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.
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See Editorial Commentary, p 741
Additional tables and information are published online only at http://jnnp.bmj.com/content/vol79/issue7
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.