Breaking News:New tool refines disorders of consciousness care– What Just Happened

An automated consciousness tool that fuses six tests has been built to sharpen diagnosis and estimate recovery in patients with disorders of consciousness.

Tested in three European centres, the tool may help clinicians give more tailored assessments of disorders of consciousness, its developers say.

After stroke, traumatic brain injury or cardiac arrest, some people sustain severe brain damage and lose consciousness for days to months.

Many then fall between wakefulness and complete unresponsiveness.

The research, coordinated by Jacobo Sitt at the Paris Brain Institute, combines six assessments, each probing a different facet of brain function: high-density electroencephalography at rest and during an auditory task (EEG, brainwave recordings), structural and functional MRI (scans of anatomy and activity), diffusion MRI (tracks water movement along nerve fibres) and positron emission tomography, or PET (metabolic imaging).

Dragana Manasova is a former PhD student in the DreamTeam at Paris Brain Institute and now a postdoctoral researcher at the Massachusetts Institute of Technology.

Manasova said: “There is no clear boundary between normal and abnormal states of consciousness.

“By convention, doctors consider patients to be recovering when they can communicate and manipulate objects.

“However, patients’ condition can fluctuate considerably, and the timing of improvement remains difficult to predict.”

As part of the European PerBrain consortium, the team recruited nearly 400 patients across France, Germany and Italy and compared clinical outcomes with predictions from multimodal analysis.

Their results indicate that combining data from multiple techniques significantly improves model performance: the more modalities available, the more reliable the predictions.

The researchers also report that the tests contributing most to diagnosis are not necessarily the same as those that predict outcomes.

Functional measures of brain activity describe a patient’s current state but say less about future change, whereas structural measures are more informative for prognosis.

Discrepancies between modalities were particularly common in patients who ultimately improved, potentially signalling “islands of consciousness” not always captured through clinical observation alone.

Manasova said: “The aim of our study was to bring together a wide range of clinical and brain imaging data within a single, coherent analytical framework.

“By combining these rich and complementary sources of information, we sought to gain a better understanding of complex brain states, as they occur in real-world clinical practice.

“This work also provides insight into how computational analyses, including artificial intelligence models, can support medical decision-making and help clinicians make more informed choices.”

Sitt, co-head of the PICNIC Lab at Paris Brain Institute, said: “Now that we have demonstrated the power and usefulness of multimodal analysis in assisting clinicians, we would like to see this tool adopted in expert centres.

“Clinical assessment of patients with disorders of consciousness is not conducted in the same way everywhere; it can vary depending on countries, professional cultures, or access to advanced technologies.

“Our aim is for all clinicians to share the same reference framework and be able to produce comparable data to advance consciousness research.”

The tool developed by the team is described as a small, easy-to-use device for clinical settings.

It provides a probabilistic, integrative picture of the patient’s condition, giving the medical team latitude to interpret the results in context.

The researchers said: “This tool does not replace human expertise but offers a way to objectify often ambiguous clinical observations and personalise patient care with a view to achieving the best possible recovery.

“It also allows us to better understand the link between brain biology and subjective experience.”