Breakdown of oscillatory effective networks in disorders of consciousness

IF 4.8 1区医学 Q1 NEUROSCIENCES

CNS Neuroscience & Therapeutics Pub Date : 2023-09-17 DOI:10.1111/cns.14469

Yang Bai, Anjuan Gong, Qijun Wang, Yongkun Guo, Yin Zhang, Zhen Feng

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Abstract

Introduction

Combining transcranial magnetic stimulation with electroencephalography (TMS-EEG), oscillatory reactivity can be measured, allowing us to investigate the interaction between local and distant cortical oscillations. However, the extent to which human consciousness is related to these oscillatory effective networks has yet to be explored.

Aims

We tend to investigate the link between oscillatory effective networks and brain consciousness, by monitoring the global transmission of TMS-induced oscillations in disorders of consciousness (DOC).

Results

A cohort of DOC patients was included in this study, which included 28 patients with a minimally conscious state (MCS) and 20 patients with vegetative state/unresponsive wakefulness syndrome (VS/UWS). Additionally, 25 healthy controls were enrolled. The oscillatory reactivity to single-pulse TMS of the frontal, sensorimotor and parietal cortex was measured using event-related spectral perturbation of TMS-EEG. The temporal–spatial properties of the oscillatory reactivity were illustrated through life time, decay gradients and accumulative power. In DOC patients, an oscillatory reactivity was observed to be temporally and spatially suppressed. TMS-EEG of DOC patients showed that the oscillations did not travel as far in healthy controls, in terms of both temporal and spatial dimensions. Moreover, cortical theta reactivity was found to be a reliable indicator in distinguishing DOC versus healthy controls when TMS of the parietal region and in distinguishing MCS versus VS/UWS when TMS of the frontal region. Additionally, a positive correlation was observed between the Coma Recovery Scale-Revised scores of the DOC patients and the cortical theta reactivity.

Conclusions

The findings revealed a breakdown of oscillatory effective networks in DOC patients, which has implications for the use of TMS-EEG in DOC evaluation and offers a neural oscillation viewpoint on the neurological basis of human consciousness.

Abstract Image

查看原文本刊更多论文

意识障碍中振荡有效网络的崩溃。

简介结合经颅磁刺激和脑电图（TMS-EEG），可以测量振荡反应性，使我们能够研究局部和远处皮层振荡之间的相互作用。目的：我们倾向于通过监测意识障碍（DOC）中 TMS 诱导的振荡的全球传输，研究振荡有效网络与大脑意识之间的联系：本研究纳入了一组意识障碍（DOC）患者，其中包括28名微意识状态（MCS）患者和20名植物状态/无反应清醒综合征（VS/UWS）患者。此外，还纳入了 25 名健康对照者。使用 TMS-EEG 的事件相关频谱扰动测量了额叶、感觉运动和顶叶皮层对单脉冲 TMS 的振荡反应性。通过生命时间、衰减梯度和累积功率说明了振荡反应性的时空特性。在 DOC 患者中，观察到振荡反应性在时间和空间上受到抑制。DOC 患者的 TMS-EEG 显示，在时间和空间维度上，振荡的传播距离都不及健康对照组。此外，在对顶叶区进行 TMS 治疗时，发现皮质 Theta 反应性是区分 DOC 和健康对照组的可靠指标；在对额叶区进行 TMS 治疗时，发现皮质 Theta 反应性是区分 MCS 和 VS/UWS 的可靠指标。此外，还观察到 DOC 患者的昏迷恢复量表（Coma Recovery Scale-Revised ）评分与皮层 Theta 反应性之间存在正相关：研究结果揭示了 DOC 患者振荡有效网络的崩溃，这对在 DOC 评估中使用 TMS-EEG 有一定影响，并为人类意识的神经学基础提供了一种神经振荡观点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CNS Neuroscience & Therapeutics 医学-神经科学

CiteScore

7.30

自引率

12.70%

发文量

240

审稿时长

2 months

期刊介绍： CNS Neuroscience & Therapeutics provides a medium for rapid publication of original clinical, experimental, and translational research papers, timely reviews and reports of novel findings of therapeutic relevance to the central nervous system, as well as papers related to clinical pharmacology, drug development and novel methodologies for drug evaluation. The journal focuses on neurological and psychiatric diseases such as stroke, Parkinson’s disease, Alzheimer’s disease, depression, schizophrenia, epilepsy, and drug abuse.