Quantitative EEG and Brain Network Analyses in Patients with Early Consciousness Disorder Following Acute Large Hemisphe
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Quantitative EEG and Brain Network Analyses in Patients with Early Consciousness Disorder Following Acute Large Hemispheric Infarction Yousef Hannawi* © 2020 Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society
Consciousness is one of the greatest human mysteries, and it has been the focus of the work of many neuroscientists, mathematicians, philosophers, and neurologists. The leading existing theories for explaining consciousness range from global workspace theory where the brain parts joint participation and coordination result in consciousness, integrated information theory which attributes consciousness to the capacity a system of integrated information and quantum theory that assumes consciousness is constituted by discrete events corresponding with varying oscillation frequencies of distinct brain regions [1]. Nevertheless, consciousness experiences in healthy individuals have been consistently found to correlate with synchronized changes in brain activity that are organized in distinct cerebral networks [2, 3]. In addition, various neurological pathologies ranging from stroke to neurodegenerative diseases result in impairment of these brain connectivity signatures and cerebral networks [4]. In particular, patients with disorders of consciousness (DOC) or consciousness impairment have been found to have a decreased level of resting-brain activity in certain brain regions and reduced degree of functional connectivity within hubs of default mode network such as the posterior cingulate cortex and precuneus [5]. Furthermore, early changes in these resting-state brain networks
*Correspondence: [email protected] Division of Cerebrovascular Diseases and Neurocritical Care, Department of Neurology, The Ohio State University, 333 West 10th Ave, Graves Hall 3172C, Columbus, OH 43210, USA
This article is related to the original work: https://doi.org/10.1007/s1202 8-020-01051-w.
in patients with anoxic brain injury predicted the long term functional outcome [6]. These studies suggest the potential roles of utilizing resting-brain networks as markers of the level of consciousness and as predictors of future recovery of consciousness in patients hospitalized in the intensive care unit (ICU). These studies, however, involved patients with diffuse brain injury such as in the cases of anoxic or traumatic brain injuries. Patients with focal brain injury due to stroke also often develop early consciousness disorder (ECD) even within 24 h of stroke in approximately 35% of the cases [7]. While the mechanisms of ECD in these patients are not clear, a study of resting-state functional MRI (fMRI) in stroke patients with ECD has shown decreased resting-brain activity and decrease in the strength of the default mode network connectivity in the precuneus and posterior cingulate cortex compared to normal subjects [8]. This suggests the potential role of brain activity and connectivity in understanding the differences in consciousness level among patients with str
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