Evidence map›Paper›PMID 41147937›Full record

ArticleAnnals of neurology2025

Detecting Awareness in the Intensive Care Unit Using Functional Near-Infrared Spectroscopy.

Karnig Kazazian, Jack de Jeu, Androu Abdalmalak, Sergio L Novi, Matthew Kolisnyk, Garima Gupta, Laura E Gonzalez-Lara, Teneille E Gofton, Loretta Norton, Derek B Debicki and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Karnig KazazianWestern Institute of Neuroscience, Western University, London, ON, Canada.ORCID 0000-0001-6157-601X
Jack de JeuWestern Institute of Neuroscience, Western University, London, ON, Canada.
Androu AbdalmalakDepartment of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Sergio L NoviDepartment of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Matthew KolisnykWestern Institute of Neuroscience, Western University, London, ON, Canada.ORCID 0000-0003-0914-6105
Garima GuptaWestern Institute of Neuroscience, Western University, London, ON, Canada.
Laura E Gonzalez-LaraDepartment of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Teneille E GoftonDepartment of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Loretta NortonWestern Institute of Neuroscience, Western University, London, ON, Canada.ORCID 0000-0002-6651-1837
Derek B DebickiWestern Institute of Neuroscience, Western University, London, ON, Canada.
Adrian M OwenWestern Institute of Neuroscience, Western University, London, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSigns of awareness after acute severe brain injury are critical for informing goals-of-care decisions, ranging from the continuation of aggressive life-sustaining therapy to comfort-focused end-of-life measures. However, awareness may go undetected in some critically ill patients when assessed using bedside behavioral neurological examination. Here, we use functional near-infrared spectroscopy to identify covert awareness in acute brain injured patients who are unable to follow behavioral commands.

methodsWe conducted a prospective, consecutive cross-sectional study of 32 critically ill patients in a single intensive care unit (ICU). All had acute brain injuries from various causes and lacked behavioral command-following on bedside examination, as determined by using the Coma Recovery Scale-Revised. Using functional near-infrared spectroscopy, an optical bedside neuroimaging technique, we assessed brain activity while patients were instructed to perform a mental imagery task in which a positive response was dependent upon preserved awareness. We referred to this phenomenon as covert awareness.

resultsOf 32 acutely brain injured patients (mean age = 63, ± 12 years, 15 females), 8 (25%) were able to willfully modulate their brain activity when instructed to imagine playing a game of tennis-providing evidence of covert awareness despite no observable behavioral signs that this was the case. We found no association between covert awareness and 3-month functional outcomes using the Glasgow Outcome Scale-Extended.

interpretationFunctional near-infrared spectroscopy detected preserved consciousness in 25% of patients who lacked behavioral command following in an intensive care setting. This finding highlights the need for further research to assess the use of advanced neuroimaging techniques in the clinical assessment of critically ill patients. Such methods could ensure that goals of care decisions are based on a more accurate understanding of a patient's level of awareness. ANN NEUROL 2025;98:1201-1209.

Indexed as

AwarenessBrain InjuriesIntensive Care UnitsAdultAgedCritical IllnessCross-Sectional StudiesFemaleHumansMaleMiddle AgedProspective StudiesSpectroscopy, Near-Infrared

Identifiers

PMID41147937
PMCPMC12682940

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.