ArticleFrontiers in neurology
Neurophysiological predictors of full clinical consciousness recovery in patients with DoC: a retrospective evaluation of the DoC-NP Score.
Article in Frontiers in neurology. 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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Abstract
Background: Prognostication in prolonged disorders of consciousness (pDoC) remains challenging, particularly when estimating recovery of a clinically observable conscious state. Multimodal neurophysiological markers may provide complementary prognostic information beyond behavioral assessment alone. Objective: To develop and retrospectively evaluate a composite neurophysiological score (DoC-NP Score) for predicting emergence from the minimally conscious state (eMCS) during post-acute neurorehabilitation. Methods: This retrospective cohort study included 76 patients with pDoC following severe acquired brain injury (sABI). Clinical assessment using the Coma Recovery Scale-Revised (CRS-R) was performed at admission (T0) and discharge (T1). Neurophysiological evaluation at T0 included EEG, upper-limbs somatosensory evoked potentials (SEPs), and auditory event-related potentials (ERPs). The DoC-NP Score integrates standard EEG features (continuity, amplitude, dominant frequency and reactivity), N20 SEPs, and P300 ERPs into a composite ordinal score. Associations between the DoC-NP Score, eMCS recovery, and functional outcomes (LCF, DRS) were analyzed using regression models and ROC analysis. Results: Higher DoC-NP scores at T0 were associated with greater likelihood of eMCS at T1 ( Conclusions: The DoC-NP Score is a feasible multiparametric neurophysiological tool that may support prognostic stratification in pDoC patients as a complementary component to multimodal assessment, although its modest incremental predictive value requires prospective validation.
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