Towards using fNIRS recordings of mental arithmetic for the detection of residual cognitive activity in patients with disorders of consciousness (DOC)

Background: Recently, fNIRS has been proposed as a promising approach for awareness detection, and a possible method to establish basic communication in patients with disorders of consciousness (DOC). Aim: Using fNIRS, the present study evaluated the applicability of auditory presented mental-arithmetic tasks in this respect. Methods: We investigated the applicability of active attention to serial subtractions for awareness detection in ten healthy controls (HC, 21–32 y/o), by comparing the measured patterns to patterns induced by self-performance of the same task. Furthermore, we examined the suitability of ignoring the given task as additional control signal to implement a two-class brain-computer interface (BCI) paradigm. Finally, we compared our findings in HC with recordings in one DOC patient (78 y/o). Results and conclusion: Results of the HC revealed no differences between the self-performance and the attention condition, making the attention task suitable for awareness detection. However, there was no general difference between the ignore and attend condition, making the tasks less suitable for BCI control. Despite inconsistent correlations between the patient data and the HC group, single runs of the patient recordings revealed task-synchronous patterns – however, we cannot conclude whether the measured activation derives from instruction based task performance and thus awareness.