Cognitive motor dissociation describes a subset of patients with disorders of consciousness who show neuroimaging evidence of consciousness but no detectable command-following behaviours. Although essential for family counselling, decision-making, and the design of rehabilitation programmes, the prognosis for patients with cognitive motor dissociation remains under-investigated. The current study included 78 patients with disorders of consciousness who showed no detectable command-following behaviours. These patients included 45 patients with unresponsive wakefulness syndrome and 33 patients in a minimally conscious state, as diagnosed using the Coma Recovery Scale-Revised. Each patient underwent an EEG-based brain-computer interface experiment, in which he or she was instructed to perform an item-selection task (i.e. select a photograph or a number from two candidates). Patients who achieved statistically significant brain-computer interface accuracies were identified as cognitive motor dissociation. Two evaluations using the Coma Recovery Scale-Revised, one before the experiment and the other 3 months later, were carried out to measure the patients' behavioural improvements. Among the 78 patients with disorders of consciousness, our results showed that within the unresponsive wakefulness syndrome patient group, 15 of 18 patients with cognitive motor dissociation (83.33%) regained consciousness, while only five of the other 27 unresponsive wakefulness syndrome patients without significant brain-computer interface accuracies (18.52%) regained consciousness. Furthermore, within the minimally conscious state patient group, 14 of 16 patients with cognitive motor dissociation (87.5%) showed improvements in their Coma Recovery Scale-Revised scores, whereas only four of the other 17 minimally conscious state patients without significant brain-computer interface accuracies (23.53%) had improved Coma Recovery Scale-Revised scores. Our results suggest that patients with cognitive motor dissociation have a better outcome than other patients. Our findings extend current knowledge of the prognosis for patients with cognitive motor dissociation and have important implications for brain-computer interface-based clinical diagnosis and prognosis for patients with disorders of consciousness.

中文翻译：

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通过脑机界面识别认知运动解离的患者的预后。

认知运动解离描述了一部分意识障碍患者，这些患者表现出意识的神经影像学证据，但没有可检测到的遵循命令的行为。尽管对于家庭咨询，决策和康复计划的设计至关重要，但认知运动障碍患者的预后仍未得到充分研究。当前的研究包括78名意识障碍患者，他们均未发现可检测的命令遵循行为。这些患者包括45名无反应的清醒综合征患者和33名处于最低意识状态的患者，这些患者使用昏迷恢复量表修订版进行了诊断。每位患者都进行了基于EEG的脑计算机接口实验，其中指示他或她执行项目选择任务（即 从两名候选人中选择一张照片或一个数字）。达到统计上显着的脑机接口准确度的患者被识别为认知运动分离。使用昏迷恢复量表修订版进行了两项评估，一项是在实验之前进行，另一项是在3个月后进行评估，以评估患者的行为改善情况。在78例意识障碍患者中，我们的结果表明，在无反应性清醒综合征患者组中，认知运动分离的18例患者中有15例（83.33％）恢复了意识，而其他27例无反应性觉醒综合征的患者中只有5例没有明显的大脑-计算机界面精度（18.52％）恢复了意识。此外，在最低意识状态的患者组中，在16名认知运动分离患者中，有14名（87.5％）的昏迷恢复量表修订评分得到改善，而在其他17例无明显脑机接口准确性的最低意识状态患者中，只有四名（23.53％）的昏迷恢复量表有所改善-修订的分数。我们的结果表明认知运动解离的患者比其他患者有更好的结局。我们的发现扩展了认知运动解离患者的预后知识，对基于脑机接口的临床诊断和意识障碍患者的预后具有重要意义。而其他17名无明显脑机接口准确性的最低意识状态患者中，只有4名（23.53％）的昏迷恢复量表修订评分得到改善。我们的结果表明认知运动解离的患者比其他患者有更好的结局。我们的发现扩展了目前认知运动解离患者预后的知识，对基于脑机接口的临床诊断和意识障碍患者的预后具有重要意义。而其他17名无明显脑机接口准确性的最低意识状态患者中，只有4名（23.53％）的昏迷恢复量表修订评分得到改善。我们的结果表明认知运动解离的患者比其他患者有更好的结局。我们的发现扩展了认知运动解离患者的预后知识，对于基于脑机接口的临床诊断和意识障碍患者的预后具有重要意义。