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Focal Electroencephalographic Changes Index Post-Traumatic Confusion and Outcome
Sudhin A Shah1, Maliheh Mohamadpour2, Gulce Askin3
11 The Feil Family Brain and Mind Research Institute , Weill Cornell Medicine, TBI/DOC Research Program, Blythedale Children's Hospital, New York, New York.
Journal of Neurotrauma
|May 3, 2017
Summary
Electroencephalography delta-to-alpha ratios (DAR) indicate post-traumatic confusional state (PTCS) severity and predict long-term functional recovery after traumatic brain injury. Posterior DARs show promise as a biomarker for PTCS and recovery.
Area of Science:
- Neuroscience
- Clinical Neurophysiology
- Traumatic Brain Injury Research
Background:
- Post-traumatic confusional state (PTCS) following traumatic brain injury (TBI) has significant long-term implications, yet its pathophysiology and impact on functional outcomes remain poorly understood.
- Current understanding of PTCS pathophysiology is limited, hindering the development of targeted interventions and accurate prognostic markers.
Purpose of the Study:
- To investigate the relationship between electrophysiological markers, specifically delta-to-alpha frequency band power ratios (DAR), and the severity and functional outcomes of PTCS.
- To explore the potential of DAR as a biomarker for PTCS and subsequent functional recovery after TBI.
Main Methods:
- Resting electroencephalography (EEG) data were analyzed in 49 patients with PTCS, focusing on delta-to-alpha frequency band power ratios (DAR) from localized scalp areas.
- DARs were correlated with the severity of PTCS using the Confusion Assessment Protocol (CAP) and with functional outcomes using the Functional Independence Measure-cognitive subscale (FIM-Cog) at various time points post-injury, controlling for injury severity.
Main Results:
- Higher global, occipital, parietal, and temporal DARs were significantly associated with PTCS severity (CAP scores), independent of injury severity.
- Posterior DARs demonstrated significant associations with cognitive functional recovery (FIM-Cog scores) at 1, 2, and 5 years post-injury, with some associations remaining significant after controlling for injury severity.
- Specific associations were found between occipital DARs and CAP disorientation and symptom fluctuation scores.
Conclusions:
- Posterior delta-to-alpha ratios (DAR) serve as a potential electrophysiological marker for post-traumatic confusional state (PTCS) and a predictor of functional recovery after traumatic brain injury (TBI).
- The findings suggest that altered function of the posterior medial complex (PMC), potentially due to functional de-afferentation, may underlie both acute and chronic confusional states in PTCS.
- These results contribute to understanding the pathophysiology of PTCS and its relationship to disorders of consciousness, highlighting the clinical utility of EEG-derived markers.
