Evaluating the efficacy of neuromodulation for the detection of consciousness in unresponsive patients

Renseignements sur le financement
Canadian Institutes of Health Research
  • Type de subvention: Bourse de recherche des IRSC
  • Années: 2017/18 à 2020/21
  • Financement total: $135,000
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Sommaire du projet

Many patients in intensive care and complex continuing care are behaviourally unresponsive (e.g. unable to move and/or speak) as a result of severe trauma or disability. These patients include those in a minimally conscious state (MCS) or unresponsive wakefulness syndrome (UWS; previously referred to as vegetative state). Distinguishing between MCS and UWS is important, as individuals in MCS have some degree of consciousness and subjective experience, while individuals in UWS do not. However, the current clinical gold standard for detecting consciousness is based solely on the patient's behavioural responses, which causes the presence of consciousness to go undetected in nearly half of patients. Misdiagnosing unresponsive patients can have major implications for prognosis and treatment, impacting the level of care obtained by patients. The goal of this study is to develop a bedside system that can accurately detect an individual's level of consciousness. More specifically, we will test whether modulating brain networks through anaesthesia and brain stimulation can enable the detection of neural markers of consciousness. Through the assessment of the connectivity in brain networks, we will assess whether neurological patterns of consciousness in UWS respond to anaesthesia and brain stimulation in a similar manner to neurologically compromised individuals with known consciousness (e.g. those in MCS). We hypothesize that anaesthesia and brain stimulation will be able to identify UWS patients that possess "covert consciousness". This study will enable the development of an accurate system for the bedside assessment of consciousness, providing a neurophysiological basis for decision-making and enabling evidence-based treatment decisions and improved quality of care. Ultimately, we aim to provide an accurate diagnosis and care to unresponsive patients, which will decrease the emotional and economic burden associated with their care, and improve their quality of life.