Electrographic Correlates of Brain Reactions to Afferent Stimuli in Postcomatose Unconscious States after Severe Brain Injury


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Abstract

Analysis of the character and systemic organization of cerebral reactions to external effects aids in adequate evaluation of functional and adaptive human capabilities in norm and pathology. Changes in the spatiotemporal organization of the EEG (according to visual and spectral coherence analyses, as well as localization of equivalent dipole sources of pathological EEG phenomena) and the electrooculogram in response to afferent stimuli at different stages of postcomatose recovery of mental activity were studied in 84 patients with severe brain injury in a prolonged postcomatose unconscious state. Both standard indifferent (a rhythmically flashing light and an acoustic tone) and functionally significant (a moving contrasting black-and-white strip, a red spot, the mother's voice, music, etc.) afferent stimuli were used. Functionally different reactive changes in the EEG were detected even in deep inhibition of consciousness (a vegetative state). EEG reactions including a strengthening of pathological foci in the CNS with dominant features suggested a poor prognosis. In the absence of such foci, a positive activating effect on mental recovery was found for afferent stimulation, in particular, functionally significant stimulation. Selective sensitivity of the CNS to certain external stimuli was observed for certain unconscious states.

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