Heart rate variability responses to personalized and non-personalized affective videos. A study on healthy subjects and patients with disorders of consciousness.

Patients with disorders of consciousness, such as those in a minimally conscious state or with unresponsive wakefulness syndrome, often face misdiagnosis because standard assessments rely on motor responses that can be absent due to cognitive-motor dissociation. This study tested whether heart rate variability (HRV) responses to personalized videos of acquaintances differ from responses to videos of strangers. In 17 healthy subjects, HRV measures significantly differed between personalized and non-personalized stimuli, but 11 patients with disorders of consciousness showed no such differences. Significant differences in HRV measures also emerged between the two groups. These findings suggest impaired emotional processing in patients with disorders of consciousness, and that integrating HRV measures may improve diagnosis.

Study at a glance

Abstract

The diagnosis of patients with disorders of consciousness (DOC), including those in a minimally conscious state (MCS) and those with unresponsive wakefulness syndrome (UWS), remains a significant clinical challenge. Neurobehavioral assessment primarily relies on motor responses to commands, which are often difficult to interpret due to impaired comprehension and cognitive-motor dissociation, resulting in a high rate of misdiagnosis. While electrical, hemodynamic, and metabolic brain responses, combined with personalized stimuli, have shown promise in improving diagnosis, the role of cardiac activity-less intrusive and time-efficient-remains underexplored. This study investigated heart rate variability (HRV) responses to personalized videos of acquaintances versus non-personalized videos of strangers. The study included 17 healthy subjects and 11 patients with DOC. Cardiac responses were recorded and analyzed to compare responses to different stimuli and to examine differences between the two groups. Healthy subjects exhibited significant differences in several HRV measures in response to both personalized and non-personalized stimuli, whereas patients with DOC did not demonstrate similar differences. Additionally, significant differences were observed in HRV measures between healthy subjects and patients with DOC. These findings suggest impaired emotional processing in patients with DOC. Further exploration of these differences may enhance diagnostic approaches for this patient population, particularly through the integration of HRV-based measures.