EEG dynamics induced by zolpidem forecast consciousness evolution in prolonged disorders of consciousness

作者：Gao, Qiong; Hao, Jianmin; Kang, Xiaogang; Yuan, Fang; Liu, Yu; Chen, Rong; Liu, Xiuyun; Li, Rui^*; Jiang, Wen^*

来源：Clinical Neurophysiology, 2023, 153: 46-56.

DOI：10.1016/j.clinph.2023.06.012

• Prolonged disorders of consciousness
• Zolpidem
• EEG
• Prognosis
• Evolution

Objective: To explore whether the EEG dynamics induced by zolpidem can predict consciousness evolu-tion in patients with prolonged disorders of consciousness (PDOC).Methods: We conducted a prospective explorative analysis on thirty-six patients with PDOC and eleven healthy controls. The EEG power spectrum was analyzed and categorized into 'ABCD' patterns at baseline and one hour after zolpidem administration at 10 mg. The clinical outcome was defined as consciousness improvement and no improvement six months after enrollment using the Coma Recovery Scale-Revised (CRS-R) score.Results: Zolpidem administration significantly increased the EEG power in the delta & theta bands and decreased EEG power in the beta bands in healthy controls. Further follow-up studies indicated that the increased EEG beta-band power induced by zolpidem can predict an improved consciousness six months after enrollment with an area under the receiver operating characteristic curve (AUC) of 0.829, the sensitivity of 94.38% and an accuracy of 81.48%.Conclusions: Our work revealed that the specific EEG responses to zolpidem can predict consciousness recovery in PDOC patients.Significance: The zolpidem-induced specific EEG responses could potentially predict the recovery of PDOC patients, which may help clinicians and patients' families in their decision-making process.& COPY; 2023 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

• 单位
  天津大学; 广州中医药大学; 中国人民解放军第四军医大学