P222 Diagnostic and therapeutic possibilities of transcranial magnetic stimulation in patients after traumatic brain injury

Kopachka, Miroslav; Troshina, E.M.; Sharova, E. V.; Zaitsev, Oleg; Chelyapina, M. V.; Окнина, Л. Б.

doi:10.1016/j.clinph.2017.07.230

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“…Given the importance of preservation (or recovery) of the structural-functional interhemispheric connectivity, as well as the front-thalamic one, for the formation of attention in a post coma disorders of consciousness, the data obtained may contribute to the development of targeted Neurotherapy. 65,66…”

Section: Discussionmentioning

confidence: 99%

Inter hemispheric connectivity and attention in patients with disorders of consciousness after severe traumatic brain injury

Ev¹,

El²,

Ev³

et al. 2018

JNSK

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The study of the function of attention in the dynamics of disturbed and recovering consciousness in severe cerebral pathology is becoming more relevant-due to the increasing number of patients with prolonged disorders of consciousness and significant difficulties in their rehabilitation.Objective: to determine the electroencephalographic correlates of modality-nonspecific attention using a clinical model of severe traumatic brain injury (STBI).Patients and methods: 35 patients with STBI in the dynamics of post coma recovery of mental activity (a study group) and 23 healthy subjects (a control group) were examined. Changes in the pattern of EEG and in the indices of its coherence in the presence and activation of different forms of attention (an orienting response to the sound and eye opening; involuntary and voluntary visual forms), by applying specially developed computerized techniques, were investigated. The features of associated with attention changes in interhemispheric EEG coherence (EEGInterCoh) with the data of 3T diffusion tensor tractography of the corpus callosum (CC) were compared.Results: Attention disorders were shown to be essential and an «axial disorder» in patients with SBI. There were statistically confirmed qualitative and quantitative differences attention-associated changes in the EEG pattern and inter hemispheric coherence in reversible and chronic unconsciousness. The important favorable prognostic sign proved to be reactive changes in inter hemispheric EEG relations, including frontal ones characterized by the absence of clear external manifestations of consciousness in the very earliest stages. There was a significant correlation between the preservation of CC tracts (primarily, the rostrum, anterior portion, and splenium) and attention-related reactivity of EEG Inter Coh, which reflects the specific, though nonrigid, structural determinacy of the latter.

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Section: Discussionmentioning

confidence: 99%