EEG power spectral density in locked-in and completely locked-in state patients: a longitudinal study
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RESEARCH ARTICLE
EEG power spectral density in locked-in and completely locked-in state patients: a longitudinal study Arianna Secco1 • Alessandro Tonin2 • Aygul Rana3 • Andres Jaramillo-Gonzalez3 • Majid Khalili-Ardali3 Niels Birbaumer3 • Ujwal Chaudhary2,3
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Received: 1 March 2020 / Revised: 14 August 2020 / Accepted: 30 September 2020 Ó The Author(s) 2020
Abstract Persons with their eye closed and without any means of communication is said to be in a completely locked-in state (CLIS) while when they could still open their eyes actively or passively and have some means of communication are said to be in locked-in state (LIS). Two patients in CLIS without any means of communication, and one patient in the transition from LIS to CLIS with means of communication, who have Amyotrophic Lateral Sclerosis were followed at a regular interval for more than 1 year. During each visit, resting-state EEG was recorded before the brain–computer interface (BCI) based communication sessions. The resting-state EEG of the patients was analyzed to elucidate the evolution of their EEG spectrum over time with the disease’s progression to provide future BCI-research with the relevant information to classify changes in EEG evolution. Comparison of power spectral density (PSD) of these patients revealed a significant difference in the PSD’s of patients in CLIS without any means of communication and the patient in the transition from LIS to CLIS with means of communication. The EEG of patients without any means of communication is devoid of alpha, beta, and higher frequencies than the patient in transition who still had means of communication. The results show that the change in the EEG frequency spectrum may serve as an indicator of the communication ability of such patients. Keywords Resting-state electroencephalogram (EEG) Completely locked-in state (CLIS) LIS (locked-in state) Power spectrum density (PSD) Alpha frequency
Introduction The cardinal feature of a patient in a locked-in state (LIS) is paralysis of most of the voluntary motor function of the body except the oculomotor function with preserved consciousness (Bauer et al. 1979; Chaudhary et al. 2020a). Because of the preserved oculomotor function and Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11571-020-09639-w) contains supplementary material, which is available to authorized users. & Ujwal Chaudhary [email protected] 1
Department of Information Engineering, Bioengineering, Universita` Degli Studi di Padova, Padua, Italy
2
Wyss-Center for Bio- and Neuro-Engineering, Chemin de Mines 9, 1202 Geneva, Switzerland
3
Institute of Medical Psychology and Behavioral Neurobiology, University of Tu¨bingen, Tu¨bingen, Germany
consciousness (Schnakers et al. 2008), patients in LIS have several means of communication (Birbaumer et al. 1999; Wolpaw and McFarland 2004; Ku¨bler et al. 2005; Sellers et al. 2010; Lesenfants et al. 2014; Wolpaw et al. 2018; Tonin et al. 2020).
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