantu Hu,
  • Xiaoli Guo

摘要

Consciousness assessment in disorders of consciousness (DoC) patients remains clinically challenging. Dynamic brain activities responsive to sensory stimulations have been suggested to contain consciousness-related information. However, primary sensory processing can occur unconsciously, necessitating evaluation of residual higher-order cognitive functions for effective assessment. In this study, we introduced a movie-viewing paradigm incorporating a scrambled version to control for primary sensory processing and applied electroencephalography (EEG) microstate analysis to capture higher-order neural dynamics. By comparing 23 DoC patients with 23 healthy individuals and 12 conscious brain-injured patients, we found significant abnormalities in microstate D in DoC patients. Healthy individuals and conscious brain-injured patients showed enhanced D-related parameters during intact movie-viewing compared to the scrambled condition. Conversely, DoC patients displayed a significant decrease in Duration, Coverage, Occurrence, and Transition Probabilities of microstate D during intact movie-viewing. Additionally, K-nearest neighbors classifier showed that the differences in microstate features between the intact and scrambled movie-viewing yielded the best classification outcome (AUC = 0.83), in which microstate D parameters serve as the most important features. Our results suggested that EEG microstates during naturalistic movie-viewing, especially microstate D, have the potential to serve as a novel, objective indicator for characterizing and diagnosing the state of consciousness. 

Graphical Abstract