Dynamic Changes of Brain Activity in Different Responsive Groups of Patients with Prolonged Disorders of Consciousness

Chen Chen; Jinying Han; Shuang Zheng; Xintong Zhang; Haibo Sun; Ting Zhou; Shunyin Hu; Xiaoxiang Yan; Changqing Wang; Kai Wang; Yajuan Hu

doi:10.3390/brainsci13010005

Dynamic Changes of Brain Activity in Different Responsive Groups of Patients with Prolonged Disorders of Consciousness

Brain Sci. 2022 Dec 20;13(1):5. doi: 10.3390/brainsci13010005.

Authors

Chen Chen^{1

2

3

4}, Jinying Han^{1

2

3

4}, Shuang Zheng^{1

2

3

4}, Xintong Zhang^{1

2

3

4}, Haibo Sun⁵, Ting Zhou⁶, Shunyin Hu⁷, Xiaoxiang Yan¹, Changqing Wang¹, Kai Wang^{1

2

3

4

8}, Yajuan Hu^{1

2

3

4}

Affiliations

¹ Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, China.
² Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230032, China.
³ Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China.
⁴ The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China.
⁵ The First Clinical College of Anhui Medical University, Hefei 230032, China.
⁶ Department of Neurology, The Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230001, China.
⁷ Department of Neurorehabilitation, Hefei Anhua Trauma Rehabilitation Hospital, Hefei 230011, China.
⁸ Hefei Comprehensive National Science Center, Institute of Artificial Intelligence, Hefei 230032, China.

Abstract

As medical technology continues to improve, many patients diagnosed with brain injury survive after treatments but are still in a coma. Further, multiple clinical studies have demonstrated recovery of consciousness after transcranial direct current stimulation. To identify possible neurophysiological mechanisms underlying disorders of consciousness (DOCs) improvement, we examined the changes in multiple resting-state EEG microstate parameters after high-definition transcranial direct current stimulation (HD-tDCS). Because the left dorsolateral prefrontal cortex is closely related to consciousness, it is often chosen as a stimulation target for tDCS treatment of DOCs. A total of 21 patients diagnosed with prolonged DOCs were included in this study, and EEG microstate analysis of resting state EEG datasets was performed on all patients before and after interventions. Each of them underwent 10 anodal tDCS sessions of the left dorsolateral prefrontal cortex over 5 consecutive working days. According to whether the clinical manifestations improved, DOCs patients were divided into the responsive (RE) group and the non-responsive (N-RE) group. The dynamic changes of resting state EEG microstate parameters were also analyzed. After multiple HD-tDCS interventions, the duration and coverage of class C microstates in the RE group were significantly increased. This study also found that the transition between microstates A and C increased, while the transition between microstates B and D decreased in the responsive group. However, these changes in EEG microstate parameters in the N-RE group have not been reported. Our findings suggest that EEG neural signatures have the potential to assess consciousness states and that improvement in the dynamics of brain activity was associated with the recovery of DOCs. This study extends our understanding of the neural mechanism of DOCs patients in consciousness recovery.

Keywords: Coma Recovery Scale-Revised (CRS-R); disorders of consciousness (DOCs); electroencephalogram microstate; high-definition transcranial direct current stimulation (HD-tDCS).

Abstract

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