EEG Assessment of Consciousness Rebooting from Coma
| Autor: | Ana-Maria Zagrean, Andrei Barborica, Mihai Moldovan, Ioana-Raluca Mîndruță, Jean Ciurea, Cosmin-Andrei Şerban, Adina-Maria Roceanu, Leon Zagrean |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Coma medicine.medical_specialty medicine.diagnostic_test media_common.quotation_subject Disorders of consciousness Audiology Electroencephalography medicine.disease Arousal 03 medical and health sciences Burst suppression 030104 developmental biology 0302 clinical medicine Level of consciousness medicine Wakefulness Consciousness medicine.symptom Psychology 030217 neurology & neurosurgery media_common |
| Zdroj: | The Physics of the Mind and Brain Disorders ISBN: 9783319296722 |
| Popis: | The bi-dimensional arousal-awareness operational framework of defining consciousness assumes a graded level of both arousal and awareness. At the lower end of both the arousal and awareness scales is coma, defined as a state of unresponsiveness, in which a patient cannot be awaken. Recovery from coma following brain injury occurs through a sequence of disorders of consciousness (DOC) ranging from unresponsive wakefulness syndrome (UWS)/vegetative state (VS) which shows no signs of awareness to minimally conscious states (MCS) from which consciousness can emerge. The graded consciousness recovery parallels scales of brain injury severity suggesting that consciousness recovers by “turning on” hierarchical services. This sequence resembles a computer “booting” process, which may “hang” at a specific “intermediate levels of consciousness” such as UWS/VS or MCS. The recovery sequence can be assessed by electroencephalography (EEG), a large-scale measure of fluctuations in electrical activity of the brain. Resting state EEG assesses the graded recovery of brain oscillations from isoelectric line to burst-suppression (BS) to EEG slowing to wakefulness alpha activity and faster rhythms. Given that some degree of “connectivity” is required for consciousness, the assessment of DOC can be improved by testing the EEG in controlled stimulation paradigms addressing either the event related potential (ERP) or the event related changes in background EEG rhythms referred to as reactivity, which can be evoked even in BS. This grading of EEG changes provides the rationale for developing EEG indexes for monitoring the “booting process” during coma recovery to improve the diagnosis and prognostication of DOC. |
| Databáze: | OpenAIRE |
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