Early Consciousness Disorder in Acute Large Hemispheric Infarction: An Analysis Based on Quantitative EEG and Brain Network Characteristics

Huang, Huijin; Niu, Zikang; Liu, Gang; Jiang, Mengdi; Jia, Qingxia; Li, Xiaoli; Su, Yingying

doi:10.1007/s12028-020-01051-w

Cited by 16 publications

(8 citation statements)

References 49 publications

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“…Consistent with previous studies, we found that theta power ( Thibaut et al, 2018 ) and alpha power ( Chennu et al, 2014 ; Cai et al, 2019 ) were significantly and positively correlated with behavioral scores based on the CRS-R. Several studies have confirmed that increased theta, alpha and beta power indicates a better state of consciousness ( Sitt et al, 2014 ; Chennu et al, 2017 ; Huang et al, 2020 ). The effect of tDCS can also appear in other brain regions besides the stimulation site ( Krause et al, 2017 ; Chan and Han, 2020 ).…”

Section: Discussionsupporting

confidence: 90%

“…Due to varying degrees of functional deafferentation at thalamic and cortical levels, slow-wave activity predominates after severe brain injury ( Schiff et al, 2014 ). In patients with large hemispheric infarctions, higher levels of consciousness were associated with more alpha and beta oscillations and fewer delta and theta oscillations ( Huang et al, 2020 ). In the present study, a significant increase in alpha and beta power was observed in the parieto-occipital region of patients with impaired consciousness after a single stimulation, when clinical behavior was not yet significantly different.…”

Section: Discussionmentioning

confidence: 99%

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High-Definition Transcranial Direct Current Stimulation of the Dorsolateral Prefrontal Cortex Modulates the Electroencephalography Rhythmic Activity of Parietal Occipital Lobe in Patients With Chronic Disorders of Consciousness

Han

Chen

Zheng

et al. 2022

Front. Hum. Neurosci.

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BackgroundDisorders of consciousness (DOC) are a spectrum of pathologies affecting one’s ability to interact with the external world. At present, High-Definition Transcranial Direct Current Stimulation (HD-tDCS) is used in many patients with DOC as a non-invasive treatment, but electrophysiological research on the effect of HD-tDCS on patients with DOC is limited.ObjectivesTo explore how HD-tDCS affects the cerebral cortex and examine the possible electrophysiological mechanisms underlying the effects of HD-tDCS on the cerebral cortex.MethodsA total of 19 DOC patients were assigned to HD-tDCS stimulation. Each of them underwent 10 anodal HD-tDCS sessions of the left dorsolateral prefrontal cortex (DLPFC) over 5 consecutive days. Coma Recovery Scale-Revision (CRS-R) scores were recorded to evaluate the consciousness level before and after HD-tDCS, while resting-state electroencephalography (EEG) recordings were obtained immediately before and after single and multiple HD-tDCS stimuli. Depending on whether the CRS-R score increased after stimulation, we classified the subjects into responsive (RE) and non-responsive (N-RE) groups and compared the differences in power spectral density (PSD) between the groups in different frequency bands and brain regions, and also examined the relationship between PSD values and CRS-R scores.ResultsFor the RE group, the PSD value of the parieto-occipital region increased significantly in the 6–8 Hz frequency band after multiple stimulations by HD-tDCS. After a single stimulation, an increase in PSD was observed at 10–13 and 13–30 Hz. In addition, for all subjects, a positive correlation was observed between the change in PSD value in the parieto-occipital region at 10–13 and 6–8 Hz frequency band and the change in CRS-R score after a single stimulation.ConclusionRepeated anodal HD-tDCS of the left DLPFC can improve clinical outcomes in patients with DOC, and HD-tDCS-related increased levels of consciousness were associated with increased parieto-occipital PSD.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

High-Definition Transcranial Direct Current Stimulation of the Dorsolateral Prefrontal Cortex Modulates the Electroencephalography Rhythmic Activity of Parietal Occipital Lobe in Patients With Chronic Disorders of Consciousness

Han

Chen

Zheng

et al. 2022

Front. Hum. Neurosci.

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“…A study of prefrontal tDCS on patients with DOCs indicated that responders showed increases in power and long-range corticocortical functional connectivity in the theta–alpha band, compared with non-responders [ 51 ]. Improvements in consciousness may be related to changes in brain networks [ 52 , 53 ]. tDCS on the prefrontal region could modulate large-scale patterns of resting-state connectivity in the human brain by inducing functional changes based on a resting-state fMRI analysis.…”

Section: Discussionmentioning

confidence: 99%

Functional Connectivity Increases in Response to High-Definition Transcranial Direct Current Stimulation in Patients with Chronic Disorder of Consciousness

et al. 2022

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High-definition transcranial direct current stimulation (HD-tDCS) has been shown to play an important role in improving consciousness in patients with disorders of consciousness (DOCs), but its neuroelectrophysiological evidence is still lacking. To better explain the electrophysiological mechanisms of the effects of HD-tDCS on patients with DOCs, 22 DOC patients underwent 10 anodal HD-tDCS sessions of the left dorsolateral prefrontal cortex (DLPFC). This study used the Coma Recovery Scale-Revised (CRS-R) to assess the level of consciousness in DOC patients. According to whether the CRS-R score increased before and after stimulation, DOC patients were divided into a responsive group and a non-responsive group. By comparing the differences in resting-state EEG functional connectivity between different frequency bands and brain regions, as well as the relationship between functional connectivity values and clinical scores, the electrophysiological mechanism of the clinical effects of HD-tDCS was further explored. The change of the phase locking value (PLV) on the theta frequency band in the left frontal–parietooccipital region was positively correlated with the change in the CRS-R scores. As the number of interventions increased, we observed that in the responsive group, the change in PLV showed an upward trend, and the increase in the PLV appeared in the left frontal–parietooccipital region at 4–8 Hz and in the intra-bifrontal region at 8–13 Hz. In the non-responsive group, although the CRS-R scores did not change after stimulation, the PLV showed a downward trend, and the decrease in the PLV appeared in the intra-bifrontal region at 8–13 Hz. In addition, at the three-month follow-up, patients with increased PLV in the intra-bifrontal region at 8–13 Hz after repeated HD-tDCS stimulation had better outcomes than those without. Repeated anodal stimulation of the left DLPFC with HD-tDCS resulted in improved consciousness in some patients with DOCs. The increase in functional connectivity in the brain regions may be associated with the improvement of related awareness after HD-tDCS and may be a predictor of better long-term outcomes.

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“…This trial was designed as a prospective, blinded cohort study and was based on our previous study, which found parameters that were closely related to consciousness (16). The participants were divided into the awakening group or the unawakening group based on whether they recovered consciousness; the patients were assessed by two experienced neurologists who were blinded to the EEG assessments.…”

Section: Methodsmentioning

confidence: 99%

Comatose Patients After Cardiopulmonary Resuscitation: An Analysis Based on Quantitative Methods of EEG Reactivity

Huang

Niu

et al. 2022

Front. Neurol.

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ObjectiveEvery year, approximately 50–110/1,00,000 people worldwide suffer from cardiac arrest, followed by hypoxic-ischemic encephalopathy after cardiopulmonary resuscitation (CPR), and approximately 40–66% of patients do not recover. The purpose of this study was to identify the brain network parameters and key brain regions associated with awakening by comparing the reactivity characteristics of the brain networks between the awakening and unawakening groups of CPR patients after coma, thereby providing a basis for further awakening interventions.MethodThis study involved a prospective cohort study. Using a 64-electrode electroencephalography (EEG) wireless 64A system, EEG signals were recorded from 16 comatose patients after CPR in the acute phase (<1 month) from 2019 to 2020. MATLAB (2017b) was used to quantitatively analyze the reactivity (power spectrum and entropy) and brain network characteristics (coherence and phase lag index) after pain stimulation. The patients were divided into an awakening group and an unawakening group based on their ability to execute commands or engage in repeated and continuous purposeful behavior after 3 months. The above parameters were compared to determine whether there were differences between the two groups.Results(1) Power spectrum: the awakening group had higher gamma, beta and alpha spectral power after pain stimulation in the frontal and parietal lobes, and lower delta and theta spectral power in the bilateral temporal and occipital lobes than the unawakening group. (2) Entropy: after pain stimulation, the awakening group had higher entropy in the frontal and parietal lobes and lower entropy in the temporal occipital lobes than the unawakening group. (3) Connectivity: after pain stimulation, the awakening group had stronger gamma and beta connectivity in nearly the whole brain, but weaker theta and delta connectivity in some brain regions (e.g., the frontal-occipital lobe and parietal-occipital lobe) than the unawakening group.ConclusionAfter CPR, comatose patients were more likely to awaken if there was a higher stimulation of fast-frequency band spectral power, higher entropy, stronger whole-brain connectivity and better retention of frontal-parietal lobe function after pain stimulation.

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Early Consciousness Disorder in Acute Large Hemispheric Infarction: An Analysis Based on Quantitative EEG and Brain Network Characteristics

Cited by 16 publications

References 49 publications

High-Definition Transcranial Direct Current Stimulation of the Dorsolateral Prefrontal Cortex Modulates the Electroencephalography Rhythmic Activity of Parietal Occipital Lobe in Patients With Chronic Disorders of Consciousness

High-Definition Transcranial Direct Current Stimulation of the Dorsolateral Prefrontal Cortex Modulates the Electroencephalography Rhythmic Activity of Parietal Occipital Lobe in Patients With Chronic Disorders of Consciousness

Functional Connectivity Increases in Response to High-Definition Transcranial Direct Current Stimulation in Patients with Chronic Disorder of Consciousness

Comatose Patients After Cardiopulmonary Resuscitation: An Analysis Based on Quantitative Methods of EEG Reactivity

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