A Potential Prognosis Indicator Based on P300 Brain-Computer Interface for Patients with Disorder of Consciousness

For patients with disorders of consciousness, such as unresponsive wakefulness syndrome (UWS) patients and minimally conscious state (MCS) patients, their long treatment cycle and high cost commonly put a heavy burden on the patient's family and society. Therefore, it is vital to accurately diagnose and predict consciousness recovery for such patients. In this paper, we explored the role of the P300 signal based on an audiovisual BCI in the classification and prognosis prediction of patients with disorders of consciousness. This experiment included 18 patients: 10 UWS patients and 8 MCS- patients. At the three-month follow-up, we defined patients with an improved prognosis (from UWS to MCS-, from UWS to MCS+, or from MCS- to MCS+) as "improved patients" and those who stayed in UWS/MCS as "not improved patients". First, we compared and analyzed different types of patients, and the results showed that the P300 detection accuracy rate of "improved" patients was significantly higher than that of "not improved" patients. Furthermore, the P300 detection accuracy of traumatic brain injury (TBI) patients was significantly higher than that of non-traumatic brain injury (NTBI, including acquired brain injury and cerebrovascular disease) patients. We also found that there was a positive linear correlation between P300 detection accuracy and CRS-R score, and patients with higher P300 detection accuracy were likely to achieve higher CRS-R scores. In addition, we found that the patients with higher P300 detection accuracies tend to have better prognosis in this audiovisual BCI. These findings indicate that the detection accuracy of P300 is significantly correlated with the level of consciousness, etiology, and prognosis of patients. P300 can be used to represent the preservation level of consciousness in clinical neurophysiology and predict the possibility of recovery in patients with disorders of consciousness.