Detection of Arousal With Facial Micro-expression in Severe Brain-damaged Patient

Study Overview
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Brief Summary
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Severe brain injuries lead to disorders of consciousness after coma. During this awakening period, detection of arousal is critical to the adaptation of medical strategy, but global paralysis, including facial expression, make the clinical assessment very difficult. Emotional facial expressions are a significant part of this clinical assessment. They are both a landmark of the internal state of the patient (comfort versus discomfort) and a landmark of the relational level with his environment. Visible emotional facial expression is a large temporal phenomenon lasting a couple of seconds, while a microexpression is barely noticeable and very brief. These micro expressions are usually produced when one tried to voluntary hide emotional expressions. In this study, we hypothesize that some patients awakening from coma could still produce microexpression before being able to produce visible emotional facial expressions. This ability to produce micro-expression could be an early landmark of relational awakening in severe brain lesions.

Official Title
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Detection of Arousal With Facial Micro-expression in Severe Brain-damaged Patient

Conditions
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Consciousness Disorder

Intervention / Treatment
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* Other: Detection of arousal


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Brain-damaged patient (stroke, traumatic brain injury, anoxia) Disorder of consciousness (CRS-R≤ 10) more than 48h after stopping sedation Patient without spontaneous or stimulated facial expressions Exclusion Criteria: Medically unstable patient

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Severe brain-damaged patient in coma awakening<br>For each patient, video sessions of the face will be performed during a waking period, until the spontaneous macro-EFE (Emotional Facial Expression) reappears. The video sessions will be done without stimulation or with visual, auditory or tactile stimulation. The sessions will be daily for 7 days then weekly for a maximum duration of 4 weeks. | Other: Detection of arousal<br>* Detecting facial microexpression before visible facial expressions in patient with disorder of consciousness after severe brain injury<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| facial micro expression found in at least one patient on one video recording | Optical camera and thermal camera | Every day for a week then once a week for four weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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arousal, Consciousness Disorders, vegetative state, minimally conscious state