Coming out of a coma is determined by the energy of the brain

A simple test shows whether a patient will come out of a coma or not

Anatoly Alizar, Giktimes based on Cell Press materials: In brain-injured patients, a way to measure awareness or its impending return

Accurate diagnosis and prognosis of recovery of patients after serious brain damage is a difficult clinical task, since some patients retain a certain level of consciousness, although they do not respond to stimuli. Should I leave a relative in this state? Is there any chance of recovery?

A team of researchers from Denmark and Belgium has developed a test that answers this question. The test determines the current state of consciousness and allows you to make a fairly accurate forecast of whether the patient will come out of a coma within a year.

The state of consciousness is well diagnosed by conventional positron emission tomography using 18F-fluorodeoxyglucose (PET-FDG). Diagnostics shows the level of glucose metabolism in brain cells.

"In almost all cases, energy consumption in the entire brain directly predicts either the current level of consciousness or its subsequent recovery," says Ron Kupers from the University of Copenhagen and Yale University, one of the authors of the scientific paper. "In short, our work shows that there is a certain minimum energy level for consciousness to recover after brain damage."

The researchers set out to develop more reliable diagnostic markers for assessing current and future levels of consciousness in addition to standard clinical examinations. They measured and documented the level of brain glucose metabolism in 131 patients with complete or partial loss of consciousness.

The study showed that brain metabolism correlates well with the level of consciousness in patients.

Restoration of consciousness after a year in patients with different levels of metabolism:
in a vegetative state (UWS) and with minimal consciousness (MCS, EMCS).

The energy level of metabolism (42% of normal), which is critical, was determined. Practically no patient with a metabolism below this level regained consciousness within a year after the examination. On the other hand, 94% of patients with a metabolism above this energy level showed signs of consciousness during examination or began to respond to stimuli within a year after injury.

The discovery means that there is a clear energy level in the brain, below which irreversible changes occur, and the restoration of consciousness becomes impossible. The "magic" level of 42% can be compared to a spark that can ignite the flame of consciousness in a living brain.

But the most important thing is that the discovery gives hope to patients who are in a vegetative state (UWS on the graph). It turns out that even from such a state, the brain is able to recover if it retains a sufficiently high glucose metabolism.

The scientific work is published in the journal Current Biology (Stender et al., The Minimal Energetic Requirement of Sustained Awareness after Brain Injury).

Portal "Eternal youth" http://vechnayamolodost.ru  30.05.2016