Electrophysiological correlates of thalamocortical function in acute severe traumatic brain injury

Details

• Alternative Title:
  Cortex
• Personal Author:
  Curley, William H. ; Bodien, Yelena G. ; Zhou, David W. ; Conte, Mary M. ; Foulkes, Andrea S. ; Giacino, Joseph T. ; Victor, Jonathan D. ; Schiff, Nicholas D. ; Edlow, Brian L.
• Description:
  Tools assaying the neural networks that modulate consciousness may facilitate tracking of recovery after acute severe brain injury. The ABCD framework classifies resting-state EEG into categories reflecting levels of thalamocortical network function that correlate with outcome in post-cardiac arrest coma. In this longitudinal cohort study, we applied the ABCD framework to 20 patients with acute severe traumatic brain injury requiring intensive care (12 of whom were also studied at ≥6-months post-injury) and 16 healthy controls. We tested four hypotheses: 1) EEG ABCD classifications are spatially heterogeneous and temporally variable; 2) ABCD classifications improve longitudinally, commensurate with the degree of behavioral recovery; 3) ABCD classifications correlate with behavioral level of consciousness; and 4) the Coma Recovery Scale-Revised arousal facilitation protocol yields improved ABCD classifications. Channel-level EEG power spectra were classified based on spectral peaks within pre-defined frequency bands: 'A' = no peaks above delta (<4 Hz) range (complete thalamocortical disruption); 'B' = theta (4-8 Hz) peak (severe thalamocortical disruption); 'C' = theta and beta (13-24 Hz) peaks (moderate thalamocortical disruption); or 'D' = alpha (8-13 Hz) and beta peaks (normal thalamocortical function). Acutely, 95% of patients demonstrated 'D' signals in at least one channel but exhibited within-session temporal variability and spatial heterogeneity in the proportion of different channel-level ABCD classifications. By contrast, healthy participants and patients at follow-up consistently demonstrated signals corresponding to intact thalamocortical network function. Patients demonstrated longitudinal improvement in ABCD classifications (p < .05) and ABCD classification distinguished patients with and without command-following in the subacute-to-chronic phase of recovery (p < .01). In patients studied acutely, ABCD classifications improved after the Coma Recovery Scale-Revised arousal facilitation protocol (p < .05) but did not correspond with behavioral level of consciousness. These findings support the use of the ABCD framework to characterize channel-level EEG dynamics and track fluctuations in functional thalamocortical network integrity in spatial detail.
• Subjects:
  Brain Injuries Brain Injuries, Traumatic Coma Electroencephalography Humans Longitudinal Studies
• Keywords:
  Consciousness EEG Intensive Care Unit Traumatic Brain Injury
• Source:
  Cortex. 152:136-152
• Pubmed ID:
  35569326
• Pubmed Central ID:
  PMC9759728
• Document Type:
  Journal Article
• Funding:
  R21 NS109627/NS/NINDS NIH HHSUnited States/ ; S10 RR023043/RR/NCRR NIH HHSUnited States/ ; U48 DP000039/DP/NCCDPHP CDC HHSUnited States/ ; RF1 NS115268/NS/NINDS NIH HHSUnited States/ ; DP2 HD101400/HD/NICHD NIH HHSUnited States/
• Volume:
  152
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:29388d3f3f928d41f26d229310b72a5520aa2d8c5cf981d1d2c3370feeab132d6a78df3136f7167f2301b85c6d73e31cba8bfd548116a113f2489912f1829052
• Download URL:
  https://stacks.cdc.gov/view/cdc/162087/cdc_162087_DS1.pdf
• File Type:
  [PDF - 1.19 MB ]