Columbia University
The purpose of this research study is to evaluate whether a smartphone-enabled EEG (electroencephalography) system can be used to detect Cognitive Motor Dissociation (CMD) in patients with acute neurological injuries who appear unable to follow commands at the bedside. CMD occurs when a person may be conscious and able to understand instructions but cannot physically respond. The study will also examine whether CMD detection is associated with short-term and long-term recovery outcomes.
Patients with severe neurological injuries, such as traumatic brain injury, intracerebral hemorrhage, subarachnoid hemorrhage, or cardiac arrest, may appear unresponsive even though some retain hidden awareness that cannot be detected through routine bedside examinations. This condition is known as Cognitive Motor Dissociation (CMD). Research studies using EEG have shown that some patients who cannot physically respond to commands may still demonstrate brain activity indicating that they understand and can follow instructions. However, these EEG methods are not widely available because they o…
Inclusion Criteria: 1. Admitted for acute traumatic brain injury, intracerebral or subarachnoid hemorrhage, or cardiac arrest 2. Neurological examination per Coma Recovery Scale-Revised (CRS-R) criteria consistent with coma, vegetative state, or minimally conscious state minus (not explained by sedation) 3. Enrollment by day 7 post injury. Exclusion Criteria: 1. EEG demonstrating ongoing seizures or ictal interictal continuum 2. Planned withdrawal of life sustaining therapy.