J Neurol Neurosurg Psychiatry 79:826-828 doi:10.1136/jnnp.2007.132738
  • Short report

Can electromyography objectively detect voluntary movement in disorders of consciousness?

  1. T A Bekinschtein1,2,3,
  2. M R Coleman3,
  3. J Niklison III2,
  4. J D Pickard3,4,
  5. F F Manes1,2,5
  1. 1
    Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina
  2. 2
    Cognitive Neurology Section, Raúl Carrea Institute for Neurological Research, Buenos Aires, Argentina
  3. 3
    Impaired Consciousness Research Group, Wolfson Brain Imaging Centre, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
  4. 4
    Academic Neurosurgery Unit, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK
  5. 5
    Neuroscience Institute, Favaloro University, Buenos Aires, Argentina
  1. Dr T A Bekinschtein, Clinical Neurophysiology Department U562, Hôpital de la Pitié-Salpêtrière, Paris, 75013 France; tb334{at}, trisbek{at}
  • Accepted 1 December 2007
  • Published Online First 20 December 2007


Determining conscious processing in unresponsive patients relies on subjective behavioural assessment. Using data from hand electromyography, the authors studied the occurrence of subthreshold muscle activity in response to verbal command, as an objective indicator of awareness in 10 disorders of consciousness patients. One out of eight vegetative state patients and both minimally conscious patients (n  =  2) demonstrated an increased electromyography signal specifically linked to command. These findings suggest electromyography could be used to assess awareness objectively in pathologies of consciousness.


  • See Editorial Commentary, p 741

  • Additional tables and information are published online only at

  • Funding: This research was supported by the following grants: Antorchas Foundation (TAB); Raul Carrea Institute and Cognition and Brain Sciences Unit (FFM) and Smith’s Charity UK (JDP, MRC).

  • Competing interests: None.

  • Ethics approval: The Cambridge Local Research Ethics Committee and Buenos Aires Ethics Committee approved this study.

  • Contributors: The authors declare they have participated in the study: Concept and design: TAB, FFM and JDP; Acquisition of data: TAB, MRC, JN; Analysis and interpretation of data: TAB, MRC, JN, FFM, JDP; Drafting of the manuscript: TAB, MRC; Critical revision of the manuscript for important intellectual content: TAB, MRC, JN, JDP, FFManes; Statistical analysis: TAB, MRC; Obtaining funding: TAB, JDP, FFM; Administrative, technical, and material support: TAB, JN, FFM; Study supervision: TAB, JN, MRC. All authors have seen and approved the final version.

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