The influence of acoustic and tactile stimulation on vegetative parameters and EEG in persistent vegetative state

In the present study, we investigated whether different kinds of stimulation in the persistent vegetative state (PVS) lead to specific patterns of physiological reactions. In addition, a possible effect of stimulating drugs was explored by comparing recordings with and without pharmacological stimulation. Eighteen patients in the PVS were submitted to tactile or acoustic stimulation. The latter consisted of white noise and of the voices of close relatives delivered via a digital voice recorder. Additionally, half of the patients were pharmacologically stimulated with amantadine, L-dopa or amphetamine. The effect of stimulation was assessed by recording the electroencephalogram (EEG), electromyogram (EMG), skin conductance response (SCR) and heart rate (HR). Tactile stimulation was associated with statistically significant increases in EEG and EMG parameters, SCR and HR. White noise stimulation led to significant increases in SCR and EMG parameters. The physiological responses to relatives? voices did not differ from baseline activity. Pharmacological stimulation increased the baseline level of activation, but showed no interaction with sensory stimulation. The data presented indicate that the level of arousal in patients in the PVS can be adequately monitored by measuring SCR, HR and EMG parameters.