Spreading depolarization occurs in repeating, recognizable, patient-specific patterns after human brain injury

Area of Science:

• Neuroscience
• Medical Technology
• Critical Care Medicine

Background:

• Electrocorticography (ECoG) is crucial for monitoring spreading depolarization (SD) in neurocritical care.
• Recognizing SD in ECoG signals with high artifact poses a significant challenge.

Purpose of the Study:

• To develop novel heuristics for ECoG analysis in high-artifact regions.
• To identify and validate patient-specific SD patterns for improved diagnostic accuracy.

Main Methods:

• ECoG leads were placed intraoperatively in patients with subarachnoid hemorrhage, stroke, or traumatic brain injury.
• SD scoring was performed using traditional criteria and for pattern identification.
• Covariance structures, graphical overlay, and DC shift measures were utilized to evaluate SD patterns.

Main Results:

• Consistently observed SD patterns were unique to each patient and lead placement.
• Each patient exhibited no more than five distinct SD patterns.
• Statistical analysis confirmed high intra-pattern consistency.

Conclusions:

• Patient-specific SD patterns provide valuable insights into ECoG readings from high-artifact regions.
• These patterns serve as an additional scoring tool for neuro-ICU care of patients experiencing SD.
• SD pattern characterization may pave the way for precision medicine in neurological diseases.