The reorganization of the electrical activity of the human brain during the depression of consciousness (comatose states)

To study the problem of consciousness an original structural-functional approach has been applied with the use of possibilities of spectral-coherent EEG analysis in evaluation of human brain functional state together with the specificity of the cerebral coma having local focal belonging. It is revealed that the most informative signs for characteristics of consciousness state are peculiarities of reconstruction of intercentral relations of the electrical brain processes: decrease of mean levels of the EEG coherence at progressive development of coma; staged approach to relative norm at regressive course of comatose state and recovery of consciousness; their stability on the low level at prolonged coma; increase in low or high (above optimum) frequencies band at neighbouring with coma states of consciousness. It may be considered that one of the necessary conditions of normal state of consciousness is preservation of the optimum level of correlation of electrical brain activity alongside with frequency-regional specificity of the EEG coherence spectrum. Any deviation from the optimum is unfavourable condition for normal course of cerebral reactions because of the disturbance of intercentral connections mosaic necessary for their realization.     

Intercentral EEG relationships in regressive and chronic post-traumatic Korsakoff syndrome.]

Dynamic EEG study of patients with posttraumatic Korsakoff's syndrome (KS) with the application of complex analysis methods revealed a complicated pathological structure of the intercentral relations of cortical electrical activity. The interhemispheric EEG coherence between symmetrical frontal cortical areas are sharply reduced, while the intrahemispheric coherence are increased in comparison with the normal values. The proposed technique of segregation of statistically homogeneous spectro-coherent characteristics made it possible to reveal the earlier intercentral EEG relations formed by stable and variable coherence spectra. The structure formed by the stable and variable coherence spectra in KS differs from that reflected in the mean coherence levels. During the KS regression, the EEG coherence between the right and left frontal areas increased to the normal level, and the variable spectra are revealed. In the chronic KS syndrome, the pathological intercentral relations persist, while the variable relations in the frontal areas are absent. A reduction of pathologically decreased intrahemispheric coherence selectively revealed in the right hemisphere during the KS regression and formation of variable relations in this hemisphere point to a leading role of the right hemisphere in development of compensatory processes in KS. The reciprocal relations between the intra- and interhemispheric coherence and coherence dynamics in the theta rhythm suggest that pathological activity in the basal diencephalic structures plays an important role in formation of the pathological EEG pattern in KS.     

Intracerebral EEG functioning as a reflexion of the systemic brain organization in norm and pathology

The authors summarized the EEG findings and defined the nature of intercentral EEG relationships in different functional states of healthy subjects and patients with organic cerebral pathology based on coherence analysis. The EEG features typical of healthy subjects were identified: an anterior-posterior gradient of the mean coherence and the character of cortical-subcortical relationships in the anterior cerebral structures. Right- and lefthanded subjects showed the frequency and regional differences in EEG coherence, which reflected, mainly, specific intracortical relationships. Development and regression of pathologic signs in right- and lefthanded patients with organic brain lesions are thought to be determined by these differences. As distinct from cortical pathology, lesions of regulatory structures (diencephalic, brainstem, and limbic) were shown to produce more diffuse changes in intercentral relationships with a tendency to reciprocity. Intercentral relations, including their interhemispheric differences, varied with changes in the functional state of healthy subjects (increase and decrease in the level of functioning). A certain time course of changes in intercentral relationships was also revealed in patients with organic brain lesions during recovery of their consciousness and mental activity. Changes in the dominance of activity of individual regulatory structures are considered to be one of the most important factors that determine the dynamic character of EEG coherence.     

The significance of interhemispheric asymmetry in the development of compensatory processes in the human brain

For more precise definition of the role of hemispheric interconnections in mechanisms of human CNS compensation the intercentral relations of the electrical activity of the left and right cerebral hemispheres were studied on physiological model of focal interhemispheric asymmetry. Spectral-coherent EEG characteristics of 36 patients with tumoral damage of one hemisphere were studied in condition of chronic (prior to operation) and acute (early terms of postoperative period) brain decompensation. In was shown that the reorganization of the structure of the EEG intercentral relations correlated with definite stages of CNS compensatory processes and that the character of hemispheric interconnections depended on the lateralization of the damage focus. The primary role was revealed of the degree of the left (dominant) hemisphere preservation in restoration of normal pattern of the interhemispheric asymmetry of the coherence of human brain electrical processes.     

Dynamics of the spectral-coherent characteristics of the human EEG in healthy subjects and brain pathology

EEGs of 15 healthy subjects and 30 patients in early period after surgical ablation of tumours with basal localization, were investigated by means of monitor "Neuro-1" which allows to obtain in continuous regime characteristics of EEG dynamics according to power spectra and reveal the characteristics of intercentral relations of electrical brain processes by coherence and phase shifts. In healthy subjects in the period of transition from wakefulness to drowsiness highly coherent beta-rhythm (16-18 Hz) was revealed, preceeding typical picture of drowsiness and sleep. Study of the patients shows that certain characteristics of coherence and phasic shifts have an important prognostic value. Conclusion is made that for estimation of the functional state of healthy subjects during transition from wakefulness to drowsiness and of patients in early postoperative period the data on spectra of coherence are most informative.     

The reflection of compensation processes in the structure of the EEG spatial-temporal relationships in patients with disordered brain regulatory mechanisms]

Studies of intercentral relations of electrical activity in the cerebral cortex of the patients with hypophysis tumours under the conditions of chronic (before operation) and acute (after tumour ablation, early post-operative period) influence of the focus on the regulatory brain systems allowed to reveal definite changes of spectral-coherent EEG characteristics, reflecting the functional state of the cerebral adaptive-compensatory apparatus. It has been shown that reciprocal character of changes of various forms of the brain electrical activity and their intercentral relations is one of manifestations of development of the processes of cerebral compensation. At the same time, global fall of the EEG intercentral relations indicating the disintegration of the cerebral functional connections, reflects a loss of CNS compensatory mechanisms. The revealed EEG-characteristics at the present time are applied in Burdenko Institute of Neurosurgery for diagnostic-prognostic estimation of the brain functional state in patients during pre- and post-operative period.     

Changes in the brain spontaneous bioelectrical activity during transcranial electrical and electromagnetic stimulation

In order to study systemic brain reactions on transcranial electrical or electromagnetic medical stimulation and specify the neurophysiological criteria of its efficiency, comparative clinical and experimental examination was performed with the analysis of spontaneous bioelectric activity and behavioral or clinical parameters. We examined 6 patients with prolonged posttraumatic unconsciousness states treated with electrical stimulation and 17 intact Wistar rats subjected to electromagnetic stimulation of the brain. The effect of the transcranial stimulation was shown to depend on the initial level of the intercentral interactions of brain bioelectrical activity, estimated by the EEG coherence. Hypersynchronization of biopotentials as the main element of the brain reactivity can be the most useful for the rehabilitation of patients with cerebral pathology in cases of initially lowered level of the intercentral interactions in the absence of pathologically strengthened functional connections.     

The reflection of different levels of the regulation of human brain activity in spectrally coherent EEG parameters]

On the basis of clinico-anatomo-electroencephalographic studies it was shown, that in early terms of cerebral trauma, at gross disturbances of the cortical functions and safety in some cases of only vital regulation, the parameters of the EEG stability or variability are of distinct information value for estimation of the functional state of patients. It was established, that changes of stability of the frequency, power, and coherent EEG characteristics correlate with different parameters of changes of the structural-functional brain organization. At this stage the greatest connection with the disease outcome reveals the EEG coherence parameters of the cortical symmetrical points reflecting the state of predominantly median formations and general brain reactions to traumatic action. In the process of restoration of disturbed neuromental functions priority prognostic significance is acquired by parameters of intrahemispheric coherence as well as by frequency-regional properties of interhemispheric asymmetry of coherence of the brain electrical processes, characterizing functional features of the lesion focus.     

Dependence of the organization of human brain electrical activity on hemispheric dominance

In healthy subjects, in a state of relative rest, with different individual profiles of asymmetry (20 right-handed and 10 left-handed subjects), a greater conjunction of electrical brain processes (estimated by mean EEG coherence levels) has been found in the dominant hemisphere as compared to the subdominant one, more distinctly expressed in the right-handed subjects. The maximum degree of interhemispheric asymmetry of the EEG coherence is observed in the posterior associative cortical areas. Specific interhemispheric theta-range differences are revealed as compared with other EEG frequency bands. Greater values are obtained of the correlation of the EEG symmetrical hemispheres points in the whole frequency band and in alpha- and beta-ranges in the right-handed subjects than in the left-handed ones.     

EEG correlates of the states of visual and auditory attention in healthy subjects

In order to determine more accurately the EEG markers of different types of attention (AT) of a healthy adult, 14 young healthy subjects (aged 18–30 years) were subjected to spectral coherent analysis of the electrical activity of the brain in the baseline state and during activation of different forms of AT (the orienting response to the sound tone and opening of the eyes, involuntary and voluntary visual AT). In the last two cases, specially developed computer-aided techniques were used. The quantitative differences in the states were assessed on the basis of nonparametric (the Mann-Whitney test) and parametric (Student’s t test) statistics. In three subjects, EEG and fMRI comparisons of the brain response to opening of the eyes were made. It was shown that the activation of different forms of AT in healthy subjects is accompanied by considerable diffuse nonspecific changes in the EEG spectral coherent characteristics (a decrease in the average spectral frequency and power, as well as in coherence) in combination with more local, more often oppositely directed shifts in the region of the cortical representation of the working analyzer. Complex systemic rearrangements of the brain activity involving all components of the activating system, as well as the specifics of different forms of AT connected with the rearrangement of activity between its divisions, are reflected in the diffuse changes of intercentral interaction. For example, marked reactivity of the symmetrical frontopolar (F _p1-F _p2) and the anterotemporal (F ₇-F ₈) cortical areas with unidirectional maximum shifts during voluntary AT is likely to reflect the responses of the frontothalamic component of the activating system. The reciprocity of the behavior of interhemispheric frontopolar and temporal relationships seems to be determined by the activity of its different components: frontothalamic and hippocampal. The local component of the EEG response to opening of the eyes in the form of increased α coherence in the occipital areas is coupled with increased oxygenation of blood in the cortical representation of the visual analyzer (the +BOLD effect of the fMRI response).     

Intercentral correlations in the cerebral cortex according to the EEG coherence index after restoration of consciousness and speech following prolonged coma

Power spectra and coherence function of EEG of various cortical areas of both hemispheres were analyzed in 9 patients with extremely protracted loss of consciousness. Five patients were in the state of posttraumatic apallic syndrome lasting for more than 4 years in one patient, and 4-9 months with successive lethal outcome in 4 patients. One patient for more than 2 years was in a state of areactivity to external signals. In 3 patients the process of recovery of consciousness and speech began in 1-2 months. At the apallic syndrome, only low-frequency EEG components were present in spectrograms, and the values of coherence function were sharply decreased. With recovering consciousness and speech, a gradual appearance of alpha-activity was observed as well as an increase of coherence values at the frequency of the alpha-rhythm. The recovery of intercentral EEG relations in the motor-verbal cortical area was shown to play a special role in further normalization of connections in the cerebral cortex.     

Cortico-hippocampal relation of electrical activity during a motor polarization dominant in rabbits

By the method of spectral-coherent analysis, the intercentral relations were studied of the electrical activity of the sensorimotor and premotor cortices and of CAs field of the dorsal hippocampus of both hemispheres during the motor polarization dominant, created by the action of the direct current on the rabbits sensorimotor cortical area. The formation was shown of a new structure of the intercentral relations of electrical activity of the sensorimotor cortex and CA3 of the dorsal hippocampus. It should be noted that the dominant optimum and its inhibition are characterized by different interhippocampal relations: at the optimum a low range of the theta-rhythm is highly coherent while at the activation of "the non-dominant" hemisphere--a high range.     

Spectral analysis of the human EEG in acutely developing foci of irritation at the diencephalic and brain stem levels

The dynamic study of EEG spectra and coherence in 52 patients in early period after tumor ablation at the diencephalic (27 patients) and brainstem (25 patients) levels with favourable (24 patients) and lethal (28 patients) outcomes revealed a dependence of their changes on the reversibility or irreversibility of pathological irritation of these brain levels. At regressively developing foci and retained compensatory mechanisms characteristic changes of EEG relations were seen in the central cortical areas, i. e. in cortical projection zone of the nonspecific thalamic pathways. The changes observed consisted of EEG synchronization in the band of 7 cps and sharp coherence increase while changes of EEG correlations in other cortical areas were unsimilar. Gradual EEG normalization with alpha-rhythm restoration passed through the stage of sigma-rhythm and slow sleeplike waves which indicated the safety of brainstem-subcortical hypnogenic systems. In patients with destructive foci at the diencephalic and brainstem levels, i. e. under conditions of brain functioning similar to "cerveau isolé" and "encephale isolé",--a general coherence decrease and EEG synchronization in the band of 5 cps, or generalized slow, monomorphic oscillations were observed.     

Characteristics of the interhemispheric EEG relationships in assessing the functional state of the human brain

In healthy subjects (11 right-handed men) reorganization was studied of intra- and interhemispheric correlation of the electrical brain activity at transition from the state of alertness to drowsiness. At the lowering of alertness level, the coherence of hemispheres symmetrical points changed not abruptly, with a tendency towards an increase at differently directed character of changes of combinations of separate physiological rhythms ranges. Comparison of the EEG coherence changes within the right and left hemispheres revealed a greater reactivity of the left (dominant) hemisphere. The reduction of the predominance (observed in the dominant hemisphere in alertness) of the degree of EEG conjunction, at transition to drowsiness, leads to smoothing of interhemispheric asymmetry in the organization of electrical brain processes.     

Cerebral responses of healthy humans to rhythmic transcranial magnetic stimulation of different intensities

The effect of rhythmic transcranial magnetic stimulation (rTMS) of different intensities (single superthreshold rTMS more intense than 1.2 T and subthreshold one with an intensity of 70–80% of the motor threshold) of sagittal premotor cortical areas on the human functional activity was estimated in eight volunteers on the basis of combined EEG, neuropsychological, and hemodynamic examinations. The objectives of the study included the selection of the frequency of activating stimulation and revision of the objective EEG criteria of rTMS efficiency. It has been demonstrated that analysis of the EEG response to photostimulation at different frequencies is efficient in selecting the rTMS frequency. The EEG coherence is one of the most informative characteristics of the rTMS effect on central neurodynamics. The functional effects of stimulation (activating or inhibitory) have been shown to depend on the initial level of intercentral coherent relationships It has been found that rTMS of the sagittal premotor cortex causes definite changes in the functional activity of a healthy brain different from those caused by placebo. These changes are greater in the left hemisphere (in the form of intrahemispheric changes in coherence and depend on the stimulation intensity (superor subthreshold) and the initial state. The vascular factor has been shown to play an important role in the formation of cerebral responses to rTMS.     

Functional regional asymmetry of the EEG intrahemispheric coherence in dogs during conditioning

Individual features of the regional interhemispheric relations in the brain were studied in dogs during alimentary conditioning. The electrical activity was recorded from symmetrical anterior (frontal and motor cortices) and posterior (visual and auditory cortices) areas of the neocortex. Comparison between the averaged left and right intrahemispheric EEG coherences revealed a dynamic character of interhemispheric relations dependent on the stage of conditioning. Individual features were shown. In a dog with strong type of the nervous system, in the anterior brain regions, the EEG coherence was higher in the left hemisphere than in the right one, whereas, on the contrary, in the posterior regions, the values were higher in the right than in the left hemisphere. In dogs with weak type of the nervous system, there was an inverse relationship. Thus, the spatial organization of the cortical electrical activity in the associative and projection brain areas was different.     

Spectral-correlation characteristics of the electrical activity of the brain of the rabbit in a state of calm wakefulness

Inter- and intrahemispheric relations of electrical activity of the pre-motor, sensorimotor (representation of forelimb and blinking) and visual zones of rabbit's cerebral cortex in calm alertness was studied by method of spectral-correlative analysis. Mean coherence levels of the EEG of tested hemispheric symmetric points and symmetric pairs of leads in the left and right hemispheres were characterized by a high temporal stability in the state of calm alertness and during sensory stimulation. A comparison of mean coherence values of EEG in symmetric leads, revealed a tendency to left-side dominance of statistical bonds of electrical processes. A tendency was shown towards interhemispheric asymmetry by mean parameters of EEG power spectra: the left hemisphere of the rabbit is characterized by a lower mean frequency of electrical activity and a more narrow effective frequency of the spectrum.     

The locked-in patient and the characteristics of the electrical activity of his brain

"Locked-in" state differs from the known states characterized by the motor activity blockade, preservation of conscience of speech contact, despite the fact that connection with outer world during this state is limited only by vertical movements of eyes and eyelids in response to speech signals. Three "locked-in" men were studied at different stages of development of this state. Spectral-coherent analysis of the EEG was conducted. The most typical for the developed state of the "locked-in" man is a uniform change of the intercentral EEG relations. In the motor areas of the cortex alpha-activity and its links are not formed (coherence in alpha-range is zero) while high and low frequencies are coherent. In the visual areas, in contrast, the alpha-rhythm is coherent. Distinct interhemispheric asymmetry of coherent connections appears. In the right hemisphere a decrease of coherence level is sharp and even, in the left one--in occipito-temporal parts the level remains close to norm, while in the frontal parts of the cortex it decreases.     

The role of cerebral regulatory structures in the formation of human EEG

This article generalizes the results of many years’ studies of the EEG of patients with tumorous lesions in the diencephalic, brainstem, and limbic structures, which fulfill the regulatory function in ensuring integral brain activity. The specific features of the inclusion of individual structures under investigation in the organization of the intra- and interhemispheric relations of cortical biopotentials were demonstrated against the background of diffuse changes in the biopotentials that reflect the systemic character of neurodynamic reorganizations when the regulatory brain structures are involved in the pathological process. This study expands the idea of the predominant functional connection of the diencephalic structures with the right hemisphere and brainstem structures with the left one with determination of the regional specific features of changes in the intrahemispheric EEG coherences. The distinguishing features of intercentral relations when the limbic structures are involved in the pathological process show similarity with the neurodynamic reorganizations in patients with lesions in both diencephalic and (even more so) brainstem structures. Universal elements were detected in the formation of integral adaptive reactions of the brain with lesions in its regulatory structures, which reflects their close functional interaction and makes it possible to consider them the individual links of an integral regulatory system. The study revealed reciprocal changes in various forms of electrical activity, which reflects reciprocation of interaction of individual regulatory structures. This is one of the EEG equivalents of the formation of adaptive-compensatory cerebral reactions. The specificity of influence of the studied regulatory structures are clearly seen in situations of their morphofunctional isolation observed during cerebral coma. In these conditions, when the cortex is functionally inactive, the authors demonstrated the dynamic character of changes in interhemispheric asymmetry, which reflects the dominance of individual links of the regulatory system playing the role of supreme regulator of life support of the body in critical states.     

Electroencephalographic correlates of individual features of the mental efficiency of adolescents

Evident correlations of spatial-temporal organization of the electrical brain activity with individual features of the mental working capacity were revealed in juveniles by the methods of analysis of spectra power density and of coherence function of rhythmic EEG components. EEG in juveniles with a low working mental capacity is characterized by hypersynchroneity, monofrequency, low reactivity of alpha-rhythm and high level of generalized spatial synchronization. Juveniles with high level of mental working capacity are characterized by regional specificity of the main EEG rhythm, the presence of the local dynamic foci of interconnected activity. It is suggested that the correlation of mechanisms of controlled local and non-specific generalized cortical activity is one of the main factors, determining the individual specificity of mental ability.