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We studied the use of spectral entropy as a measure of focal attention in order to develop a motor-independent, portable, and objective diagnostic tool for patients with locked-in syndrome (LIS), answering the issues of accuracy and training requirement. Data from 20 healthy volunteers, 6 LIS patients, and 10 patients with a vegetative state\/unresponsive wakefulness syndrome (VS\/UWS) were included. Spectral entropy was computed during a gaze-independent 2-class (attention vs rest) paradigm, and compared with EEG rhythms (delta, theta, alpha, and beta) classification. Spectral entropy classification during the attention-rest paradigm showed 93% and 91% accuracy in healthy volunteers and LIS patients respectively. VS\/UWS patients were at chance level. EEG rhythms classification reached a lower accuracy than spectral entropy. Resting-state EEG spectral entropy could not distinguish individual VS\/UWS patients from LIS patients. The present study provides evidence that an EEG-based measure of attention could detect command-following in patients with severe motor disabilities. The entropy system could detect a response to command in all healthy subjects and LIS patients, while none of the VS\/UWS patients showed a response to command using this system.<\/jats:p>","DOI":"10.1177\/1550059416674842","type":"journal-article","created":{"date-parts":[[2016,11,7]],"date-time":"2016-11-07T21:13:16Z","timestamp":1478553196000},"page":"122-135","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":26,"title":["Toward an Attention-Based Diagnostic Tool for Patients With Locked-in Syndrome"],"prefix":"10.1177","volume":"49","author":[{"given":"Damien","family":"Lesenfants","sequence":"first","affiliation":[{"name":"Coma Science Group, GIGA-Research, CHU University Hospital of Liege, Liege, Belgium"},{"name":"School of Engineering and Institute for Brain Science, Brown University, Providence, RI, USA"},{"name":"Center for Neurorestoration and Neurotechnology, Rehabilitation R&D Service, Department of VA 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