Electrophysiological correlates of thalamocortical function in acute severe traumatic brain injury. 2022

William H Curley, and Yelena G Bodien, and David W Zhou, and Mary M Conte, and Andrea S Foulkes, and Joseph T Giacino, and Jonathan D Victor, and Nicholas D Schiff, and Brian L Edlow
Harvard Medical School, Boston, MA, USA; Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.

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.

UI MeSH Term Description Entries
D008137 Longitudinal Studies Studies in which variables relating to an individual or group of individuals are assessed over a period of time. Bogalusa Heart Study,California Teachers Study,Framingham Heart Study,Jackson Heart Study,Longitudinal Survey,Tuskegee Syphilis Study,Bogalusa Heart Studies,California Teachers Studies,Framingham Heart Studies,Heart Studies, Bogalusa,Heart Studies, Framingham,Heart Studies, Jackson,Heart Study, Bogalusa,Heart Study, Framingham,Heart Study, Jackson,Jackson Heart Studies,Longitudinal Study,Longitudinal Surveys,Studies, Bogalusa Heart,Studies, California Teachers,Studies, Jackson Heart,Studies, Longitudinal,Study, Bogalusa Heart,Study, California Teachers,Study, Longitudinal,Survey, Longitudinal,Surveys, Longitudinal,Syphilis Studies, Tuskegee,Syphilis Study, Tuskegee,Teachers Studies, California,Teachers Study, California,Tuskegee Syphilis Studies
D001930 Brain Injuries Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits. Brain Lacerations,Acute Brain Injuries,Brain Injuries, Acute,Brain Injuries, Focal,Focal Brain Injuries,Injuries, Acute Brain,Injuries, Brain,Acute Brain Injury,Brain Injury,Brain Injury, Acute,Brain Injury, Focal,Brain Laceration,Focal Brain Injury,Injuries, Focal Brain,Injury, Acute Brain,Injury, Brain,Injury, Focal Brain,Laceration, Brain,Lacerations, Brain
D003128 Coma A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem RETICULAR FORMATION. Comatose,Pseudocoma,Comas,Pseudocomas
D004569 Electroencephalography Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. EEG,Electroencephalogram,Electroencephalograms
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000070642 Brain Injuries, Traumatic A form of acquired brain injury which occurs when a sudden trauma causes damage to the brain. Trauma, Brain,Traumatic Brain Injury,Encephalopathy, Traumatic,Injury, Brain, Traumatic,TBI (Traumatic Brain Injury),TBIs (Traumatic Brain Injuries),Traumatic Encephalopathy,Brain Injury, Traumatic,Brain Trauma,Brain Traumas,Encephalopathies, Traumatic,TBI (Traumatic Brain Injuries),Traumas, Brain,Traumatic Brain Injuries,Traumatic Encephalopathies

Related Publications

William H Curley, and Yelena G Bodien, and David W Zhou, and Mary M Conte, and Andrea S Foulkes, and Joseph T Giacino, and Jonathan D Victor, and Nicholas D Schiff, and Brian L Edlow
January 2006, Functional neurology,
William H Curley, and Yelena G Bodien, and David W Zhou, and Mary M Conte, and Andrea S Foulkes, and Joseph T Giacino, and Jonathan D Victor, and Nicholas D Schiff, and Brian L Edlow
March 2017, Journal of neurotrauma,
William H Curley, and Yelena G Bodien, and David W Zhou, and Mary M Conte, and Andrea S Foulkes, and Joseph T Giacino, and Jonathan D Victor, and Nicholas D Schiff, and Brian L Edlow
January 2000, Vision research,
William H Curley, and Yelena G Bodien, and David W Zhou, and Mary M Conte, and Andrea S Foulkes, and Joseph T Giacino, and Jonathan D Victor, and Nicholas D Schiff, and Brian L Edlow
March 2010, Journal of the International Neuropsychological Society : JINS,
William H Curley, and Yelena G Bodien, and David W Zhou, and Mary M Conte, and Andrea S Foulkes, and Joseph T Giacino, and Jonathan D Victor, and Nicholas D Schiff, and Brian L Edlow
January 2004, Critical care medicine,
William H Curley, and Yelena G Bodien, and David W Zhou, and Mary M Conte, and Andrea S Foulkes, and Joseph T Giacino, and Jonathan D Victor, and Nicholas D Schiff, and Brian L Edlow
January 2016, Clinical neurology and neurosurgery,
William H Curley, and Yelena G Bodien, and David W Zhou, and Mary M Conte, and Andrea S Foulkes, and Joseph T Giacino, and Jonathan D Victor, and Nicholas D Schiff, and Brian L Edlow
February 2015, Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology,
William H Curley, and Yelena G Bodien, and David W Zhou, and Mary M Conte, and Andrea S Foulkes, and Joseph T Giacino, and Jonathan D Victor, and Nicholas D Schiff, and Brian L Edlow
May 2017, Physical medicine and rehabilitation clinics of North America,
William H Curley, and Yelena G Bodien, and David W Zhou, and Mary M Conte, and Andrea S Foulkes, and Joseph T Giacino, and Jonathan D Victor, and Nicholas D Schiff, and Brian L Edlow
February 2017, Cognitive, affective & behavioral neuroscience,
William H Curley, and Yelena G Bodien, and David W Zhou, and Mary M Conte, and Andrea S Foulkes, and Joseph T Giacino, and Jonathan D Victor, and Nicholas D Schiff, and Brian L Edlow
August 2012, Journal of neurosurgery,
Copied contents to your clipboard!