Audiomotor Integration in Minimally Conscious State: Proof of Concept!

Table 2

The time course of the individual raw values of the electrophysiological parameters in the HC and MCS and UWS participants. At , there were not significant differences among the three groups concerning RMT% and MEP amplitude. MCS displayed partially preserved audiomotor connectivity, although weakened (i.e., increased AMI). The UWS showed instead markedly weakened AMI and a global impairment of cortical excitability, connectivity, and LLAEP N1 latency and amplitude (increased and decreased, resp.). Data are summarized as mean ± se (in italic). The MCS patients who ameliorated at the auditory function (. 3, 6, 7, 8, and 10) at following the real_protocol are marked in bold.

(a)

Parameter	Protocol	HC			MCS patients			UWS patients
		RMT (%)	rES_alone	58	52	52	58	56	58	58	62	67
		52	57	58	60	57	55	68	59	57
		53	57	57	59	54	58	57	60	53
		55	55	54	56	60	55	60	62	57
		58	58	54	59	55	56	66	59	56
		52	56	55	56	58	59	55	66	67
		53	55	53	58	60	57	57	55	65
		56	52	53	57	58	59	66	62	60
		56	55	52	56	60	56	53	60	61
		57	55	53	57	59	58	64	63	54
		55 ± .7	55 ± .6	54 ± .6	58 ± .5	58 ± .7	57 ± .5	60 ± 1.7	61 ± .9	60 ± 1.6
	rTMS_alone	54	54	56	57	54	60	68	53	65
		53	56	53	57	55	58	63	63	65
		58	52	57	58	59	57	67	55	53
		55	58	53	59	59	55	66	67	60
		53	55	58	54	55	57	64	61	58
		52	53	53	55	55	59	60	65	56
		55	57	55	56	56	57	62	55	56
		56	53	55	54	58	60	63	61	59
		53	56	58	58	54	57	56	66	58
		56	54	52	59	56	57	53	54	59
		55 ± .6	55 ± .6	55 ± .7	57 ± .6	56 ± .6	58 ± .5	62 ± 1.5	60 ± 1.7	59 ± 1.2
	real_protocol	53	52	52	60	56	57	60	58	62
		58	56	58	54	56	56	57	53	67
		58	57	56	59	54	59	61	58	56
		58	57	55	58	54	59	54	64	55
		53	54	53	60	55	60	61	60	69
		56	52	52	56	60	57	56	53	61
		53	58	57	57	56	60	66	60	64
		52	57	58	58	59	57	58	60	57
		56	56	55	59	54	56	65	67	67
		56	53	52	58	58	59	57	61	57
		55 ± .8	55 ± .7	54 ± .8	57 ± .6	56 ± .7	58 ± .5	59 ± 1.2	59 ± 1.4	61 ± 1.6
MEP (mV6)	rES_alone	0.3	0.3	0.3	0.5	0.5	0.7	0.6	0.6	0.5
		0.6	0.6	0.6	0.6	0.6	0.7	0.5	0.5	0.6
		0.9	0.9	0.9	0.6	0.6	0.6	0.4	0.5	0.5
		0.8	0.8	0.8	0.6	0.6	0.7	0.5	0.5	0.5
		0.9	0.9	0.9	0.6	0.7	0.5	0.6	0.4	0.5
		0.9	0.9	0.9	0.7	0.6	0.6	0.6	0.5	0.5
		0.8	0.8	0.8	0.6	0.5	0.7	0.6	0.5	0.6
		0.8	0.8	0.8	0.7	0.5	0.7	0.5	0.5	0.5
		0.8	0.8	0.8	0.6	0.5	0.5	0.5	0.6	0.5
		0.8	0.8	0.8	0.7	0.5	0.6	0.6	0.5	0.5
		0.7 ± .1	0.7 ± .1	0.7 ± .1	0.6 ± 0.02	0.6 ± 0.02	0.6 ± 0.02	0.5 ± 0.02	0.5 ± 0.02	0.5 ± 0.02
	rTMS_alone	0.3	0.3	0.3	0.7	0.5	0.7	0.5	0.5	0.6
		0.6	0.6	0.6	0.6	0.6	0.5	0.4	0.5	0.5
		0.9	0.9	0.9	0.7	0.5	0.7	0.6	0.5	0.5
		0.8	0.8	0.8	0.7	0.6	0.6	0.6	0.5	0.5
		0.9	0.9	0.9	0.6	0.6	0.6	0.6	0.6	0.6
		0.9	0.9	0.9	0.5	0.6	0.6	0.6	0.6	0.4
		0.8	0.8	0.8	0.7	0.6	0.5	0.4	0.6	0.4
		0.8	0.8	0.8	0.6	0.5	0.7	0.5	0.4	0.4
		0.8	0.8	0.8	0.6	0.6	0.5	0.5	0.6	0.4
		0.8	0.8	0.8	0.7	0.6	0.6	0.5	0.5	0.5
		0.7 ± .1	0.7 ± .1	0.7 ± .1	0.6 ± .1	0.6 ± .1	0.6 ± .1	0.5 ± 0.02	0.5 ± 0.02	0.5 ± 0.02
	real_protocol	0.3	0.7	0.3	0.8	0.8	0.8	0.5	0.6	0.5
		0.6	0.8	0.6	0.9	0.9	0.9	0.5	0.5	0.5
		0.9	1.2	0.9	0.6	0.8	0.6	0.4	0.6	0.4
		0.8	1.0	0.8	0.8	0.9	0.8	0.6	0.4	0.4
		0.9	1.2	0.9	0.8	0.8	0.8	0.4	0.5	0.5
		0.9	1.2	0.9	0.9	1	0.9	0.4	0.5	0.5
		0.8	1.1	0.8	0.8	1	0.8	0.5	0.5	0.5
		0.8	1.1	0.8	0.3	0.9	0.3	0.6	0.5	0.5
		0.8	1.2	0.8	0.8	0.8	0.8	0.5	0.5	0.4
		0.8	1.1	0.8	0.9	1	0.9	0.5	0.5	0.6
		0.7 ± .1	1.1 ± .1	0.7 ± .1	0.7 ± .1	0.9 ± .05	0.7 ± .1	0.5 ± 0.02	0.5 ± 0.02	0.5 ± 0.02
AMI (mV)	rES_alone	0.5	0.4	0.3	0.6	0.5	0.5	0.6	0.5	0.5
		0.3	0.5	0.4	0.4	0.5	0.5	0.4	0.5	0.5
		0.4	0.5	0.3	0.4	0.5	0.5	0.4	0.5	0.5
		0.5	0.3	0.4	0.5	0.5	0.5	0.5	0.5	0.5
		0.5	0.5	0.3	0.4	0.6	0.5	0.4	0.6	0.5
		0.5	0.3	0.4	0.5	0.4	0.5	0.5	0.4	0.5
		0.3	0.3	0.4	0.4	0.5	0.6	0.4	0.5	0.6
		0.5	0.4	0.3	0.5	0.5	0.4	0.5	0.5	0.4
		0.3	0.4	0.3	0.5	0.6	0.4	0.5	0.6	0.4
		0.5	0.4	0.3	0.5	0.4	0.4	0.5	0.4	0.4
		0.4 ± 0.02	0.4 ± 0.02	0.4 ± 0.02	0.5 ± 0.02	0.5 ± 0.02	0.5 ± 0.02	0.5 ± 0.02	0.5 ± 0.02	0.5 ± 0.02
	rTMS_alone	0.5	0.3	0.4	0.5	0.4	0.5	0.5	0.4	0.5
		0.5	0.4	0.4	0.5	0.5	0.6	0.5	0.5	0.6
		0.4	0.3	0.3	0.5	0.6	0.5	0.5	0.6	0.5
		0.3	0.3	0.4	0.5	0.4	0.5	0.5	0.4	0.5
		0.3	0.5	0.4	0.6	0.4	0.6	0.6	0.4	0.6
		0.3	0.3	0.5	0.5	0.5	0.5	0.5	0.5	0.5
		0.3	0.3	0.4	0.5	0.5	0.4	0.5	0.5	0.4
		0.4	0.3	0.3	0.4	0.5	0.5	0.4	0.5	0.5
		0.4	0.3	0.5	0.6	0.5	0.5	0.6	0.5	0.5
		0.4	0.4	0.5	0.6	0.5	0.5	0.6	0.5	0.5
		0.4 ± 0.02	0.4 ± 0.01	0.4 ± 0.02	0.5 ± 0.02	0.5 ± 0.02	0.5 ± 0.02	0.5 ± 0.02	0.5 ± 0.02	0.5 ± 0.02
	real_protocol	0.5	0.9	0.4	0.6	0.3	0.5	0.6	0.4	0.6
		0.4	1	0.3	0.4	0.6	0.4	0.5	0.4	0.5
		0.3	1	0.4	0.6	0.9	0.5	0.5	0.4	0.4
		0.3	0.8	0.5	0.5	0.8	0.5	0.6	0.6	0.6
		0.4	0.9	0.5	0.4	0.9	0.4	0.5	0.6	0.5
		0.5	0.8	0.3	0.5	0.9	0.6	0.6	0.5	0.4
		0.4	0.8	0.4	0.4	0.8	0.5	0.4	0.5	0.5
		0.4	0.9	0.4	0.5	0.8	0.6	0.5	0.5	0.5
		0.5	1	0.4	0.4	0.8	0.6	0.5	0.5	0.5
		0.4	0.8	0.5	0.4	0.8	0.5	0.5	0.6	0.6
		0.4 ± .03	0.9 ± .05	0.4 ± .02	0.5 ± 0.5	0.7 ± .1	0.5 ± 0.02	0.5 ± 0.02	0.5 ± 0.02	0.5 ± 0.02
LLAEP amplitude (V)	rES_alone	16	3	7	7	11	11	5	0	2
		6	4	2	11	11	7	4	2	5
		3	6	7	10	10	13	0	7	1
		14	1	8	11	9	6	7	6	2
		2	3	6	6	12	5	2	0	0
		9	10	15	5	11	8	6	7	2
		16	8	15	12	7	12	6	7	6
		10	12	11	12	5	5	5	1	4
		1	5	16	5	13	9	6	6	2
		9	3	16	8	6	10	5	2	6
		9 ± 1	6 ± 2	10 ± 2	9 ± 1	10 ± 1	9 ± 1	5 ± 1	4 ± 0.4	3 ± 1
	rTMS_alone	16	0	2	12	8	7	2	1	7
		7	10	7	13	13	6	3	1	4
		7	6	8	12	11	8	7	7	6
		16	15	10	5	11	5	2	7	4
		14	1	0	8	9	11	4	7	6
		16	8	4	12	8	7	4	6	2
		5	10	11	6	11	13	5	7	4
		5	16	13	5	13	10	6	1	5
		15	9	5	6	9	10	3	4	0
		1	2	2	7	13	13	2	1	4
		10 ± 2	8 ± 2	6 ± .4	9 ± 1	11 ± 1	9 ± 1	4 ± 1	4 ± 1	4 ± 1
	real_protocol	12	3	13	9	9	11	0	0	2
		16	5	6	9	9	7	0	1	4
		6	6	6	12	12	10	7	4	5
		3	16	2	13	11	8	6	2	2
		12	10	2	7	9	12	7	3	6
		4	7	16	11	6	5	2	4	3
		6	11	10	10	5	9	4	5	6
		14	15	8	13	11	13	3	2	2
		3	3	14	10	11	6	3	5	6
		4	14	6	9	5	7	5	6	4
		8 ± 2	9 ± 1	8 ± 1	10 ± .4	9 ± 1	9 ± 1	4 ± .4	3 ± 1	4 ± 1
LLAEP latency (ms)	rES_alone	89	124	100	111	118	114	131	124	123
		81	95	90	98	117	126	162	135	125
		95	127	133	95	115	131	117	118	106
		84	97	110	110	147	135	162	163	121
		89	96	127	111	145	114	161	161	119
		95	105	126	110	130	151	164	126	122
		82	110	88	109	140	140	139	138	110
		79	84	103	102	107	115	130	140	107
		91	109	105	108	132	143	138	133	106
		86	94	103	101	136	128	116	148	108
		87 ± 2	104 ± 4	109 ± 5	106 ± 2	129 ± 4	130 ± 4	142 ± 3	138 ± 5	115 ± 6
	rTMS_alone	89	109	97	113	111	133	126	123	124
		81	86	82	103	98	111	171	125	157
		95	130	106	103	95	105	135	106	146
		84	107	89	148	110	126	132	121	153
		89	95	117	122	111	111	166	119	129
		95	119	104	110	110	115	142	122	147
		82	95	107	132	109	117	146	110	134
		79	104	84	131	102	114	131	107	127
		91	113	105	138	108	128	145	106	126
		86	109	100	135	101	108	113	108	110
		87 ± 2	107 ± 4	99 ± 4	123 ± 2	106 ± 5	117 ± 3	141 ± 3	115 ± 6	135 ± 5
	real_protocol	89	116	117	155	119	111	128	137	159
		81	97	90	124	122	98	106	146	139
		95	96	114	102	110	95	133	110	121
		84	86	96	135	107	110	147	126	128
		89	120	111	139	106	111	142	140	119
		95	121	124	135	122	110	132	146	168
		82	108	106	111	110	109	132	153	125
		79	86	94	103	107	102	103	119	109
		91	97	116	116	106	108	150	123	110
		86	105	97	117	108	101	126	115	132
		87 ± 2	103 ± 4	106 ± 4	124 ± 2	112 ± 5	106 ± 5	130 ± 2	132 ± 5	131 ± 6

(b)

Parameter	HC/DOC	MCS/UWS
RMT (%)	NS	NS
MEP (mV)	NS	NS
AMI (%)	0.002	0.002
N1 latency (ms)	<0.001	0.005
N1 amplitude (V)	NS	0.05

AMI: audiomotor integration; LLAEP: long-latency auditory potential; MEP: motor evoked potential; NS: nonsignificant; rES: repetitive electric stimulation; RMT: resting motor threshold; rTMS: repetitive transcranial magnetic stimulation.