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Spreading depression in continuous electroencephalography of brain trauma
Jed A Hartings1, J Adam Wilson, Jason M Hinzman
1Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH; Neurotrauma Center at University of Cincinnati Neuroscience Institute, Cincinnati, OH; Mayfield Clinic, Cincinnati, OH.
Annals of Neurology
|August 27, 2014
Summary
Cortical spreading depolarizations, a key mechanism in acute brain injury, can be detected using standard continuous electroencephalography (EEG). This noninvasive neuromonitoring method shows promise for various neurological disorders.
Area of Science:
- Neuroscience
- Neurology
- Critical Care Medicine
Background:
- Cortical spreading depolarizations (CSDs) are a significant pathophysiological mechanism in acute brain injury.
- CSDs are a potential target for advanced neuromonitoring strategies.
- Current monitoring methods for CSDs can be invasive.
Purpose of the Study:
- To investigate the manifestations of CSDs in continuous electroencephalography (EEG).
- To establish EEG as a broadly applicable, noninvasive method for neuromonitoring of CSDs.
- To correlate invasive electrocorticography (ECoG) findings with noninvasive EEG during acute brain injury.
Main Methods:
- Simultaneous invasive ECoG and noninvasive scalp EEG monitoring in 18 patients with traumatic brain injury.
- Identification of CSDs via ECoG, followed by visual and quantitative analysis of EEG correlates.
- Analysis of EEG amplitude depressions, propagation delays, and direct current potential shifts associated with CSDs.
Main Results:
- 455 CSDs were recorded over 65.9 days of monitoring.
- CSDs caused transient EEG amplitude depressions (57% of baseline) lasting 21 minutes in 39% of events.
- EEG showed evidence of CSDs through widespread propagation (35% of events), continuous EEG depression (41% of events), and direct current potential shifts.
Conclusions:
- Leão's spreading depression is observable in standard continuous scalp EEG.
- CSDs can spread widely across the injured cerebral hemisphere and be monitored noninvasively.
- Continuous EEG offers a novel application for monitoring CSDs in conditions like stroke, hemorrhage, and trauma.
