Comparison of Neural Tracking and Spectral Entropy in Patients with Disorders of Consciousness

Objectives: This study investigates brain responses to natural speech in patients with disorders of consciousness (DoC), focusing on the speech envelope. Two measures were used: neural tracking, which evaluates how well brain activity follows the speech envelope, and spectral entropy, which assesses the complexity of brain responses. These measures were compared to clinical diagnosis and behavioral responsiveness, assessed via the Coma Recovery Scale-Revised (CRS-R). Design: Four DoC patients underwent electroencephalography (EEG) recording while listening to a narrated story in Dutch and Swedish, alongside baseline EEG. We employed both spectral entropy and a backward modeling approach to evaluate the speech envelope’s neural tracking. This technique involves training a model to map the relationship between EEG signals and the corresponding speech envelope. Once the model is trained, it can use unseen EEG data to reconstruct the speech envelope, which is then compared to the original speech envelope to assess how effectively the patient processed the auditory stimulus. For the behavioral assessment, CRS-R scores were converted into the CRS-R index. Results: Spectral entropy positively correlated with the CRS-R index during listening. Neural tracking correlated with CRS-R diagnoses but not the index. An interaction showed that higher neural tracking strengthened the link between spectral entropy and behavioral responsiveness. Conclusion: This study demonstrated the potential of neural tracking and spectral entropy as complementary tools to investigate patients with DoC. Spectral entropy proved valuable for assessing behavioral responsiveness, while neural tracking shows promise in assessing the DoC diagnosis. Supplementary Material File (manuscript.pdf) - Download - 294.88 KB Information & Authors Information Version history Copyright This work is licensed under a Non Exclusive No Reuse License.

Authors Metrics & Citations Metrics Article Usage 196views 112downloads Citations Download citation Rien Sonck, Steven Laureys, Peter Diels, et al. Comparison of Neural Tracking and Spectral Entropy in Patients with Disorders of Consciousness. Authorea. 18 June 2025. DOI: https://doi.org/10.22541/au.175021927.71772631/v1 DOI: https://doi.org/10.22541/au.175021927.71772631/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu.