[en] The functional consequences of focal brain injury are thought to be contingent on neuronal alterations extending beyond the area of structural damage. This phenomenon, also known as diaschisis, has clinical and metabolic correlates but lacks a clear electrophysiological counterpart, except for the long-standing evidence of a relative EEG slowing over the injured hemisphere. Here, we aim at testing whether this EEG slowing is linked to the pathological intrusion of sleep-like cortical dynamics within an awake brain. We used a combination of transcranial magnetic stimulation and electroencephalography (TMS/EEG) to study cortical reactivity in a cohort of 30 conscious awake patients with chronic focal and multifocal brain injuries of ischaemic, haemorrhagic and traumatic aetiology. We found that different patterns of cortical reactivity typically associated with different brain states (coma, sleep, wakefulness) can coexist within the same brain. Specifically, we detected the occurrence of prominent sleep-like TMS-evoked slow waves and off-periods-reflecting transient suppressions of neuronal activity-in the area surrounding focal cortical injuries. These perilesional sleep-like responses were associated with a local disruption of signal complexity whereas complex responses typical of the awake brain were present when stimulating the contralesional hemisphere. These results shed light on the electrophysiological properties of the tissue surrounding focal brain injuries in humans. Perilesional sleep-like off-periods can disrupt network activity but are potentially reversible, thus representing a principled read-out for the neurophysiological assessment of stroke patients, as well as an interesting target for rehabilitation.
Disciplines :
Neurology Neurology
Author, co-author :
Sarasso, Simone
D'Ambrosio, Sasha
Fecchio, Matteo
Casarotto, Silvia
Viganò, Alessandro
Landi, Cristina
Mattavelli, Giulia
Gosseries, Olivia ; Université de Liège - ULiège > GIGA Consciousness - Coma Science Group
Quarenghi, Matteo
Laureys, Steven ; Université de Liège - ULiège > GIGA Consciousness - Coma Science Group
Local sleep-like cortical reactivity in the awake brain after focal injury.
Publication date :
2020
Journal title :
Brain: a Journal of Neurology
ISSN :
0006-8950
eISSN :
1460-2156
Publisher :
Oxford University Press, Oxford, United Kingdom
Volume :
143
Issue :
12
Pages :
3672-3684
Peer reviewed :
Peer Reviewed verified by ORBi
European Projects :
H2020 - 785907 - HBP SGA2 - Human Brain Project Specific Grant Agreement 2 H2020 - 686764 - LUMINOUS - Studying, Measuring and Altering Consciousness through information theory in the electrical brain
Funders :
FERB - Fondazione Europea Ricerca Biomedica [IT] EU - European Union [BE] SNSF - Swiss National Science Foundation [CH] JSMF - James S McDonnell Foundation [US-MO] [US-MO] Tiny Blue Dot Foundation [US-CA] [US-CA] F.R.S.-FNRS - Fonds de la Recherche Scientifique [BE] Bial Foundation [PT] AstraZeneca [BE] FRB - Fondation Roi Baudouin [BE] CE - Commission Européenne [BE]
Funding number :
Fondazione Regionale per la Ricerca Biomedica (Regione Lombardia), Project ERAPERMED2019-101, GA 779282
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