{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T04:53:47Z","timestamp":1781844827060,"version":"3.54.5"},"reference-count":69,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prognostication in prolonged disorders of consciousness (pDoC) remains challenging, particularly when estimating recovery of a clinically observable conscious state. Multimodal neurophysiological markers may provide complementary prognostic information beyond behavioral assessment alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop and retrospectively evaluate a composite neurophysiological score (DoC-NP Score) for predicting emergence from the minimally conscious state (eMCS) during post-acute neurorehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 76 patients with pDoC following severe acquired brain injury (sABI). Clinical assessment using the Coma Recovery Scale\u2013Revised (CRS-R) was performed at admission (T0) and discharge (T1). Neurophysiological evaluation at T0 included EEG, upper-limbs somatosensory evoked potentials (SEPs), and auditory event-related potentials (ERPs). The DoC-NP Score integrates standard EEG features (continuity, amplitude, dominant frequency and reactivity), N20 SEPs, and P300 ERPs into a composite ordinal score. Associations between the DoC-NP Score, eMCS recovery, and functional outcomes (LCF, DRS) were analyzed using regression models and ROC analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Higher DoC-NP scores at T0 were associated with greater likelihood of eMCS at T1 (\n                      <jats:italic>OR<\/jats:italic>\n                      = 1.768 per point; AUC = 0.768, optimal cut-off = 6) and independently predicted better functional (LCF,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.005) and disability (DRS,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.025) outcomes. eMCS was achieved at T1 by 35 patients (46%), independent of injury etiology (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;gt; 0.05). EEG AFR (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.854), EEG continuity (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.668) and SEPs (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.673) contributed most to the prognostic value of the composite score, while ERPs showed moderate (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.489). Moreover, the DoC-NP score correlates moderately with the change in CRS-R total score (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.434,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), auditory function (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.445,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), motor function (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.435,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001), motor oral\/verbal function (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.334,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003), communication (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.315,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003); poorly with visual function (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.27,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.016) and no correlation with vigilance (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.168).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The DoC-NP Score is a feasible multiparametric neurophysiological tool that may support prognostic stratification in pDoC patients as a complementary component to multimodal assessment, although its modest incremental predictive value requires prospective validation.<\/jats:p>\n                  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