Vaz Alex, Wathen Connor, Miranda Stephen, Thomas Rachel, Darlington Timothy, Jabarkheel Rashad, Tomlinson Samuel, Arena John, Bond Kamila, Salwi Sanjana, Ajmera Sonia, Bachschmid-Romano Ludovica, Gugger James, Sandsmark Danielle, Diaz-Arrastia Ramon, Schuster James, Ramayya Ashwin G, Cajigas Iahn, Pesaran Bijan, Chen H Isaac, Petrov Dmitriy
Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, 19104, USA.
Surgical Neurology Branch, NINDS, National Institutes of Health, Bethesda, MD 20892, USA.
bioRxiv. 2024 Jul 23:2024.07.19.604293. doi: 10.1101/2024.07.19.604293.
Traumatic brain injury (TBI) remains a pervasive clinical problem associated with significant morbidity and mortality. However, TBI remains clinically and biophysically ill-defined, and prognosis remains difficult even with the standardization of clinical guidelines and advent of multimodality monitoring. Here we leverage a unique data set from TBI patients implanted with either intracranial strip electrodes during craniotomy or quad-lumen intracranial bolts with depth electrodes as part of routine clinical practice. By extracting spectral profiles of this data, we found that the presence of narrow-band oscillatory activity in the beta band (12-30 Hz) closely corresponds with the neurological exam as quantified with the standard Glasgow Coma Scale (GCS). Further, beta oscillations were distributed over the cortical surface as traveling waves, and the evolution of these waves corresponded to recovery from coma, consistent with the putative role of waves in perception and cognitive activity. We consequently propose that beta oscillations and traveling waves are potential biomarkers of recovery from TBI. In a broader sense, our findings suggest that emergence from coma results from recovery of thalamo-cortical interactions that coordinate cortical beta rhythms.
创伤性脑损伤（TBI）仍然是一个普遍存在的临床问题，与显著的发病率和死亡率相关。然而，TBI在临床和生物物理学方面的定义仍不明确，即使临床指南实现了标准化且多模态监测得以应用，其预后仍然难以判断。在此，我们利用了一个独特的数据集，该数据集来自于在开颅手术期间植入颅内条形电极或作为常规临床实践一部分植入带有深度电极的四腔颅内螺栓的TBI患者。通过提取这些数据的频谱特征，我们发现β波段（12 - 30赫兹）中窄带振荡活动的存在与通过标准格拉斯哥昏迷量表（GCS）量化的神经学检查密切相关。此外，β振荡以行波的形式分布在皮质表面，并且这些波的演变与从昏迷中恢复相对应，这与波在感知和认知活动中的假定作用一致。因此，我们提出β振荡和行波是TBI恢复的潜在生物标志物。从更广泛的意义上讲，我们的研究结果表明，从昏迷中苏醒是由于协调皮质β节律的丘脑 - 皮质相互作用的恢复。
