Toward an attention-based diagnostic tool for patients with locked-in syndrome

Damien Lesenfants*, Dina Habbal, Camille Chatelle, Andrea Soddu, Steven Laureys, Quentin Noirhomme

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Electroencephalography (EEG) has been proposed as a supplemental tool for reducing clinical misdiagnosis in severely brain-injured populations helping to distinguish conscious from unconscious patients. We studied the use of spectral entropy as a measure of focal attention in order to develop a motor-independent, portable, and objective diagnostic tool for patients with locked-in syndrome (LIS), answering the issues of accuracy and training requirement. Data from 20 healthy volunteers, 6 LIS patients, and 10 patients with a vegetative state/unresponsive wakefulness syndrome (VS/UWS) were included. Spectral entropy was computed during a gaze-independent 2-class (attention vs rest) paradigm, and compared with EEG rhythms (delta, theta, alpha, and beta) classification. Spectral entropy classification during the attention-rest paradigm showed 93% and 91% accuracy in healthy volunteers and LIS patients respectively. VS/UWS patients were at chance level. EEG rhythms classification reached a lower accuracy than spectral entropy. Resting-state EEG spectral entropy could not distinguish individual VS/UWS patients from LIS patients. The present study provides evidence that an EEG-based measure of attention could detect command-following in patients with severe motor disabilities. The entropy system could detect a response to command in all healthy subjects and LIS patients, while none of the VS/UWS patients showed a response to command using this system.

Original languageEnglish
Pages (from-to)122-135
Number of pages14
JournalClinical Eeg and Neuroscience
Issue number2
Early online date7 Nov 2016
Publication statusPublished - Mar 2018


  • locked-in syndrome
  • diagnostic tool
  • response to command
  • focal attention
  • entropy
  • BCI
  • COMA
  • Humans
  • Middle Aged
  • Wakefulness/physiology
  • Male
  • Rest/physiology
  • Young Adult
  • Quadriplegia/diagnosis
  • Adult
  • Female
  • Electroencephalography/methods
  • Brain/physiopathology
  • Consciousness Disorders/physiopathology
  • Persistent Vegetative State/physiopathology
  • Aged
  • Attention/physiology


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