In patients with severe brain injury, the neurological wake-up test—a brief interruption of sedation to check responsiveness—often yields ambiguous or absent behavioral responses, limiting its prognostic value. Recording 128-channel EEG from 41 such patients during propofol sedation interruption revealed that brain responses, measured by EEG power, spatial ratios, and the spectral exponent, can show signs of waking even when behavior does not. Combining EEG with behavioral assessment improved predictions of survival, recovery of consciousness, and long-term functional outcomes, outperforming the predictions of attending physicians. EEG can complement the wake-up test to better inform clinicians, families, and treatment planning.
Functional magnetic resonance imaging (fMRI) was used to investigate autobiographical memory in a single patient with a disorder of consciousness (DoC). The patient viewed video clips from their own recent mall visit, a control's visit to the same mall, and a novel bookstore. A machine-learning classifier trained on twelve healthy participants decoded the patient's brain activity, distinguishing the three conditions with balanced accuracy of 0.448 (p = .032) and distinguishing the patient's own clips from the control's clips with balanced accuracy of 0.609 (p = .032), both within the control group's performance range. These results suggest that autobiographical memory processes may remain intact in some DoC patients despite their inability to report them.