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<p>Accurate differentiation between unresponsive wakefulness syndrome/vegetative state (UWS/VS) and minimally conscious state or emergence from the minimally conscious state (MCS/EMCS) remains clinically challenging in prolonged disorders of consciousness (pDoC), particularly when behavioral responses fluctuate or motor output is limited. We investigated whether short-term heart rate variability (HRV) responses to a standardized 40-Hz auditory perturbation could provide complementary bedside physiological information. Fifty-five patients with pDoC underwent a 10-minute protocol consisting of a 5-minute resting baseline followed by 5 minutes of binaural 40-Hz amplitude-modulated auditory stimulation, with continuous ECG recording. Resting HRV features showed no clear group-level separation between UWS/VS and MCS/EMCS, whereas stimulus-evoked time-domain changes, particularly <InlineEquation ID="IEq1"><EquationSource Format="TEX">\(\Delta\)</EquationSource></InlineEquation>NN50 and <InlineEquation ID="IEq2"><EquationSource Format="TEX">\(\Delta\)</EquationSource></InlineEquation>pNN50, differed between groups after false-discovery-rate correction. Exploratory logistic regression models based on NN50- and pNN50-related response features showed measurable internal held-out test performance. These findings suggest that standardized auditory-evoked HRV dynamics may provide a low-burden physiological complement to repeated Coma Recovery Scale-Revised assessment. The results remain exploratory and require validation in larger independent cohorts.</p>

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Dynamic heart rate variability assessment based on fixed-frequency auditory perturbation in prolonged disorders of consciousness

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月7日

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  • Zuojun Cao,
  • Nianze Chen,
  • Yiqi Tang,
  • Ling Zhu,
  • Hongtao Ji,
  • Yue Shen,
  • Xinwei Tang,
  • Weiqiang Cai,
  • Xi Zhang,
  • Qun Zhang,
  • Yuanyuan Chu,
  • Longwen He,
  • Ning Yang,
  • Yanqin Xi,
  • Guheng Pan,
  • Junfa Wu,
  • Yi Wu,
  • Junwei Lv,
  • Hongyu Xie

摘要

Accurate differentiation between unresponsive wakefulness syndrome/vegetative state (UWS/VS) and minimally conscious state or emergence from the minimally conscious state (MCS/EMCS) remains clinically challenging in prolonged disorders of consciousness (pDoC), particularly when behavioral responses fluctuate or motor output is limited. We investigated whether short-term heart rate variability (HRV) responses to a standardized 40-Hz auditory perturbation could provide complementary bedside physiological information. Fifty-five patients with pDoC underwent a 10-minute protocol consisting of a 5-minute resting baseline followed by 5 minutes of binaural 40-Hz amplitude-modulated auditory stimulation, with continuous ECG recording. Resting HRV features showed no clear group-level separation between UWS/VS and MCS/EMCS, whereas stimulus-evoked time-domain changes, particularly \(\Delta\)NN50 and \(\Delta\)pNN50, differed between groups after false-discovery-rate correction. Exploratory logistic regression models based on NN50- and pNN50-related response features showed measurable internal held-out test performance. These findings suggest that standardized auditory-evoked HRV dynamics may provide a low-burden physiological complement to repeated Coma Recovery Scale-Revised assessment. The results remain exploratory and require validation in larger independent cohorts.