[en] [en] 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.
Disciplines :
Neurosciences & behavior
Author, co-author :
He, Jianghong ; 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
Zhang, Haoran ; 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
Dang, Yuanyuan; Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
Zhuang, Yutong; Department of Neurosurgery, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
Ge, Qianqian ; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
Yang, Yi; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
Xu, Long; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
Xia, Xiaoyu; Department of Neurosurgery, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China
Laureys, Steven ; Université de Liège - ULiège > Département des sciences cliniques
Yu, Shan; 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. Electronic address: shan.yu@nlpr.ia.ac.cn
Zhang, Wangming ; 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. Electronic address: wzhang@vip.126.com
Language :
English
Title :
Electrophysiological characteristics of CM-pf in diagnosis and outcome of patients with disorders of consciousness.
Publication date :
2023
Journal title :
Brain Stimulation
ISSN :
1935-861X
eISSN :
1876-4754
Publisher :
Elsevier, United States
Volume :
16
Issue :
5
Pages :
1522 - 1532
Peer reviewed :
Peer Reviewed verified by ORBi
Funding text :
This research was supported by grants from the National Natural Science Foundation of China ( 81771128 ), the Key R&D Program of Guangdong Province, China ( 2018B030339001 ), and the International Partnership Program of the Chinese Academy of Sciences ( 173211KYSB20200021 ). Steven Laureys is Research Director at the Belgian National Fund for Scientific Research (FRS-FNRS) and supported by the European Foundation of Biomedical Research FERB Onlus, fund Generet of King Baudouin Foundation, Mind Care International Foundation.
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