Research Projects

Developing a Cognition Detection System to Improve state
Diagnoses in non-Responsive Patients

  Dr. Thilo Hinterberger, Northampton University
Amanda Feilding, Beckley Foundation, Oxford

Using similar methodologies and expertise as in the project monitoring higher states of consciousness, this project will develop a device that will be able to determine the level and nature of cognitive processing in both comatose patients and those suffering from a variety of mentally impaired states. There exist a number of medical conditions in which the degree to which patients' cognitive abilities are impaired is unclear e.g. vegetative states and minimally conscious states, or in which patients are incapable of successfully interacting with their environment despite having largely undamaged cognitive abilities e.g. Locked–in syndrome. This study seeks to devise a Cognition Detection System (CDS) that would determine the extent of cognitive integrity in such patients, and so facilitate the diagnosis of their mental state and their prognosis.

Previous research has highlighted monitoring the processing of complex linguistic stimuli as being a reliable indicator of the level of conscious awareness. This research has shown that differences in semantic processing abilities are reflected in differences in the ERP response to auditory linguistic stimuli, and that such differences present a reliable means on which to base diagnosis. By assessing responses to a standardised set of auditory stimuli in patients presenting a range of disorders, as well as in healthy individuals, we will develop an easy-to-use device that should allow clinicians to judge the degree of cognitive processing and so diagnose the exact disorder from which a patient is suffering. Additional cognitive and emotional tasks of greater complexity may be progressively incorporated into the CDS device for increasingly fine-tuned assessment of cognitive processing.

Once the CDS device has been improved and refined, we hope to incorporate it into a previously designed Thought-Translation Device (TTD), a brain-computer interface that allows patients to communicate nonverbally. Although successful use of such device requires extensive training, we envisage the possibility of certain patient groups being able to use this refined device to restore many of the communicative faculties they have lost.

The CDS will therefore be of great practical importance. For comatose patients, it will greatly aid in diagnoses of their cognitive integrity, distinguishing between those patients who are in persistent vegetative states from those in less severe, minimally-conscious states. Such diagnoses have serious consequences for the treatments applied and the prognosis of the patient, and misdiagnosis is currently estimated to be around 40%. By combining this device with the Thought Translation Device, we hope to restore communication to patients who have lost this ability, and so dramatically improve their quality of life.