Patients diagnosed with disorders of consciousness show minimal or inconsistent behavioural evidence of conscious awareness. However, using functional neuroimaging, recent research in clinical neuroscience has identified a subpopulation of these patients who reliably produce neural markers indicative of awareness. In this study, we recorded electroencephalograms during a response-free movie task to assess narrative processing in patients with disorders of consciousness. Thirteen patients diagnosed with a disorder of consciousness and 28 healthy controls participated in this study. We designed a movie-watching/listening paradigm involving two suspenseful movie clips, one audiovisual and one audio-only, and used electroencephalography to extract patterns of brain activity that were maximally correlated between subjects. These activity patterns served as electrophysiological indices of narrative processing, which were compared to the neural responses of patients during the same movies. Our analysis revealed two patterns of neural activity, one for each movie condition, that were significantly and reliably correlated between healthy participants. Of the twelve patients who watched the audiovisual movie, 25% produced a pattern of activity that was significantly correlated with the healthy group, while of the ten who listened to the audio narrative, 30% produced electrophysiological patterns similar to controls (one patient responded appropriately to both). The method presented here allows for rapid bedside assessment of higher-order cognitive processing in patients with disorders of consciousness. By leveraging the common neural response to movie stimuli, we were able to identify comparable patterns of brain activity in individual, behaviourally non-responsive patients, reflecting a capacity for narrative processing.

被诊断患有意识障碍的患者表现出很少或不一致的意识意识行为证据。然而，利用功能性神经影像学，临床神经科学的最新研究已经确定了这些患者中的一个亚群，他们能够可靠地产生指示意识的神经标记。在这项研究中，我们在无反应电影任务中记录了脑电图，以评估意识障碍患者的叙事处理。 13 名被诊断患有意识障碍的患者和 28 名健康对照者参与了这项研究。我们设计了一种电影观看/聆听范例，涉及两个悬疑电影剪辑，一个视听的和一个纯音频的，并使用脑电图提取受试者之间最大相关的大脑活动模式。这些活动模式作为叙事处理的电生理指标，与同一部电影中患者的神经反应进行比较。我们的分析揭示了两种神经活动模式，每种模式对应一种电影条件，这两种模式在健康参与者之间显着且可靠地相关。在观看视听电影的 12 名患者中，25% 产生了与健康组显着相关的活动模式，而在听音频叙述的 10 名患者中，30% 产生了与对照组相似的电生理模式（一名患者做出了适当的反应）两者）。这里提出的方法允许对意识障碍患者的高阶认知处理进行快速床边评估。 通过利用对电影刺激的常见神经反应，我们能够识别个体、行为无反应的患者的大脑活动的类似模式，反映叙事处理的能力。