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

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.

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.

Detecting facial microexpression before visible facial expressions in patient with disorder of consciousness after severe brain injury

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