Article (Scientific journals)
Sleep-like cortical OFF-periods disrupt causality and complexity in the brain of unresponsive wakefulness syndrome patients
Rosanova, Mario; Fecchio, M.; Casarotto, Silvia et al.
2018In Nature Communications, 9 (1)
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Abstract :
[en] Unresponsive wakefulness syndrome (UWS) patients may retain intact portions of the thalamocortical system that are spontaneously active and reactive to sensory stimuli but fail to engage in complex causal interactions, resulting in loss of consciousness. Here, we show that loss of brain complexity after severe injuries is due to a pathological tendency of cortical circuits to fall into silence (OFF-period) upon receiving an input, a behavior typically observed during sleep. Spectral and phase domain analysis of EEG responses to transcranial magnetic stimulation reveals the occurrence of OFF-periods in the cortex of UWS patients (N = 16); these events never occur in healthy awake individuals (N = 20) but are similar to those detected in healthy sleeping subjects (N = 8). Crucially, OFF-periods impair local causal interactions, and prevent the build-up of global complexity in UWS. Our findings link potentially reversible local events to global brain dynamics that are relevant for pathological loss and recovery of consciousness. © 2018, The Author(s).
Disciplines :
Neurology
Author, co-author :
Rosanova, Mario ;  Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, 20157, Italy, Fondazione Europea per la Ricerca Biomedica Onlus, Milan, 20063, Italy, Neurointensive Care Unit, ASTT Grande Ospedale Metropolitano Niguarda, Milan, 20162, Italy
Fecchio, M. ;  Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, 20157, Italy
Casarotto, Silvia;  Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, 20157, Italy, IRCCS Fondazione Don Gnocchi, Milan, 20149, Italy
Sarasso, Simone;  Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, 20157, Italy
Casali, A. G.;  Instituto de Ciência e Tecnologia, Universidade Federal de São Paulo, Sao Jose dos Campos, 12231-280, Brazil
Pigorini, A.;  Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, 20157, Italy
Comanducci, A.;  Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, 20157, Italy
Seregni, F.;  Department of Paediatrics, Cambridge University Hospital NHS Foundation Trust, Cambridge, CB2 0QQ, United Kingdom
Devalle, G.;  IRCCS Fondazione Don Gnocchi, Milan, 20149, Italy
Citerio, Giuseppe;  Scuola di Medicina e Chirurgia, University of Milan Bicocca, Milan, 20126, Italy
BODART, Olivier  ;  Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de neurologie
Boly, Mélanie;  Department of Neurology, University of Wisconsin, Madison, WI 53705, United States, Department of Psychiatry, University of Wisconsin, Madison, WI 53719, United States
Gosseries, Olivia  ;  Université de Liège - ULiège > GIGA : Coma Group
Laureys, Steven  ;  Université de Liège - ULiège > GIGA : Coma Group
Massimini, Marcello;  Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, Milan, 20157, Italy, IRCCS Fondazione Don Gnocchi, Milan, 20149, Italy
More authors (5 more) Less
 These authors have contributed equally to this work.
Language :
English
Title :
Sleep-like cortical OFF-periods disrupt causality and complexity in the brain of unresponsive wakefulness syndrome patients
Publication date :
2018
Journal title :
Nature Communications
eISSN :
2041-1723
Publisher :
Nature Publishing Group
Volume :
9
Issue :
1
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 15 January 2019

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