Cortical synchrony changes detected by scalp electrode electroencephalograph as traumatic brain injury patients emerge from coma

• Published in: Surgical neurology Vol. 67; no. 4; pp. 354 - 359
• Main Authors: Shields, Donald C., MD, PhD, Leiphart, James W., MD, PhD, McArthur, David L., PhD, Vespa, Paul M., MD, LeVan Quyen, Michel, PhD, Martinerie, Jacques, PhD, Soss, Jason R., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2007; Elsevier
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Algorithms; Biological and medical sciences; Brain Injuries - complications; Brain Injuries - physiopathology; Cerebral Cortex - physiopathology; Coma; Coma, Post-Head Injury - etiology; Coma, Post-Head Injury - physiopathology; Consciousness; Cortical Synchronization; EEG; Female; Glasgow Coma Scale; Head trauma; Humans; Male; Medical sciences; Middle Aged; Neurology; Neurosurgery; Predictive Value of Tests; Recovery of Function - physiology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Synchrony; Coma; fMRI; Consciousness; Glasgow Coma Scale; EEG; GCS; Functional magnetic resonance imaging; Electroencephalography; Head trauma; Positron emission tomography; PET; Synchrony; Human; Nervous system diseases; Consciousness impairment; Craniocerebral; Scalp; Surgery; Neurological disorder
• ISSN: 0090-3019; 1879-3339
• DOI: 10.1016/j.surneu.2006.09.036

Abstract Background Recent studies show conscious perception is correlated with firing rate synchronization across multiple neuronal assemblies. This study explores the synchrony between multiple cortical surface sites as brain injury patients emerge from coma. Methods Scalp electrode EEG recordings were collected and analyzed from 13 traumatic brain injury patients during their stay in a neurosurgical intensive care unit. Neuronal synchrony was calculated between various electrode pairs during comatose and conscious periods defined by the GCS. Frequency bands from 1 to 30 Hz were evaluated in each patient. Results As patients emerged from coma at GCS 3 to GCS scores ≥8, synchrony values from all electrode pairs revealed a global decrease in synchrony at higher GCS scores. No significant effects were detected relative to the amount of sedation given, but at higher GCS scores significantly increased neuronal synchrony was observed between occipital lobes and right parietal and temporal lobe sites. Synchrony was decreased between frontal-occipital, frontal-parietal, and parietal-occipital electrodes. Conclusions In frequencies from 1 to 30 Hz, synchrony between right parietal and temporal lobes, as well as bilateral occipital lobes, tends to be increased as patients emerge from comatose states. However, synchrony between most intrahemispheric cortical sites is decreased at higher GCS scores in most of the above frequency bands. Thus, brain injury patients demonstrate both increased and decreased cortical surface synchrony between different lobes during emergence from coma.