Explora"on des troubles de la conscience: Analyse
Transcription
Explora"on des troubles de la conscience: Analyse
Explora(ondestroublesdelaconscience: Analysequan,ta,veautoma,séedel’EEG DrBenjaminRohaut Unitéderéanima(on DépartementdeNeurologie Pr.Baulac&Dr.Bolgert ICM Neuropsychologieetneuroimagerie Physiologiedulangageetdelaconscience P.rL.Naccache GroupePi,é-Salpêtrière,Paris Prédic(onsthéoriquescommunesdes principauxmodèlesdelaconscience Global neuronal workspace theory Dehaene et. al. Recurrent processing theory Lamme et. al. Integrated Information theory Tononi et. al. I. Echanged’informa(on Prédic'ons II. Informa(oncomplexe Communes: III. Main(endel’informa(on IV. Bandesdefréquencesspécifiques Meso-circuit theory Schiff et. al. FromJDSiL BrainInforma'onsharingisafingerprintofthe consciousstate 2. The joint probability matrix is estimated. 3. Weights are used to discard trivial correlations. Probability(X,Y) Weights(X,Y) King*, Sitt*,et al. (2013) Current Biology BrainInforma'onsharingisafingerprintofthe consciousstate King*, Sitt*,et al. (2013) Current Biology Theweightedsymbolicmutualinforma,on(wSMI)increases withthestatesofconsciousness… …independently of factors like etiology and delay from the accident King*, Sitt*,et al. (2013) Current Biology Stronger effect for longer brain distances King*, Sitt*,et al. (2013) Current Biology Goingbeyondsinglemarkers Comparingandcombiningsignatures Several“signatures”proposed: Ø ERPs Ø Spectrales,ma,ons Ø Complexity Ø Connec,vity Canwecomparetheirperformance? Dotheycarryindependentinforma,on? Canweop,mallycombinethem? Sitt*, King*,et al. Brain (2014) 92EEGmarkers Reflects expectancy & attention towards an incoming stimulus Synchronous slow activity marking unconscious states. Permutation Entropy, Kolmogorov & Spectral complexity. Sitt*, King*,et al. Brain (2014) Goingbeyondsinglemarkers Comparingandcombiningsignatures Sitt*, King*,et al. Brain (2014) Sitt*, King*,et al. Brain (2014) CaseReport:MrFa 65yearoldman scheduleddiges,vesurgery Post-surgeryperitoni,s,sep,cshock,ICU Delayedawakeninga_erseda,onwithdrawal Rohaut.Betal.Inprep Clinicalexam novisualpoursuitnoblinktovisualthreat nocommandfollowing(spokenorwriLen) pupillaryandcornealreflexespreserved oculocephalicandcaloricresponsesabolished nostartlereflex facialdiplegia,slightneckmovementatpain tendonreflexesprésent hypotonictetraplegia,upperlimb:flexionto painwithheadrota,ontowardthes,mulated side,lowerlimb:triplewithdrawaltopain - CRS-R4[001102] - - - - - - - - BrainstemauditoryEvokedpoten(als MrFa Normal responses Icochlearnerve IIcochlearnuclei IIIsuperiorolive IVlaterallemniscus Overall Prediction! orCS Replica,on/Valida,on • Nouvellesdonnées • McDonnellFounda,onComaand consciousnessconsor,um • Dansd’autressitua,onclinique (ex.sommeil) Automa,cpipeline • automa,callyfileadatabaseofEEG-measuresof consciousness • providepredic,onsofanewpa,ent'slevelof consciousness • deployefficientreportstoresearchersandclinicians Stratégie CodeOpensourcepourleprocessingEEG etlemachinelearning Unreporthtml/ (A) (C) (B) (D) Onlinemonitoring KingJR,SiLJD,FaugerasF,RohautB,ElKarouiI, CohenL,NaccacheL,DehaeneS.Informa'onsharing inthebrainindexesconsciousnessin noncommunica'vepa'ents.CurrBiol.2013. SiLJD,KingJR,ElKarouiI,RohautB,FaugerasF, GramfortA,CohenL,SigmanM,DehaeneS,Naccache L.Largescalescreeningofneuralsignaturesof consciousnessinpa'entsinavegeta'veorminimally consciousstate.Brain.2014. PICNICLab LionelNaccache FredericFaugeras ImenElKaroui JeanRemiKing JacoboSiL MélanieValente ClémenceMarois MariamChammat PaulinePerez Réanima(onNeurologique DrBolgert DrDemeret DrWeiss DrGrinéa