Local sleep-like cortical reactivity in the awake brain after focal injury.
Aged
Brain
/ physiopathology
Brain Injuries, Traumatic
/ physiopathology
Cerebral Cortex
/ physiopathology
Cohort Studies
Consciousness
Electroencephalography
Female
Functional Laterality
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Sleep
Stroke
/ physiopathology
Transcranial Magnetic Stimulation
Wakefulness
TMS/EEG
sleep
stroke
Journal
Brain : a journal of neurology
ISSN: 1460-2156
Titre abrégé: Brain
Pays: England
ID NLM: 0372537
Informations de publication
Date de publication:
01 12 2020
01 12 2020
Historique:
received:
02
04
2020
revised:
08
07
2020
accepted:
10
08
2020
pubmed:
15
11
2020
medline:
2
3
2021
entrez:
14
11
2020
Statut:
ppublish
Résumé
The functional consequences of focal brain injury are thought to be contingent on neuronal alterations extending beyond the area of structural damage. This phenomenon, also known as diaschisis, has clinical and metabolic correlates but lacks a clear electrophysiological counterpart, except for the long-standing evidence of a relative EEG slowing over the injured hemisphere. Here, we aim at testing whether this EEG slowing is linked to the pathological intrusion of sleep-like cortical dynamics within an awake brain. We used a combination of transcranial magnetic stimulation and electroencephalography (TMS/EEG) to study cortical reactivity in a cohort of 30 conscious awake patients with chronic focal and multifocal brain injuries of ischaemic, haemorrhagic and traumatic aetiology. We found that different patterns of cortical reactivity typically associated with different brain states (coma, sleep, wakefulness) can coexist within the same brain. Specifically, we detected the occurrence of prominent sleep-like TMS-evoked slow waves and off-periods-reflecting transient suppressions of neuronal activity-in the area surrounding focal cortical injuries. These perilesional sleep-like responses were associated with a local disruption of signal complexity whereas complex responses typical of the awake brain were present when stimulating the contralesional hemisphere. These results shed light on the electrophysiological properties of the tissue surrounding focal brain injuries in humans. Perilesional sleep-like off-periods can disrupt network activity but are potentially reversible, thus representing a principled read-out for the neurophysiological assessment of stroke patients, as well as an interesting target for rehabilitation.
Identifiants
pubmed: 33188680
pii: 5981995
doi: 10.1093/brain/awaa338
pmc: PMC7805800
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
3672-3684Commentaires et corrections
Type : CommentIn
Informations de copyright
© The Author(s) (2020). Published by Oxford University Press on behalf of the Guarantors of Brain.
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