AlphaGalileo Foundation, Université de Montréal, 17 September 2013
Researchers
from the University of Montreal and their colleagues have found brain activity
beyond a flat line EEG, which they have called Nu-complexes (from the Greek
letter n). According to existing scientific data, researchers and doctors had
established that beyond the so-called "flat line" (flat
electroencephalogram or EEG), there is nothing at all, no brain activity, no
possibility of life. This major discovery suggests that there is a whole new
frontier in animal and human brain functioning.
The
researchers observed a human patient in an extreme deep hypoxic coma under
powerful anti-epileptic medication that he had been required to take due to his
health issues. “Dr. Bogdan Florea from Romania contacted our research team
because he had observed unexplainable phenomena on the EEG of a coma patient.
We realized that there was cerebral activity, unknown until now, in the
patient’s brain,” says Dr. Florin Amzica, director of the study and professor
at the University of Montreal’s School of Dentistry.
Dr.
Amzica’s team then decided to recreate the patient’s state in cats, the
standard animal model for neurological studies. Using the anesthetic
isoflurane, they placed the cats in an extremely deep—but completely
reversible—coma. The cats passed the flat (isoelectric) EEG line, which is
associated with silence in the cortex (the governing part of the brain). The
team observed cerebral activity in 100% of the cats in deep coma, in the form
of oscillations generated in the hippocampus, the part of the brain responsible
for memory and learning processes. These oscillations, unknown until now, were
transmitted to the master part of the brain, the cortex. The researchers
concluded that the observed EEG waves, or Nu-complexes, were the same as those
observed in the human patient.
Dr. Amzica
stresses the importance of understanding the implications of these findings.
“Those who have decided to or have to 'unplug’ a near-brain-dead relative needn’t
worry or doubt their doctor. The current criteria for diagnosing brain death
are extremely stringent. Our finding may perhaps in the long term lead to a
redefinition of the criteria, but we are far from that. Moreover, this is not
the most important or useful aspect of our study,” Dr. Amzica said.
From
Nu-complexes to therapeutic comas
The most
useful aspect of this finding is the therapeutic potential, the
neuroprotection, of the extreme deep coma. After a major injury, some patients
are in such serious condition that doctors deliberately place them in an
artificial coma to protect their body and brain so they can recover. But Dr.
Amzica believes that the extreme deep coma experimented on the cats may be more
protective.
“Indeed, an
organ or muscle that remains inactive for a long time eventually atrophies. It
is plausible that the same applies to a brain kept for an extended period in a
state corresponding to a flat EEG," says Professor Amzica. “An inactive
brain coming out of a prolonged coma may be in worse shape than a brain that
has had minimal activity. Research on the effects of extreme deep coma during
which the hippocampus is active, through Nu-complexes. is absolutely vital for
the benefit of patients.”
“Another
implication of this finding is that we now have evidence that the brain is able
to survive a an extremely deep coma if the integrity of the nervous structures
is preserved,” said lead author of the study, Daniel Kroeger. “We also found
that the hippocampus can send 'orders’ to the brain's commander in chief, the
cortex. Finally, the possibility of studying the learning and memory processes
of the hippocampus during a state of coma will help further understanding of
them. In short, all sorts of avenues for basic research are now open to us.”
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