Characterizing consciousness states: EEG microstate dynamics in patients with disorders of consciousness during naturalistic movie-viewing.

Xiyuan Lei, Anqi Wang, Kexu Zhang, Siyang Liu, Ying Zhao, Steven Laureys, Shanbao Tong, Haibo Di, Nantu Hu, Xiaoli Guo

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Article in Medical & biological engineering & computing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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10 authors.

Xiyuan Lei *School of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, 200240, China.

Anqi Wang *International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, and, School of Basic Medicine , Hangzhou Normal University, Hangzhou, 311121, China.

Kexu ZhangSchool of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, 200240, China.

Siyang LiuSchool of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, 200240, China.

Ying ZhaoInternational Unresponsive Wakefulness Syndrome and Consciousness Science Institute, and, School of Basic Medicine , Hangzhou Normal University, Hangzhou, 311121, China.

Steven LaureysInternational Unresponsive Wakefulness Syndrome and Consciousness Science Institute, and, School of Basic Medicine , Hangzhou Normal University, Hangzhou, 311121, China.

Shanbao TongSchool of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, 200240, China.

Haibo DiInternational Unresponsive Wakefulness Syndrome and Consciousness Science Institute, and, School of Basic Medicine , Hangzhou Normal University, Hangzhou, 311121, China.

Nantu HuInternational Unresponsive Wakefulness Syndrome and Consciousness Science Institute, and, School of Basic Medicine , Hangzhou Normal University, Hangzhou, 311121, China. hunt@hznu.edu.cn.

Xiaoli GuoSchool of Biomedical Engineering, Shanghai Jiaotong University, Shanghai, 200240, China. meagle@sjtu.edu.cn.ORCID http://orcid.org/0000-0002-6346-1846

Funding

National Key Research and Development Program of China 2022YFC3601200National Key Research and Development Program of China 2022YFE0141300National Natural Science Foundation of China 81920108023Natural Science Foundation of Zhejiang Province LZ21H170001

6 · The paper itself

Abstract

Consciousness assessment in disorders of consciousness (DoC) patients remains clinically challenging. Dynamic brain activities responsive to sensory stimulations have been suggested to contain consciousness-related information. However, primary sensory processing can occur unconsciously, necessitating evaluation of residual higher-order cognitive functions for effective assessment. In this study, we introduced a movie-viewing paradigm incorporating a scrambled version to control for primary sensory processing and applied electroencephalography (EEG) microstate analysis to capture higher-order neural dynamics. By comparing 23 DoC patients with 23 healthy individuals and 12 conscious brain-injured patients, we found significant abnormalities in microstate D in DoC patients. Healthy individuals and conscious brain-injured patients showed enhanced D-related parameters during intact movie-viewing compared to the scrambled condition. Conversely, DoC patients displayed a significant decrease in Duration, Coverage, Occurrence, and Transition Probabilities of microstate D during intact movie-viewing. Additionally, K-nearest neighbors classifier showed that the differences in microstate features between the intact and scrambled movie-viewing yielded the best classification outcome (AUC = 0.83), in which microstate D parameters serve as the most important features. Our results suggested that EEG microstates during naturalistic movie-viewing, especially microstate D, have the potential to serve as a novel, objective indicator for characterizing and diagnosing the state of consciousness.

Indexed as

ConsciousnessConsciousness DisordersElectroencephalographyMotion PicturesAdultBrainFemaleHumansMaleMiddle AgedSignal Processing, Computer-AssistedYoung AdultDisorders of consciousness (DoC)Electroencephalography (EEG)MicrostatesMovie-viewing

Identifiers

PMID40736881

DOI10.1007/s11517-025-03415-w

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.