Multisensory integration in peripersonal space indexes consciousness states in sleep and disorders of consciousness.
Tommaso Bertoni, Giulia Ricci, Jane Jöhr, Brunella Donno, Jacinthe Cataldi, Julia Fellrath, Aurelie Stephan, Carolina Foglia, Sandro Lecci, Floriane Dauvin, Marina Lopes da Silva, Mattia Galigani, Polona Pozeg, Vincent Dunet, Marzia De Lucia, Jean-Paul Noel, Elisa Magosso, Karin Diserens, Francesca Siclari, Andrea Serino
Cell reports. Medicine April 21, 2026 DOI: 10.1016/j.xcrm.2026.102705 via PubMed
Summary
AI-generated from the abstractA neural marker based on high-beta oscillations measured during a simple audiotactile task can detect consciousness and predict recovery in patients with disorders of consciousness. The marker, derived from the peripersonal space system, was present in healthy participants during wakefulness and dreaming but absent in dreamless sleep. In 72 patients with disorders of consciousness, the marker correlated with behavioral measures of consciousness and predicted recovery at discharge. The marker was also associated with forebrain mesocircuit integrity, suggesting a bedside-compatible tool for detecting covert consciousness and guiding clinical decisions in unresponsive patients.
Study at a glance
| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 72 |
| Population | Patients with disorders of consciousness |
| Keywords | EEG Beta oscillations Disorders of consciousness Multisensory integration Peripersonal space |
| Key finding | A peripersonal space index based on high-beta oscillations correlates with behavioral measures of consciousness and predicts recovery at discharge in patients with disorders of consciousness. |
Abstract
Reliably detecting consciousness in unresponsive patients remains an urgent ethical and clinical challenge, as no behavior-independent marker is currently accepted in clinical practice. We characterize consciousness as linked to a representation of the embodied subject of experience, mediated by multisensory integration within the peripersonal space (PPS) system. We test whether a neural marker of PPS representation could detect consciousness and predict clinical outcome in disorders of consciousness (DoC) patients. Using high-density electroencephalography (EEG) during a task-free audiotactile task, we derive a PPS index based on high-beta oscillations. In healthy participants, the PPS index is present during wakefulness and dreaming, but absent in dreamless sleep. In 72 DoC patients, the PPS index correlates with behavioral measures of consciousness and predicts recovery at discharge. The index is associated with forebrain mesocircuit integrity. These findings highlight a bedside-compatible electrophysiological marker with potential clinical utility for detecting covert consciousness and predicting outcomes in non-responsive patients.