Abstract
An integrated neuroreconstructive approach to stimulating the pathogenetic mechanisms of a vegetative state developed due to a severe traumatic brain injury (TBI) is suggested. It has been shown that a faster and more pronounced therapeutic effect, compared with conventional therapies, could be achieved through the application of transtimpanal chemical vestibular dereception and transcranial micropolarization. The results of neurophysiological in-depth examination in dynamics have shown that over time interregional cortical interactions become more intense, “rigid,” and “tight” in patients with a vegetative state, while the temporal-parietal-occipital areas begin to dominate in the organization of these interactions in the cortex of both hemispheres. It is assumed that the vestibulothalamic tract, owing to its anatomical location, appears to be the least vulnerable under the conditions of brain stem dislocation due to a severe TBI. As a result, vestibular afferentation appears to become a predominant kind of afferentation for generating interregional cortical interactions. A pathological functional system develops on the basis of this afferentation, blocking other functional systems in the damaged brain. The suggested therapies significantly reduce the amount of vestibular afferent inputs and open a possibility for restoring more effective afferent interactions. This significantly facilitates the functioning of the brain as a multimodal analyzer.
Similar content being viewed by others
References
Jennet, B. and Plum, F., Persistent vegetative state after brain damage. A syndrome in search of a name, Lancet, 1972, no. 1, p. 734.
Adams, J.H., Graham, D.I., and Jennett, B., The neuropathology of the vegetative state after an acute brain insult, Brain, 2000, vol. 123, p. 1327.
Sharova, E.V., Electrographic correlates of brain reactions to afferent stimuli in postcomatose unconscious states after severe brain injury, Hum. Physiol., 2005, vol. 31, no. 3, p. 245.
Fields, A.I., Coble, D.H., Pollack, M.M., et al., Outcomes of children in a persistent vegetative state, Crit. Care Med., 1993, vol. 21, no. 12, p. 1890.
Principles of Neurosurgery, Grossman, R.G., Loftus, C.M., Eds., Philadelphia, 1998.
Klimash, A.V., Tsitseroshin, M.N., Shepoval’nikov, A.N., et al., Disorders of the spatiotemporal organization of the brain’s bioelectrical activity in patients with different depressions of consciousness after severe head injury, Hum. Physiol., 2010, vol. 36, no. 5, p. 49.
Boldyreva, G.N., Zhavoronkova, L.A., Sharova, E.V., et al., EEG-fMRT analysis of the functional specialization of the human brain in norm and in a cerebral pathology, Med. Vizual., 2012, no. 1, p. 15.
Livanov, M.N. and Khrizman, T.P., Spatial-temporal organization of human brain biopotentials, in Estestvenno-nauchnye osnovy psikhologii (Natural Scientific Basics of Psychology), Smirnov, A.A., Luriya, A.R., and Nebylitsyn, V.D., Eds., Moscow: Pedagogika, 1978.
Tsitseroshin, M.N. and Shepoval’nikov, A.N., Stanovlenie integrativnoi funktsii mozga (Development of Integrative Activity of the Brain), St. Petersburg: Nauka, 2009.
Naryshkin, A.G. and Shelyakin, A.M., A method for treating the extrapyramidal nervous system diseases, RF Patent 2 168 997, 2000.
Naryshkin, A.G., Gorelik, A.L., Skoromets, T.A., and Vtorov, A.V., Twenty-year experience of the application of vestibular dereception in the treatment of extrapyramidal pathology (indications, efficency, catamnesis, mechanisms), Polenovskie chteniya (Polenov Lectures) (Proc. 9th All-Russian Scientific-Practical Conference), Bersnev, V.P. and Yakovenko, I.V., Eds., St. Petersburg: Chelovek i Ego Zdorov’e, 2010, p. 398.
Naryshkin, A.G., Shelyakin, A.M., Tyul’kin, O.N., and Gorelik, A.L., A method for treating acute focal lesions of the brain, RF Patent 2 188 674, 2002.
Naryshkin, A.G., Gorelik, A.L., Skoromets, T.A., and Bukhartsev, N.N., Transkranial’naya mikropolyarizatsiya v kompleksnom lechenii bol’nykh s ostrymi tserebral’nymi sosudistymi porazheniyami. Metodicheskie rekomendatsii (Transcranial micropolarization in the complex treatment of patients with acute cerebrovascular lesions: Methodical recommendations), St. Petersburg: NIPNI im. V.M. Bechtereva, 2008.
Naryshkin, A.G., Etimizol as a medicine acting on the human muscle tone, in Farmakologiya neirotropnykh sredstv (Pharmacology of Neurotropic Drugs), Binder, K.I., Ed., Saratov, 1982, p. 56.
Dzugaeva, S.B., Provodyashchie puti golovnogo mozga cheloveka (v ontogeneze) (Human Brain Pathways in Ontogeny), Moscow: Meditsina, 1975.
Grindel’, O.M., Romanova, N.V., Zaitsev, O.S., et al., Mathematical analysis of EEGs in restoring consciousness after a severe craniocerebral injury, Zh. Nevrol. Psikhiatr. im. S.S. Korsakova, 2006, no. 12, p. 47.
Vainshenker, Yu.I., Ivchenko, I.M., Korotkov, A.D., et al., The vegetative state as a manifestation of a stable pathological state, Hum. Physiol., 2010, vol. 36, no. 1, p. 118.
Naryshkin, A.G. and Gorelik, A.L., Coherent analysis of EEG of patients with cervical dystonia in the process of treatment using the transtimpanal chemical vestibular dereception method, Vestnik SPb GMA im. I.I. Mechnikova, 2004, vol. 2, p. 88.
Naryshkin, A.G., Gorelik, A.L., Skoromets, T.A., and Egorov, A.Yu., Clinical and neurophysiological manifestations of the interhemispheric asymmetry in cervical dystonia, Zh. Nevrol. Psikhiatr. im. S.S. Korsakova, 2009, vol. 109, no. 10, p. 51.
Bechtereva, N.P., Magiya mozga i labirinty zhizni (The Magic of the Brain and Labyrinths of Life), St. Petersburg: Notabene, 2007.
Dizregulyatsionnaya patologiya nervnoi sistemy (Dysregulatory Pathology of the Nervous System), Gusev, E.I., Kryzhanovskii, G.N., Eds., Moscow: Med. Inform. Agentstvo, 2009.
Dougherty, J.H., Rawlinson, D., Levy, D.E., et al., Hypoxic-ischemic brain injury and the vegetative state. Clinical and neuropathologic correlation, Neurology, 1979, no. 29, p. 591.
Anokhin, P.K., Sistemnye mekhanizmy vysshei nervnoi deyatel’nosti (Systemic Mechanisms of Higher Nervous Activity), Moscow: Nauka, 1979.
Gnezditskii, V.V., Vyzvannye potentsialy mozga v klinicheskoi praktike (Induced Potentials of the Brain in Clinical Practice), Moscow: MEDpress-Inform, 2003.
Noirhomme, Q., Soddu, A., Lehembre, R., et al., Brain connectivity in pathological and pharmacological coma, Front. Syst. Neurosci., 2010, vol. 4, p. 1.
Rosanova, M., Gosseries, O., Casarotto, S., et al., Recovery of cortical effective connectivity and recovery of consciousness in vegetative patients, Brain, vol. 135, no. 4, p. 1308.
Balashov, A.N., Syndrome of brain stem dissociations in neuroemergent patients (cliniconeurological, electrophysiological and morphological study), Extended Abstract of Cand. Sci. Dissertation, St. Petersburg, 1991.
Khechinashvili, S.N., Vestibulyarnaya funktsiya (voprosy fiziologii i metodiki issledovaniya) (Vestibular Function (Issues of Physiology and Research Methods)), Tbilisi: AN Gruzinskoi SSR, 1958, p. 23.
Triumfov, A.V., Topicheskaya diagnostika zabolevanii nervnoi sistemy (Topic Diagnostics of the Nervous System Diseases), Moscow: MEDpress Inform, 2001.
Monti, M.M., Vanhaudenhuyse, A., Coleman, M.R., et al., Willful modulation of brain activity in disorders of consciousness, N. Engl. J. Med., 2010, vol. 362, no. 7, p. 579.
Cruse, D., Chennu, S., Chatelle, C. et al., Relationship between etiology and covert cognition in the minimally conscious state, Neurology, 2012, vol. 78, no. 11, p. 816.
Author information
Authors and Affiliations
Corresponding author
Additional information
Original Russian Text © A.G. Naryshkin, A.L. Gorelik, T.A. Skoromets, A.Yu. Egorov, A.V. Vtorov, I.V. Martynov, 2014, published in Fiziologiya Cheloveka, 2014, Vol. 40, No. 5, pp. 69–79.
Rights and permissions
About this article
Cite this article
Naryshkin, A.G., Gorelik, A.L., Skoromets, T.A. et al. The possibilities for partial rehabilitation of the integrative activity of the brain in patients in a vegetative state. Hum Physiol 40, 532–541 (2014). https://doi.org/10.1134/S0362119714030116
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1134/S0362119714030116