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Cited by 106Heart Rate Variability and Autonomic ControlTraumatic Brain Injury ResearchPhilosophy and Theoretical Science

Brain–heart interactions reveal consciousness in noncommunicating patients

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Raimondo, Federico, Rohaut, Benjamin, Demertzi, Athena, Valente, Melanie, Engemann, Denis A., Salti, Moti, Fernandez Slezak, Diego, Naccache, Lionel +1 more·2017·Annals of Neurology
DOI 10.1002/ana.25045
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Abstract

Objective: We here aimed at characterizing heart–brain interactions in patients with disorders of consciousness. We tested how this information impacts data‐driven classification between unresponsive and minimally conscious patients. Methods: A cohort of 127 patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS; n = 70) and minimally conscious state (MCS; n = 57) were presented with the local–global auditory oddball paradigm, which distinguishes 2 levels of processing: short‐term deviation of local auditory regularities and global long‐term rule violations. In addition to previously validated markers of consciousness extracted from electroencephalograms (EEG), we computed autonomic cardiac markers, such as heart rate (HR) and HR variability (HRV), and cardiac cycle phase shifts triggered by the processing of the auditory stimuli. Results: HR and HRV were similar in patients across groups. The cardiac cycle was not sensitive to the processing of local regularities in either the VS/UWS or MCS patients. In contrast, global regularities induced a phase shift of the cardiac cycle exclusively in the MCS group. The interval between the auditory stimulation and the following R peak was significantly shortened in MCS when the auditory rule was violated. When the information for the cardiac cycle modulations and other consciousness‐related EEG markers were combined, single patient classification performance was enhanced compared to classification with solely EEG markers. Interpretation: Our work shows a link between residual cognitive processing and the modulation of autonomic somatic markers. These results open a new window to evaluate patients with disorders of consciousness via the embodied paradigm, according to which body–brain functions contribute to a holistic approach to conscious processing. Ann Neurol 2017;82:578–591

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  • Cardiac cycle duration is systematically modified by stimulus presentation and target detection, with a small but consistent change.

    “In perceptual and cognitive paradigms, cardiac cycle duration is also systematically modified 31-36 with a small but consistent change of cardiac cycle duration induced by stimulus presentation and target detection.”

    From Interoceptive rhythms in the brain (2023) · cites this paper as [34]

    The Results section (“Cardiac cycle modulation induced by the auditory stimulation protocol”; page not supplied) reports a shortened post-stimulus interval for global auditory deviants in minimally conscious patients. The Discussion also describes cardiac changes associated with visual target detection. The claim is broader than these findings: the paper reports no comparable modulation for several other trial types or patient groups, and the cited passages do not establish that the change is consistently small. (LLM, conf=0.84)

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References 55 · Cited by 106

Research works printed but not linked: 34

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Authors
Raimondo, F., Rohaut, B., Demertzi, A., Valente, M., Engemann, D. A., Salti, M., Fernandez Slezak, D., Naccache, L., & Sitt, J. D.
Affiliations
  • Consejo Nacional de Investigaciones Científicas y Técnicas (AR)
  • Inserm (FR)
  • Brain and Spine Institute Paris France
  • Université Paris-Sud (FR)
  • Ben-Gurion University of the Negev (IL)
  • Department of Computer Science, Faculty of Exact and Natural Sciences University of Buenos Aires Buenos Aires Argentina
Corresponding author
Sitt, Jacobo D.
ORCID
Venue
Annals of Neurology
Publisher
Wiley
Published
2017-10
Volume
82
Issue
4
Pages
578-591
ISSN
  • 0364-5134 (ISSN-L)
  • 1531-8249
DOI
10.1002/ana.25045
OpenAlex
W2755887109
Cited by
106
References
55
Citations by year
2026: 5 · 2025: 14 · 2024: 17 · 2023: 16 · 2022: 9 · 2021: 10 · 2020: 8 · 2019: 5 · 2018: 21 · 2017: 1
FWCI
7.41
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 10 d)
Locations
  • Annals of Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
  • Americanae (AECID Library) (submittedVersion, cc-by-nc-sa)
  • Open Repository and Bibliography (University of Liège) (submittedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-sa)
Funders
  • Consejo Nacional de Investigaciones Científicas y Técnicas
  • Institut National de la Santé et de la Recherche Médicale
  • James S. McDonnell Foundation
  • Fondation pour la Recherche Médicale
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Philosophy and Theoretical Science
Keywords
disorders of consciousness, vegetative state, minimally conscious state, heart-brain interaction, heart rate variability, auditory oddball paradigm, global-local processing, patient classification, embodied consciousness
MeSH terms
Acoustic Stimulation, Adolescent, Adult, Aged, Aged, 80 and over, Brain, Brain Mapping, Consciousness Disorders, Electrocardiography, Electroencephalography, Evoked Potentials, Auditory, Female, Heart Rate, Humans, Male, Middle Aged, Cohort Studies, Young Adult

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