Stony Brook University.
J Cogn Neurosci. 2024 Jul 1;36(8):1643-1652. doi: 10.1162/jocn_a_02154.
Severe traumatic brain injuries typically result in loss of consciousness or coma. In deeply comatose patients with traumatic brain injury, cortical dynamics become simple, repetitive, and predictable. We review evidence that this low-complexity, high-predictability state results from a passive cortical state, represented by a stable repetitive attractor, that hinders the flexible formation of neuronal ensembles necessary for conscious experience. Our data and those from other groups support the hypothesis that this cortical passive state is because of the loss of thalamocortical input. We identify the unpredictability and complexity of cortical dynamics captured by local field potential as a sign of recovery from this passive coma attractor. In this Perspective article, we discuss how these electrophysiological biomarkers of the recovery of consciousness could inform the design of closed-loop stimulation paradigms to treat disorders of consciousness.
严重创伤性脑损伤通常导致意识丧失或昏迷。在创伤性脑损伤的深度昏迷患者中，皮质动力学变得简单、重复且可预测。我们回顾了证据，表明这种低复杂度、高可预测性状态是由于皮质被动状态引起的，这种状态表现为稳定的重复吸引子，阻碍了形成意识体验所需的神经元集合的灵活性。我们的数据和其他小组的数据支持这样的假设，即这种皮质被动状态是由于丘脑皮质输入的丧失。我们将局部场电位捕获的皮质动力学的不可预测性和复杂性确定为从这种被动昏迷吸引子中恢复的标志。在这篇观点文章中，我们讨论了这些意识恢复的电生理生物标志物如何为治疗意识障碍的闭环刺激范式的设计提供信息。
