Sorbonne Université, Paris Brain Institute (ICM), INRIA, CNRS, INSERM, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France; Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Forschungszentrum Jülich, Jülich, Germany; Institute of Systems Neuroscience, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
Pauline Pérez
Sorbonne Université, Paris Brain Institute (ICM), INRIA, CNRS, INSERM, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France; AP-HP, Hôpital de la Pitié Salpêtrière, Neuro ICU, DMU Neurosciences, Paris, France
Lionel Naccache
Sorbonne Université, Paris Brain Institute (ICM), INRIA, CNRS, INSERM, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France; Pitié-Salpêtrière Faculty of Medicine, Pierre and Marie Curie University, Sorbonne Universities, Paris, France; INSERM, National Institute of Health and Medical Research, Paris, France; Department of Neurology, Pitié-Salpêtrière Hospital Group, Public Hospital Network of Paris, Paris, France; Department of Neurophysiology, Pitié-Salpêtrière Hospital Group, Public Hospital Network of Paris, Paris, France
Laboratoire de Neurosciences Cognitives et Computationnelles, Département d’Etudes Cognitives, École Normale Supérieure, INSERM, Université PSL, Paris, France
Sorbonne Université, Paris Brain Institute (ICM), INRIA, CNRS, INSERM, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France; INSERM, National Institute of Health and Medical Research, Paris, France
Recent research suggests that brain-heart interactions are associated with perceptual and self-consciousness. In this line, the neural responses to visceral inputs have been hypothesized to play a leading role in shaping our subjective experience. This study aims to investigate whether the contextual processing of auditory irregularities modulates both direct neuronal responses to the auditory stimuli (ERPs) and the neural responses to heartbeats, as measured with heartbeat-evoked responses (HERs). HERs were computed in patients with disorders of consciousness, diagnosed with a minimally conscious state or unresponsive wakefulness syndrome. We tested whether HERs reflect conscious auditory perception, which can potentially provide additional information for the consciousness diagnosis. EEG recordings were taken during the local-global paradigm, which evaluates the capacity of a patient to detect the appearance of auditory irregularities at local (short-term) and global (long-term) levels. The results show that local and global effects produce distinct ERPs and HERs, which can help distinguish between the minimally conscious state and unresponsive wakefulness syndrome patients. Furthermore, we found that ERP and HER responses were not correlated suggesting that independent neuronal mechanisms are behind them. These findings suggest that HER modulations in response to auditory irregularities, especially local irregularities, may be used as a novel neural marker of consciousness and may aid in the bedside diagnosis of disorders of consciousness with a more cost-effective option than neuroimaging methods.
