Electroencephalographic markers of the spontaneous recovery of the vertical posture in patients with consequences of traumatic brain injury

Nine patients (mean age, 23.6 ± 3.15 years) with a severe traumatic brain injury (TBI) associated with a loss of the ability to maintain vertical posture were enrolled in a comprehensive clinical and electroencephalographic study during the spontaneous recovery of vertical posture (VP). The patients were divided into three groups according to their functional deficit assessed on the international MPAI, FIM, and MMSE scales, which was determined by the severity of the TBI. The EEG data were compared to those of ten healthy subjects (mean age, 22.8 ± 0.67 years). In patients with a moderate impairment of the brain and a rapid recovery of VP (over two weeks), a change in the sitting position revealed EEG signs similar to reactive EEG restructurings of healthy individuals during the maintenance of VP in the form of a predominant EEG coherence increase in the right hemisphere for most of the rhythm bands; however, at this stage of VP recovery, the EEG restructurings retained pathological signs. In patients with a more severe functional deficit, spontaneous recovery of VP was accompanied by hyperreactive EEG restructurings for all rhythm bands without regional specificity. This finding showed up irrespective of the lateralization of the brain injury, which could be considered as a marker of positive dynamics of VP recovery. In patients with the most severe impairment and functional deficit and long-term (more than three months) absence of spontaneous VP recovery, the absence of reactive EEG restructurings was revealed in their passive verticalization, which could be used as a marker of negative prognosis.