| Reference code: | NDE-24 |
| Location: | Arquivo PCA - Pasta 1/Outros Apoios
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Title:
| A heartbeat away from consciousness: Heart rate variability entropy can discriminate disorders of consciousness and is correlated with resting-state fMRI brain connectivity of the central autonomic network
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| Publication year: | 2018
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URL:
| https://www.frontiersin.org/articles/10.3389/fneur.2018.00769/full
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| Abstract/Results: | ABSTRACT:
BACKGROUND
Disorders of consciousness are challenging to diagnose, with inconsistent behavioral responses, motor and cognitive disabilities, leading to approximately 40% misdiagnoses. Heart rate variability (HRV) reflects the complexity of the heart-brain two-way dynamic interactions. HRV entropy analysis quantifies the unpredictability and complexity of the heart rate beats intervals. We here investigate the complexity index (CI), a score of HRV complexity by aggregating the non-linear multi-scale entropies over a range of time scales, and its discriminative power in chronic patients with unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS), and its relation to brain functional connectivity.
METHODS
We investigated the CI in short (CIs) and long (CIl) time scales in 14 UWS and 16 MCS sedated. CI for MCS and UWS groups were compared using a Mann-Whitney exact test. Spearman's correlation tests were conducted between the Coma Recovery Scale-revised (CRS-R) and both CI. Discriminative power of both CI was assessed with One-R machine learning model. Correlation between CI and brain connectivity (detected with functional magnetic resonance imagery using seed-based and hypothesis-free intrinsic connectivity) was investigated using a linear regression in a subgroup of 10 UWS and 11 MCS patients with sufficient image quality.
RESULTS
Higher CIs and CIl values were observed in MCS compared to UWS. Positive correlations were found between CRS-R and both CI. The One-R classifier selected CIl as the best discriminator between UWS and MCS with 90% accuracy, 7% false positive and 13% false negative rates after a 10-fold cross-validation test. Positive correlations were observed between both CI and the recovery of functional connectivity of brain areas belonging to the central autonomic networks (CAN).
CONCLUSION
CI of MCS compared to UWS patients has high discriminative power and low false negative rate at one third of the estimated human assessors' misdiagnosis, providing an easy, inexpensive and non-invasive diagnostic tool. CI reflects functional connectivity changes in the CAN, suggesting that CI can provide an indirect way to screen and monitor connectivity changes in this neural system. Future studies should assess the extent of CI's predictive power in a larger cohort of patients and prognostic power in acute patients.
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| Accessibility: | Document exists in file
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Language:
| eng
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Author:
| Riganello, F.
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Secondary author(s):
| Larroque, S., Ali Bahri, M., Heine, L., Martial, C., Charland-Verville, V., Aubinet, C., Vanhaudenhuyse, A., Chatelle, C., Laureys, S., Di Perri, C.
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Document type:
| Article
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Number of reproductions:
| 3
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Reference:
| Riganello, F., Larroque, S., Ali Bahri, M., Heine, L., Martial, C., Charland-Verville, V., Aubinet, C., Vanhaudenhuyse, A., Chatelle, C., Laureys, S., Di Perri, C. (2018). A heartbeat away from consciousness: Heart rate variability entropy can discriminate disorders of consciousness and is correlated with resting-state fMRI brain connectivity of the central autonomic network. Frontiers in Neurology, 9, 769.
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| 2-year Impact Factor: | 2.635|2018
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| Times cited: | 48|2025-09-17
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| Indexed document: | Yes
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| Quartile: | Q3
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| Keywords: | Heart rate variability entropy (HRV) / Disorders of consciousness (DOC) / Unresponsive wakefulness syndrome/vegetative state (UWS/VS) / Minimally conscious state / Functional connectivity / Resting-state fMRI / Machine learning
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A heartbeat away from consciousness: Heart rate variability entropy can discriminate disorders of consciousness and is correlated with resting-state fMRI brain connectivity of the central autonomic network |