Unser Gehirn - Definitionen des Bewusstseins. Spontane Oszillationen & Gehirnaktivität. Zirkadiane Rhythmik im Wachkoma

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1 Unser Gehirn - Von Bewusstsein, Lernen und Erkrankungen Dr. Manuel Schabus Dr. Kerstin Hödlmoser MSc. Renata del Giudice Mag. Dominik Heib Mag. Julia Lechinger *Laboratory for Sleep, Cognition and Consciousness Research, Division of hysiological sychology, University of Salzburg + Centre for Cognitive Neuroscience Salzburg, Salzburg, Austria BSc. Adriana Michalak BSc. Tomasz Wielek Mag. Christine Blume BSc. Małgorzata Wisłowska Bsc. Daniel Körner Bsc. Maria-Teresa Gnjezda Definitionen des Bewusstseins NORMAL CONSCIOUSNESS SLEE MINIMALLY CONSCIOUS VEGETATIVE Spontane Oszillationen & Gehirnaktivität Zirkadiane Rhythmik im Wachkoma Informationsverabeitung in veränderten Bewusstseinszuständen Wachkoma Schlaf Babys - Behavioral assessment remains the gold standard to monitor level of consciousness in patients with DOC. - However, high rate of misdiagnosis for the vegetative state (VS) evident. COMA r M VEGETATIVE r M Regional decrements in frontoparietal association cortices. LOCKED-IN SYNDROME WAKEULNESS - Neuroscientific Evidence for Consciousness and DOC SLEE GENERAL ANESTHESIA C r r M M, prefrontal; M, mesiofrontal;, posterior parietal cortex; r, posterior cingulate/precuneus Baars, Ramsoy, Laureys Trends in Neurosiences 23 1

2 Spindle Activity (C3) Sleep spindles are related to fading of C but also learning Sleep architecture appears more complex in MCS than VS/UWS (Cologan, Schabus et al., 21; Cologan et al., 213) incl. spindles Attempt to develop individual and quantitative markers for diagnosis and prognosis. 132Ch Baby EEG Advantage: Resting state EEG is independent of the patient s will to cooperate and does not rely on specific abilities! ellinger, & Schabus, (211) Slow CONJUNCTION ast a e i D z = 6 z = 8 z = 6 Ab f j General Cognitive Ability ( g ) measured with Raven s Advanced rogressive Matrices (AM) ast (>13 Hz) AM Groups High Medium Low Bc d x = -6 g x = -4 h x = -36 x = -1 x = -6 x = -36 k l x = -1 E x = -2 x = 34 Control Night Learning Night Schabus, M. et al. (26). Sleep spindle-related activity in the human EEG and its relation to general cognitive and learning abilities. European Journal of Neuroscience, 23(7), Schabus, M., et al. (27). Hemodynamic cerebral correlates of sleep spindles during human non-rem sleep. roceedings of the National Academy of Sciences USA, 14(32),

3 Hippocampus recentral Gyrus Mesial refrontal Cortex Nishida & Walker, LoS One, ostcentral Gyrus Schabus et al., NAS, 27 Lower spindle activity relates to lower memory performance in Alzheimer s Disease (e.g., Schabus et al., 26; Rauchs et al., 28)! Even ipsilateral deviations after hemispheric strokes (e.g., Gottselig et al., 22) Wyatt et al. (1999) Bekinschtein et al. (29) Sequences of 8 equiprobable first names: the own name and 7 non-familiar first names Simon atrick Hector Helmut Helmut Manuel Lichtstimulation & Melatonin Gabe zur Schlaf Normalisierung Identifizierung von Arousal Windows errin, Schnakers, Schabus et al, Arch Neurol, 26 3

4 In DOC: In healthy SLEE: Antonym Satzparadigmen Das Gegenteil von X ist Y Stimulus-Material: Emotional-relevante Eigennamen bzw. Kinderreime In Newborns: 2 x Antonym aare (z.b. schwarz weiß) 2 x verwandte Wortpaare (z.b. schwarz ) 2 x nicht verwandte aare (z.b. schwarz nett) Schabus et al. (211) MCS- atienten verlieren sprachliche Vorhersage- unktionen? Results: Topographic ERS/ERD distribution during video observation (5-25ms) Schabus et al. (211) Lower alpha (8-1Hz) SMR (12-15Hz) Lechinger et al. (212) Theta band (video onset) L-Alpha band (video observation) L-Alpha band (imagination period) Tones / light NREM, A1 (red circles), thalamus (red dotted circles), brainstem (purple circles), cerebellum (purple dotted circle), posterior cingulate gyrus (green circles) and precuneus (green dotted circle). Y=-3 X=8 Tones / present SINDLES arahippocampal gyrus (blue circles) and brainstem (purple circle). No Thalamus or A1 activations! Y=-36 X=3 Z=2 Z=-28 Dang-Vu, Bonjean, Schabus et al., NAS, 211 4

5 Bekannter Reim und vor allem die vertraute Mutterstimme scheinen besondere Relevanz zu besitzen! Kritischer Blick auf das Bewusstsein Schlaf-Wach bei Gesunden Störungen des Bewusstseins nicht-sprachlichen Individuen EEG- Theta Antwort EEG- Alpha Antwort Wachkoma und deren Diagnose/rognose besser verstehen Eventuell sensiblere Detektion von minimalen Bewusstseinszeichen 5 V_R UV_R V_UR UV_UR -5-1 V_R UV_R V_UR UV_UR Am Ende geht es einfach darum den Kern dessen besser zu verstehen der uns menschlich macht Bewusstsein 5