Sleep-like cortical OFF-periods disrupt causality and complexity in the brain of unresponsive wakefulness syndrome patients

Autor(es):Mostrar menos -

Rosanova, M. ^{[1, 2, 3]} ; Fecchio, M. ^[1] ; Casarotto, S. ^{[1, 4]} ; Sarasso, S. ^[1] ; Casali, A. G. ^[5] ; Pigorini, A. ^[1] ; Comanducci, A. ^[1] ; Seregni, F. ^[6] ; Devalle, G. ^[4] ; Citerio, G. ^[7] ; Bodart, O. ^{[8, 9]} ; Boly, M. ^{[10, 11]} ; Gosseries, O. ^{[8, 9]} ; Laureys, S. ^{[8, 9]} ; Massimini, M. ^{[1, 4]}

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^[1] Univ Milan, Dept Biomed & Clin Sci L Sacco, I-20157 Milan - Italy

^[2] Fdn Europea Ric Biomed Onlus, I-20063 Milan - Italy

^[3] ASTT Grande Osped Metropolitano Niguarda, Neurointens Care Unit, I-20162 Milan - Italy

^[4] IRCCS Fdn Don Gnocchi, I-20149 Milan - Italy

^[5] Univ Fed Sao Paulo, Inst Ciencia & Tecnol, BR-12231280 Sao Jose Dos Campos - Brazil

^[6] Cambridge Univ Hosp NHS Fdn Trust, Dept Paediat, Cambridge CB2 0QQ - England

^[7] Univ Milano Bicocca, Scuola Med & Chirurgia, I-20126 Milan - Italy

^[8] Univ Liege, Coma Sci Grp, GIGA Consciousness, B-4000 Liege - Belgium

^[9] Univ Hosp Liege, B-4000 Liege - Belgium

^[10] Univ Wisconsin, Dept Neurol, Madison, WI 53705 - USA

^[11] Univ Wisconsin, Dept Psychiat, Madison, WI 53719 - USA

• Tipo de documento: Artigo Científico
• Fonte: NATURE COMMUNICATIONS; v. 9, OCT 24 2018.
• Citações Web of Science: 9

Resumo

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. (AU)

• Processo FAPESP: 16/08263-9 - Padronização, validação e caracterização de uma nova medida de complexidade cerebral
• Beneficiário: Adenauer Girardi Casali
• Modalidade de apoio: Auxílio à Pesquisa - Jovens Pesquisadores