Point-of-care brain injury evaluation of conscious awareness: wide scale deployment of portable HCS EEG evaluation

• Published in: Neuroscience of consciousness Vol. 2018; no. 1; p. niy011
• Main Authors: Fleck-Prediger, Carolyn M, Ghosh Hajra, Sujoy, Liu, Careesa C, Gray, D Shaun, Weaver, Donald F, Gopinath, Shishir, Dick, Bruce D, D'Arcy, Ryan C N
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 2018
• Subjects: Halifax Consciousness Scanner; ERP; EEG; P300; Disorders of Consciousness
• ISSN: 2057-2107; 2057-2107
• DOI: 10.1093/nc/niy011

Survivors of severe brain injury may remain in a decreased state of conscious awareness for an extended period of time. Clinical scales are used to describe levels of consciousness but rely on behavioural responses, precipitating misdiagnosis. We have previously utilized event-related potentials (ERPs) to circumvent reliance on behavioural responses. However, practical implementation barriers limit the clinical utility of ERP assessment at point-of-care (POC). To address this challenge, we developed the Halifax Consciousness Scanner (HCS)-a rapid, semi-automated electroencephalography system. The current study evaluated: (i) HCS feasibility in sub-acute, POC settings nationwide; (ii) ERP P300 responses in patients with acquired brain injury versus healthy controls; and (iii) correlations within and between clinical measures and P300 latencies. We assessed 28 patients with severe, chronic impairments from brain injuries and contrasted the results with healthy control data (  = 100). Correlational analyses examined relationships between P300 latencies and the commonly used clinical scales. P300 latencies were significantly delayed in patients compared to healthy controls (  < 0.05). Clinical assessment scores were significantly inter-correlated and correlated significantly with P300 latencies (  < 0.05). In sub-acute and chronic care settings, the HCS provided a physiological measure of neurocognitive processing at POC for patients with severe acquired brain injury, including those with disorders of consciousness.