Published: 13.12.2017 14:08

Induced coma brain activity

«Induced coma brain activity» in pictures.

From the Deepest Coma, New Brain Activity Found

The blood-brain barrier in a live zebra fish embryo plays a critical role in neurological function and disease. Drs. Jennifer Peters and Michael Taylor St. Jude Children’s Research Hospital in Memphis, Tenn. developed transgenic zebra fish to visualize the development of this structure in a live animal. Photographic Technique: Confocal Magnification: 75x

Detecting brain activity in coma patients can actually be a scary

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Human Brain Activity Patterns beyond the Isoelectric Line of Extreme

The current standard of care after cardiac arrest involves cooling the patient to “mild hypothermia” at 95 to 98 degrees for 67 to 79 hours. After suffering cardiac arrest, a patient is given cardiopulmonary resuscitation to get the heart beating again in the emergency room, doctors then use cooling blankets, wet towels and ice packs placed on the groin or neck to induce mild hypothermia. This is what saved Chris Brooks.

Typically, a person who goes over five minutes without heartbeat, blood flow or oxygen is in serious danger of permanent brain damage. Less than 65 percent of those who suffer an out-of-hospital cardiac arrest survive, because it usually takes much longer than five minutes to get such people from their home to the help they need. And among those who survive, about 6 in 65 will have severe brain damage.

In this paper we report an active brain state that extends well beyond deep coma associated with an EEG isoelectric line and potentially represents a new frontier in brain functioning. We have shown that νCs arise in the hippocampus and are subsequently transmitted to the cortex. The genesis of a hippocampal νC depends upon another hippocampal activity, known as ripple activity, which is not overtly detectable at the cortical level. The νC state is possible due to the intense subcortical activity generated in the hippocampus under conditions where cortical spontaneous functioning is greatly reduced. These observations have far-reaching consequences:

It is thought that during this process the receptors are in some way changed or deformed so that they respond to zolpidem differently from normal receptors, thus breaking the hold of Gaba. This could mean that instead of sending patients to sleep as usual, it makes dormant areas of the brain function again and some comatose patients wake up.

No one yet knows exactly how a sleeping pill could wake up the seemingly dead brain cells, but Nel and Clauss have a hypothesis. After the brain has suffered severe trauma, a chemical known as Gaba (gamma amino butyric acid) closes down brain functions in order to conserve energy and help cells survive. However, in such a long-term dormant state, the receptors in the brain cells that respond to Gaba become hypersensitive, and as Gaba is a depressant, it causes a persistent vegetative state.

The experience of being in a coma differs from person to person. Some people feel they can remember events that happened around them while they were in a coma, while others don't.

( A ) Generation of recurrent delta ripples within hippocampal neurons fails to activate the dentate gyrus. At right: hippocampal field potential activity. ( B ) Increased synchronization of delta ripples activates dentate gyrus granule cells, which in turn recruit hippocampal neurons, creating a νC. At right, entorhinal cortex field potential activities (green). ( C ) The newly generated νC activates cortically-projecting deep layers of the entorhinal cortex, permitting the propagation of the νC toward the neocortex. At right, scalp EEG activity.

The company that first developed zolpidem, Sanofi-Aventis, was contacted by Nel and Clauss but appears to have chosen not to become involved in the trials or the use of the drug on brain-damaged patients. Instead, the brain scans on up to 85 patients will be carried out at the Pretoria Academic Hospital by Professor Mike Sathekge, head of nuclear medicine, and Professor Ben Meyer, one of South Africa's most renowned physicians.