Electrophysiological characteristics of CM-pf in diagnosis and outcome of patients with disorders of consciousness

Jianghong He; Haoran Zhang; Yuanyuan Dang; Yutong Zhuang; Qianqian Ge; Yi Yang; Long Xu; Xiaoyu Xia; Steven Laureys; Shan Yu; Wangming Zhang

Brain Stimulation (Sep 2023)

Electrophysiological characteristics of CM-pf in diagnosis and outcome of patients with disorders of consciousness

Jianghong He,
Haoran Zhang,
Yuanyuan Dang,
Yutong Zhuang,
Qianqian Ge,
Yi Yang,
Long Xu,
Xiaoyu Xia,
Steven Laureys,
Shan Yu,
Wangming Zhang

Affiliations

Jianghong He: Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
Haoran Zhang: Laboratory of Brain Atlas and Brain-inspired Intelligence, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China; School of Future Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
Yuanyuan Dang: Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
Yutong Zhuang: Department of Neurosurgery, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
Qianqian Ge: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
Yi Yang: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
Long Xu: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
Xiaoyu Xia: Department of Neurosurgery, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China
Steven Laureys: CERVO Brain Research Centre, Laval University, Canada; Coma Science Group, GIGA Consciousness Research Unit, Liège University Hospital, Belgium; International Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang, China
Shan Yu: Laboratory of Brain Atlas and Brain-inspired Intelligence, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China; School of Future Technology, University of Chinese Academy of Sciences, Beijing, 100049, China; Corresponding author. Laboratory of Brain Atlas and Brain-inspired Intelligence, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China.
Wangming Zhang: Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, China; Corresponding author. Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China.

Journal volume & issue: Vol. 16, no. 5
pp. 1522 – 1532

Abstract

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Background: Deep brain stimulation (DBS) in the centromedian-parafascicular complex (CM-pf) has been reported as a potential therapeutic option for disorders of consciousness (DoC). However, the lack of understanding of its electrophysiological characteristics limits the improvement of therapeutic effect. Objective: To investigate the CM-pf electrophysiological characteristics underlying disorders of consciousness (DoC) and its recovery. Methods: We collected the CM-pf electrophysiological signals from 23 DoC patients who underwent central thalamus DBS (CT-DBS) surgery. Five typical electrophysiological features were extracted, including neuronal firing properties, multiunit activity (MUA) properties, signal stability, spike-MUA synchronization strength (syncMUA), and the background noise level. Their correlations with the consciousness level, the outcome, and the primary clinical factors of DoC were analyzed. Results: 11 out of 23 patients (0/2 chronic coma, 5/13 unresponsive wakefulness syndrome/vegetative state (UWS/VS), 6/8 minimally conscious state minus (MCS-)) exhibited an improvement in the level of consciousness after CT-DBS. In CM-pf, significantly stronger gamma band syncMUA strength and alpha band normalized MUA power were found in MCS- patients. In addition, higher firing rates, stronger high-gamma band MUA power and alpha band normalized power, and more stable theta oscillation were correlated with better outcomes. Besides, we also identified electrophysiological properties that are correlated with clinical factors, including etiologies, age, and duration of DoC. Conclusion: We provide comprehensive analyses of the electrophysiological characteristics of CM-pf in DoC patients. Our results support the ‘mesocircuit’ hypothesis, one proposed mechanism of DoC recovery, and reveal CM-pf electrophysiological features that are crucial for understanding the pathogenesis of DoC, predicting its recovery, and explaining the effect of clinical factors on DoC.

Published in Brain Stimulation

ISSN: 1935-861X (Print); 1876-4754 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Neurosciences. Biological psychiatry. Neuropsychiatry
Website: https://www.journals.elsevier.com/brain-stimulation

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