Do unresponsive wakefulness syndrome patients feel pain? Role of laser-evoked potential-induced gamma-band oscillations in detecting cortical pain processing

Neuroscience
Antonino NaroRocco Salvatore Calabrò

Abstract

It has been proposed that a neural signature of aware pain perception could be represented by the modulation of gamma-band oscillation (GBO) power induced by nociceptive repetitive laser stimulation (RLS). The aim of our study was to correlate the RLS-induced GBO modulation with the Nociception Coma Scale-Revised (NCS-R) scores (a validated scale assessing possible aware pain perception in patients with chronic disorders of consciousness), in an attempt to differentiate unresponsive wakefulness syndrome (UWS) patients from minimally conscious state (MCS) ones (both of them are awake but exhibit no or limited and fluctuant behavioral signs of awareness and mentation, and low and high NCS-R scores, respectively). In addition, we attempted to identify those among UWS patients who probably experienced pain at covert level (i.e. being aware but unable to show pain-related purposeful behaviors, which are those sustained, reproducible, and voluntary behavioral responses to nociceptive stimuli). Notably, the possibility of clearly differentiating UWS from MCS patients has outmost consequences concerning prognosis (worse in UWS) and adequate pain treatment. RLS consisted in 80 trains of three laser stimuli (delivered at 1Hz), at four di...Continue Reading

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Citations

Nov 17, 2016·Frontiers in Neuroscience·Jing WangYou Wan
Mar 28, 2018·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Sergio BagnatoGiuseppe Galardi

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