Advances on neurophysiological monitoring methods for consciousness disorder after brain injury

doi:10.3969/j.issn.1672-6731.2023.10.002

Abstract

Abstract:

An accurate diagnosis of consciousness disorder after brain injury is the basis for further treatment. The previous evaluation of consciousness disorder after brain injury is mainly based on behavior scales and imaging examination, which is limited to subjective factors and external interference and difficult to detect and evaluate in real time. The development of objective and efficient evaluation methods of consciousness disorder after brain injury is currently a hot spot in clinical research. Neurophysiological monitoring is safe, objective, simple to operate, and can be detected continuously timely. It can be used as an evaluation method for consciousness disorder after brain injury. In this paper, we summarize the application paradigms and analysis methods of evoked potential and EEG in the clinical evaluation of consciousness disorder after brain injury in recent years, in order to provide new technical ideas for improving the clinical diagnosis and treatment of consciousness disorder after brain injury.

Key words: Brain injuries, Consciousness disorders, Neurophysiological monitoring, Review

摘要：

脑损伤后意识障碍的准确诊断是治疗的基础，既往脑损伤后意识障碍的评价主要基于行为量表测验、影像学检查等，易受主观因素和外界的干扰，发展客观高效的脑损伤后意识障碍评价方法是当前研究热点，神经电生理监测安全、客观、操作简单，可实现实时连续监测。本文总结脑诱发电位和脑电图在脑损伤后意识障碍评价中的应用范式和分析方法，以为改进脑损伤后意识障碍诊断与治疗方案提供新的技术思路。

关键词: 脑损伤, 意识障碍, 神经电生理监测, 综述

Zhong-peng WANG, Wen-lei WANG, Long CHEN, Xiu-yun LIU, Dong MING. Advances on neurophysiological monitoring methods for consciousness disorder after brain injury[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2023, 23(10): 878-883.

王仲朋, 王文磊, 陈龙, 刘秀云, 明东. 脑损伤后意识障碍神经电生理监测方法研究进展[J]. 中国现代神经疾病杂志, 2023, 23(10): 878-883.

/ / Recommend / Download Citations

URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2023.10.002

https://journal11.magtechjournal.com/cjcnn/EN/Y2023/V23/I10/878

References 51

1	Smith LGF , Milliron E , Ho ML , Hu HH , Rusin J , Leonard J , Sribnick EA . Advanced neuroimaging in traumatic brain injury: an overview. Neurosurg Focus, 2019, 47: E17.
2	Amiri M , Fisher PM , Raimondo F , Sidaros A , Cacic Hribljan M , Othman MH , Zibrandtsen I , Albrechtsen SS , Bergdal O , Hansen AE , Hassager C , Højgaard JLS , Jakobsen EW , Jensen HR , Møller J , Nersesjan V , Nikolic M , Olsen MH , Sigurdsson ST , Sitt JD , Sølling C , Welling KL , Willumsen LM , Hauerberg J , Larsen VA , Fabricius M , Knudsen GM , Kjaergaard J , Møller K , Kondziella D . Multimodal prediction of residual consciousness in the intensive care unit: the CONNECT - ME study. Brain, 2023, 146: 50- 64. doi: 10.1093/brain/awac335
3	Wang J , Liu JF . Clinical application of electroencephalogram in traumatic brain injury. Lin Chuang Wai Ke Za Zhi, 2020, 28: 914- 916. doi: 10.3969/j.issn.1005-6483.2020.10.006
	王健, 刘劲芳. 脑电图在创伤性脑损伤的临床应用. 临床外科杂志, 2020, 28: 914- 916. doi: 10.3969/j.issn.1005-6483.2020.10.006
4	Bodien YG , Barra A , Temkin NR , Barber J , Foreman B , Vassar M , Robertson C , Taylor SR , Markowitz AJ , Manley GT , Giacino JT , Edlow BL . TRACK - TBI Investigators. Diagnosing level of consciousness: the limits of the glasgow coma scale total score. J Neurotrauma, 2021, 38: 3295- 3305. doi: 10.1089/neu.2021.0199
5	Daia C , Scheau C , Spinu A , Andone I , Popescu C , Toader C , Bumbea AM , Verenca MC , Onose G . Modulated neuroprotection in unresponsive wakefulness syndrome after severe traumatic brain injury. Brain Sci, 2021, 11: 1044. doi: 10.3390/brainsci11081044
6	Porcaro C , Marino M , Carozzo S , Russo M , Ursino M , Ruggiero V , Ragno C , Proto S , Tonin P . Fractal dimension feature as a signature of severity in disorders of consciousness: an EEG study. Int J Neural Syst, 2022, 32: 2250031. doi: 10.1142/S0129065722500319
7	Anestis DM , Foroglou NG , Varoutis PC , Monioudis PM , Tsonidis CA , Tsitsopoulos PP . Comparison of the prognostic value of coma scales among health - care professionals: a prospective observational study. Acta Neurol Belg, 2023, 123: 893- 902. doi: 10.1007/s13760-022-02063-3
8	Raso MG , Arcuri F , Liperoti S , Mercurio L , Mauro A , Cusato F , Romania L , Serra S , Pignolo L , Tonin P , Cerasa A . Telemonitoring of patients with chronic traumatic brain injury: a pilot study. Front Neurol, 2021, 12: 598777. doi: 10.3389/fneur.2021.598777
9	Porcaro C , Nemirovsky IE , Riganello F , Mansour Z , Cerasa A , Tonin P , Stojanoski B , Soddu A . Diagnostic developments in differentiating unresponsive wakefulness syndrome and the minimally conscious state. Front Neurol, 2022, 12: 778951. doi: 10.3389/fneur.2021.778951
10	Vitello MM , Szymkowicz E , Laureys S , Alnagger N , Gosseries O , Thibaut A . Neuroimaging and neurophysiological diagnosis and prognosis in paediatric disorders of consciousness. Dev Med Child Neurol, 2022, 64: 681- 690. doi: 10.1111/dmcn.15150
11	Jain R , Ramakrishnan AG . Electrophysiological and neuroimaging studies - during resting state and sensory stimulation in disorders of consciousness: a review. Front Neurosci, 2020, 14: 555093. doi: 10.3389/fnins.2020.555093
12	Yu J , Cheng Q , He F , Meng F , Yu Y , Xu C , Wen X , Hong L , Gao J , Li J , Pan G , Li MD , Luo B . Altered Intestinal microbiomes and lipid metabolism in patients with prolonged disorders of consciousness. Front Immunol, 2022, 13: 781148. doi: 10.3389/fimmu.2022.781148
13	Wutzl B , Golaszewski SM , Leibnitz K , Langthaler PB , Kunz AB , Leis S , Schwenker K , Thomschewski A , Bergmann J , Trinka E . Narrative review: quantitative EEG in disorders of consciousness. Brain Sci, 2021, 11: 697. doi: 10.3390/brainsci11060697
14	Møller MLH , Højlund A , Jensen M , Gansonre C , Shtyrov Y . Applied potential of task - free event - related paradigms for assessing neurocognitive functions in disorders of consciousness. Brain Commun, 2020, 2: fcaa087. doi: 10.1093/braincomms/fcaa087
15	Daltrozzo J , Wioland N , Mutschler V , Kotchoubey B . Predicting coma and other low responsive patients outcome using event - related brain potentials: a meta - analysis. Clin Neurophysiol, 2007, 118: 606- 614. doi: 10.1016/j.clinph.2006.11.019
16	Steppacher I , Eickhoff S , Jordanov T , Kaps M , Witzke W , Kissler J . N400 predicts recovery from disorders of consciousness. Ann Neurol, 2013, 73: 594- 602. doi: 10.1002/ana.23835
17	Meiron O , Barron J , David J , Jaul E . Neural reactivity parameters of awareness predetermine one - year survival in patients with disorders of consciousness. Brain Inj, 2021, 35: 453- 459. doi: 10.1080/02699052.2021.1879398
18	Steppacher I , Fuchs P , Kaps M , Nussbeck FW , Kissler J . A tree of life: multivariate logistic outcome - prediction in disorders of consciousness. Brain Inj, 2020, 34: 399- 406. doi: 10.1080/02699052.2019.1695289
19	Zhang Y , Song W , Du J , Huo S , Shan G , Li R . Transcranial direct current stimulation in patients with prolonged disorders of consciousness: combined behavioral and event - related potential evidence. Front Neurol, 2017, 8: 620. doi: 10.3389/fneur.2017.00620
20	Wang XY , Wu HY , Lu HT , Huang TT , Zhang H , Zhang T . Assessment of mismatch negativity and P300 response in patients with disorders of consciousness. Eur Rev Med Pharmacol Sci, 2017, 21: 4896- 4906.
21	Wu M , Li F , Wu Y , Zhang T , Gao J , Xu P , Luo B . Impaired frontoparietal connectivity in traumatic individuals with disorders of consciousness: a dynamic brain network analysis. Aging Dis, 2020, 11: 301- 314. doi: 10.14336/AD.2019.0606
22	Ma X , Chen W , Yang NN , Wang L , Hao XW , Tan CX , Li HP , Liu CZ . Potential mechanisms of acupuncture for neuropathic pain based on somatosensory system. Front Neurosci, 2022, 16: 940343. doi: 10.3389/fnins.2022.940343
23	Lechinger J , Chwala - Schlegel N , Fellinger R , Donis J , Michitsch G , Pichler G , Schabus M . Mirroring of a simple motor behavior in disorders of consciousness. Clin Neurophysiol, 2013, 124: 27- 34. doi: 10.1016/j.clinph.2012.05.016
24	Sandroni C , D'Arrigo S , Cacciola S , Hoedemaekers CWE , Westhall E , Kamps MJA , Taccone FS , Poole D , Meijer FJA , Antonelli M , Hirsch KG , Soar J , Nolan JP , Cronberg T . Prediction of good neurological outcome in comatose survivors of cardiac arrest: a systematic review. Intensive Care Med, 2022, 48: 389- 413. doi: 10.1007/s00134-022-06618-z
25	Schorl M , Valerius - Kukula SJ , Kemmer TP . Median - evoked somatosensory potentials in severe brain injury: does initial loss of cortical potentials exclude recovery?. Clin Neurol Neurosurg, 2014, 123: 25- 33. doi: 10.1016/j.clineuro.2014.05.004
26	Zanatta P , Linassi F , Mazzarolo AP , Aricò M , Bosco E , Bendini M , Sorbara C , Ori C , Carron M , Scarpa B . Pain - related somato sensory evoked potentials: a potential new tool to improve the prognostic prediction of coma after cardiac arrest. Crit Care, 2015, 19: 403. doi: 10.1186/s13054-015-1119-y
27	Liu ZB , Liu YS , Zhao L , Li MY , Liu CH , Zhang CX , Li HL . Short - term efficacy of music therapy combined with α binaural beat therapy in disorders of consciousness. Front Psychol, 2022, 13: 947861. doi: 10.3389/fpsyg.2022.947861
28	Dreszer J , Grochowski M , Lewandowska M , Nikadon J , Gorgol J , Bałaj B , Finc K , Duch W , Kałamała P , Chuderski A , Piotrowski T . Spatiotemporal complexity patterns of resting-state bioelectrical activity explain fluid intelligence: sex matters. Hum Brain Mapp, 2020, 41: 4846- 4865. doi: 10.1002/hbm.25162
29	Jafari Z , Kolb BE , Mohajerani MH . Neural oscillations and brain stimulation in Alzheimer's disease. Prog Neurobiol, 2020, 194: 101878. doi: 10.1016/j.pneurobio.2020.101878
30	Pauli R , O'Donnell A , Cruse D . Resting - state electroencephalography for prognosis in disorders of consciousness following traumatic brain injury. Front Neurol, 2020, 11: 586945. doi: 10.3389/fneur.2020.586945
31	Van DJ , Koenders SS , Vendel BN , Jager PL , Van Dijk JD . Entropy -based myocardial blood flow measurements using pet: a way to improve reproducibility. Eur Heart J Cardiovasc Imaging, 2021, 22 (Supplement 3): iii83.
32	González HFJ , Narasimhan S , Johnson GW , Wills KE , Haas KF , Konrad PE , Chang C , Morgan VL , Rubinov M , Englot DJ . Role of the nucleus basalis as a key network node in temporal lobe epilepsy. Neurology, 2021, 96: e1334- e1346. doi: 10.1212/WNL.0000000000011523
33	Wang Z . The neurocognitive correlates of brain entropy estimated by resting state fMRI. Neuroimage, 2021, 232: 117893. doi: 10.1016/j.neuroimage.2021.117893
34	Estraneo A , Loreto V , Guarino I , Boemia V , Paone G , Moretta P , Trojano L . Standard EEG in diagnostic process of prolonged disorders of consciousness. Clin Neurophysiol, 2016, 127: 2379- 2385. doi: 10.1016/j.clinph.2016.03.021
35	Duszyk - Bogorodzka A , Zieleniewska M , Jankowiak - Siuda K . Brain activity characteristics of patients with disorders of consciousness in the EEG resting state paradigm: a review. Front Syst Neurosci, 2022, 16: 654541. doi: 10.3389/fnsys.2022.654541
36	Lechinger J , Bothe K , Pichler G , Michitsch G , Donis J , Klimesch W , Schabus M . CRS - R score in disorders of consciousness is strongly related to spectral EEG at rest. J Neurol, 2013, 260: 2348- 2356. doi: 10.1007/s00415-013-6982-3
37	Sutter R , Kaplan PW , Valença M , De Marchis GM . EEG for diagnosis and prognosis of acute nonhypoxic encephalopathy: history and current evidence. J Clin Neurophysiol, 2015, 32: 456- 464. doi: 10.1097/WNP.0000000000000164
38	Young GB , McLachlan RS , Kreeft JH , Demelo JD . An electroencephalographic classification for coma. Can J Neurol Sci, 1997, 24: 320- 325. doi: 10.1017/S0317167100032996
39	Lehembre R , Marie - Aurélie B , Vanhaudenhuyse A , Chatelle C , Cologan V , Leclercq Y , Soddu A , Macq B , Laureys S , Noirhomme Q . Resting - state EEG study of comatose patients: a connectivity and frequency analysis to find differences between vegetative and minimally conscious states. Funct Neurol, 2012, 27: 41- 47.
40	Blume C , Del Giudice R , Wislowska M , Lechinger J , Schabus M . Across the consciousness continuum: from unresponsive wakefulness to sleep. Front Hum Neurosci, 2015, 9: 105.
41	Gosseries O , Schnakers C , Ledoux D , Vanhaudenhuyse A , Bruno MA , Demertzi A , Noirhomme Q , Lehembre R , Damas P , Goldman S , Peeters E , Moonen G , Laureys S . Automated EEG entropy measurements in coma, vegetative state/unresponsive wakefulness syndrome and minimally conscious state. Funct Neurol, 2011, 26: 25- 30.
42	Badran BW , Caulfield KA , Lopez JW , Cox C , Stomberg - Firestein S , DeVries WH , McTeague LM , George MS , Roberts D . Personalized TMS helmets for quick and reliable TMS administration outside of a laboratory setting. Brain Stimul, 2020, 13: 551- 553. doi: 10.1016/j.brs.2020.01.009
43	Cappon D , den Boer T , Jordan C , Yu W , Metzger E , Pascual - Leone A . Transcranial magnetic stimulation (TMS) for geriatric depression. Ageing Res Rev, 2022, 74: 101531. doi: 10.1016/j.arr.2021.101531
44	Rosanova M , Gosseries O , Casarotto S , Boly M , Casali AG , Bruno MA , Mariotti M , Boveroux P , Tononi G , Laureys S , Massimini M . Recovery of cortical effective connectivity and recovery of consciousness in vegetative patients. Brain, 2012, 135 (Pt 4): 1308- 1320.
45	Bertazzoli G , Esposito R , Mutanen TP , Ferrari C , Ilmoniemi RJ , Miniussi C , Bortoletto M . The impact of artifact removal approaches on TMS - EEG signal. Neuroimage, 2021, 239: 118272. doi: 10.1016/j.neuroimage.2021.118272
46	Darmani G , Bergmann TO , Zipser C , Baur D , Müller - Dahlhaus F , Ziemann U . Effects of antiepileptic drugs on cortical excitability in humans: a TMS - EMG and TMS - EEG study. Hum Brain Mapp, 2019, 40: 1276- 1289. doi: 10.1002/hbm.24448
47	Casali AG , Gosseries O , Rosanova M , Boly M , Sarasso S , Casali KR , Casarotto S , Bruno MA , Laureys S , Tononi G , Massimini M . A theoretically based index of consciousness independent of sensory processing and behavior. Sci Transl Med, 2013, 5: 198ra105.
48	Sinitsyn DO , Poydasheva AG , Bakulin IS , Legostaeva LA , Iazeva EG , Sergeev DV , Sergeeva AN , Kremneva EI , Morozova SN , Lagoda DY , Casarotto S , Comanducci A , Ryabinkina YV , Suponeva NA , Piradov MA . Detecting the potential for consciousness in unresponsive patients using the perturbational complexity Index. Brain Sci, 2020, 10: 917. doi: 10.3390/brainsci10120917
49	Koenig MA , Kaplan PW . Measuring depth in still water: electrophysiologic indicators of residual consciousness in the unresponsive patient. Epilepsy Curr, 2018, 18: 147- 150. doi: 10.5698/1535-7597.18.3.147
50	Zrenner C , Galevska D , Nieminen JO , Baur D , Stefanou MI , Ziemann U . The shaky ground truth of real - time phase estimation. Neuroimage, 2020, 214: 116761.
51	Huang J , Qiu L , Lin Q , Xiao J , Huang Y , Huang H , Zhou X , Shi X , Wang F , He Y , Pan J . Hybrid asynchronous brain - computer interface for yes, no communication in patients with disorders of consciousness. J Neural Eng, 2021, 18 (5)

[1]	Zhi-yong TONG. Intracranial aneurysms and cerebral revascularization [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(8): 595-598.
[2]	Zhi-yong TONG. History of cerebral revascularization [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(8): 599-605.
[3]	Ling-ji JIN, Jun-wen HU, Yin LI, Lin WANG. Intracranial-intracranial bypass for the treatment of complex intracranial aneurysms: technical advances and surgical experience [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(8): 606-612.
[4]	Pei-xi LIU, Yuan SHI, Wei ZHU. Application of whole-region cerebral vascular bypass for intracranial aneurysms treatment in the flow diversion era [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(8): 613-618.
[5]	Feng ZHANG, Fan-gang MENG. Research progress of subthalamic nucleus deep brain stimulation in treatment of autonomic nerve dysfunction in Parkinson's disease [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(7): 510-515.
[6]	Gui-zhi WU, Hong TIAN. Clinical research progress of deep brain stimulation for Meige's syndrome [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(7): 516-521.
[7]	Fan-gang MENG, Jian-guo ZHANG. Application of retroauricular bone grinding groove technology in deep brain stimulation [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(7): 522-524.
[8]	Lin CHEN, Hua PAN. Electrophysiological diagnosis of functional tremor [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(7): 573-578.
[9]	Jun-ji WEI, Jian-bo CHANG. Promoting the concept of neurosurgical critical care in primary hospitals [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(6): 403-406.
[10]	Ming-yu ZHAO, Chen YANG, Yu-heng LIU, Jing LI, Ming-sheng YU, Zeng-guang WANG. Effect of bone window closure on moderate to severe traumatic brain injury models in mice [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(6): 425-434.
[11]	Bo TAN, Yue ZHANG, Jia-qiang YANG, Yong-dong LIU, Yang JIAO, Bei WANG. Risk factors analysis and Bayesian network model construction of hydrocephalus after decompressive craniectomy in patients with cerebral hernia after traumatic brain injury [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(6): 442-449.
[12]	Cheng-wen ZHANG, Zhi-guo ZHANG. Correlation analysis of CT parameters of brain tissue displacement degree and increased intracranial pressure in patients with closed traumatic brain injury [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(6): 478-482.
[13]	Ruo-lin SHI, Xiu-jie GAO, Jia-ning CUI, Yan SHAO, Lu-shuang XIE, Yi LIU. Advance on association between 5-hydroxytryptamine and non-motor symptoms in Parkinson's disease [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(6): 497-501.
[14]	Hai-feng LI. Glucocorticoids remain the basis for treatment of myasthenia gravis in the era of targeted therapies [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(5): 295-307.
[15]	Hong-jia XU, Ya-qing SHU, Pin WANG, Fan LI, Shun-liang XU, Wei QIU, Xiao-yu MA. Advances on the diagnosis and treatment of aquaporin 4 antibody positive neuromyelitis optica spectrum disorders [J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2024, 24(5): 308-314.

Please choose a citation manager

Content to export