Disorders of the spatiotemporal organization of the brains bioelectrical activity in patients with different depressions of consciousness after severe head injury


Klimash, A.V.; Tsitseroshin, M.N.; Shepovalnikov, A.N.; Zajceva, L.G.; Kondakov, E.N.; Borovikova, V.N.

Human Physiology 36(5): 535-549

2010


ISSN
0362-1197,
Human
Physiology,
2010,
Vol.
36,
No.
5,
pp.
535-549.
©
Pleiades
Publishing,
Inc.,
2010.
Original
Russian
Text
©
A.V
Iaimash,
M.N.
Thitseroshin,
A.N.
Shepovalnikov,
L.G.
Zajceva,
E.N.
Kondakov,
V.N.
Borovikova,
2010,
published
in
Fiziologijm
Cheloveka,
2010,
Vol.
36,
No.
5,
pp.
49-65.
Disorders
of
the
Spatiotemporal
Organization
of
the
Brain's
Bioelectrical
Activity
in
Patients
with
Different
Depressions
of
Consciousness
after
Severe
Head
Injury
A.
V.
Klimasha,
M.
N.
Tsitseroshinb,
A.
N.
Shepovalnikovb,
L.
G.
Zajcevab,
E.
N.
Kondakova,
and
V.
N.
Borovikovaa
a
Polenov
Russian
Neurosurgical
Research
Institute,
St.
Petersburg,
191104
Russia
b
Sechenov
Institute
of
Evolutionary
Physiology
and
Biochemistry,
Russian
Academy
of
Sciences,
St.
Petersburg,
194223
Russia
Received
February
28,
2010
Abstract—Specific
changes
in
the
bioelectrical
activity
of
the
brain
have
been
found
in
27
patients
with
dif-
ferent
levels
of
posttraumatic
consciousness
depression
(stupor,
spoor—coma
I,
coma
II)
by
the
methods
of
cross
correlation,
and
coherence
and
factor
EEG
analysis.
The
changes
in
activity
of
the
morphofunctional
systems
of
intracerebral
integrations
were
expressed
partly
in
a
decrease
in
the
nonspecific
activating
effects
from
brainstem
structures,
which
was
reflected
in
an
increase
in
the
slow
wave
activity
along
with
a
consider-
able
decrease
in
the
level
of
EEG
coherence
in
the
a
and
f3
ranges.
The
observed
depression
of
the
system's
organization
of
the
interrelations
of
the
bioelectrical
brain
activity
in
the
frontal
and
occipital
regions
of
both
hemispheres
could
be
due
to
a
decreased
activity
of
the
associative
systems
of
intercortical
and
thalamocor-
tical
integration.
The
results
suggest
a
certain
facilitation
of
the
activity
of
the
system
providing
direct
inter-
hemispheric
connections
through
the
corpus
calossum
and
other
commissural
tracts
of
the
telencephalon
as
a
consequence
of
the
depression
of
the
mesodiencephalon
structures
(which
normally
largely
contribute
to
the
synergistic
interhemispheric
interaction
via
synchronous
ascending
effects
on
the
cortex
of
both
hemi-
spheres).
This
results
in
steady,
reciprocal,
and
almost
antiphase
relations
of
slow
wave
activity
in
symmetrical
areas
of
the
hemispheres.
Key
words:
craniocerebral
injury,
depression
of
consciousness,
spatiotemporal
organization
of
the
bioelectri-
cal
activity
of
the
brain,
system-defined
brain
activity,
methods
of
cross
correlation,
coherence
and
factor
EEG
analysis.
DOI:
10.1134/SO362119710050051
The
analysis
of
clinical
and
physiological
observa-
tions,
in
particular,
the
data
on
the
level
of
depression
of
consciousness
depending
on
the
level
of
the
involvement
of
brain
structures
in
the
rostral—caudal
direction
in
the
dislocation
process,
is
rightfully
considered
to
be
an
effi-
cient
methodical
approach
for
studying
the
nature
of
consciousness.
Severe
craniocerebral
injury
(CCI)
is
accompanied
by
various
manifestations
of
neurological
dysfunctions,
impairment
of
vital
functions
and,
as
a
rule,
significant
electroencephalographic
(EEG)
changes.
One
of
the
cri-
teria
of
brain
function
deficit
after
CCI
is
the
disorder
of
the
system-defined
organization
of
intercortical
interre-
lations
resulting
in
structural
changes
in
the
brain's
bio-
electric
potential
field
[1-3].
The
EEG
study
of
patients
with
severe
CCI
has
shown
that
the
greatest
changes
in
the
spatial
organization
of
interregional
relations
between
the
brain's
bioelectric
potentials
are
observed
under
the
pathological
involvement
of
the
structures
responsible
for
the
regulation
of
wakefulness
and
con-
sciousness,
especially,
the
diencephalic
and
brainstem
parts
[4-6].
Complex
analysis
of
secondary
EEG
parameters
of
CNS
activity
under
normal
and
pathological
conditions
made
it
possible
to
determine
more
accurately
the
mech-
anisms
of
appearance
of
inter-central
disorders
and
showed
that
the
level
of
interhemispheric
EEG
coher-
ence
in
symmetrical
zones
of
the
cortex
reflects
mainly
the
state
of
diencephalic
and
midbrain
structures,
while
the
changes
in
EEG
coherence
within
the
hemispheres
reflect
the
peculiarities
of
intercortical
and
cortical—sub-
cortical
relations
[7-10].
The
main
objective
of
our
research
was
to
gain
a
deeper
insight
into
the
specific
characteristics
of
disor-
ders
of
the
activity
of
integrative
brain
systems
providing
the
processes
of
intercortical
and
cortical
—subcortical
interactions
in
patients
with
different
levels
of
depression
of
consciousness
as
a
result
of
posttraumatic
supratento-
rial
brain
compression
by
intracranial
hematomas
and
brain
lesion
foci.
535
536
KLIMASH
et
al.
METHODS
The
disorders
of
the
spatiotemporal
organization
of
interregional
relations
between
brain
cortex
bioelectric
potentials
were
analyzed
in
27
patients
(2
women
and
25
men),
19
to
52
years
old
(the
mean
age
was
34
years),
with
different
levels
of
posttraumatic
consciousness
depression
as
a
result
of
severe
CCI.
All
patients
under-
went
standard
clinical
neurological
examination,
includ-
ing
estimation
of
the
changes
in
consciousness,
brain-
stem
reflexes,
and
vital
functions
[11].
The
changes
in
the
level
of
consciousness
in
the
states
of
stupor,
spoor,
coma
I,
and
coma
II
were
estimated
using
the
criteria
accepted
in
1982
by
the
All-Union
Problem
Commission,
which
are
obligatory
in
the
Rus-
sian
Federation
[11].
The
computer
X-ray
tomography
of
the
brain
diag-
nosed
a
right-side
brain
compression
in
11
out
of
27
patients
and
left-side
brain
compression
in
another
16
patients.
Twenty
patients
underwent
EEG
examina-
tion
on
day
3-5
after
surgery.
In
the
seven
patients
having
no
indications
for
surgery,
the
EEG
was
recorded
within
2-5
days
after
the
moment
of
admission
to
hospital.
Some
of
the
patients
underwent
repeated
EEG
record-
ing,
especially
in
the
cases
of
stupor
and
spoor.
The
con-
trol
group
("norm")
of
16
clinically
healthy
volunteers,
20
to
50
years
old
(11
males
and
5
females),
had
an
EEG
examination
by
analogous
methods
of
recording
and
multiparametric
data
processing.
The
EEG
was
recorded
in
a
lying
position
with
the
eyes
closed
by
means
of
a
24-channel
EEG
computer
analyzer
(Brain
Dynamics
Analyzer)
with
a
0.5-30
Hz
bandwidth
at
a
sampling
rate
of
185
per
second
by
each
channel.
Twenty
monopolar
derivations
were
used.
Six-
teen
of
them
were
placed
in
accordance
with
the
Interna-
tional
10-20
System
symmetrically
in
the
prefrontal
(FA,
Fp
2
),
postfrontal
(F
3
,
F
4
),
inferior
frontal
(F
7
,
F
8
),
central
(C
3
,
C
4
),
central—temporal
(T
3
,
T
4
),
posterotem-
poral
(T
5
,
T
6
),
parietal
(P
3
,
P
4
),
and
occipital
(0
k
,
0
2
)
areas.
The
remaining
four
electrodes
were
placed
in
pairs
in
the
anteriotemporal
regions
of
each
hemisphere
(T
1
,
T
2
)
and
in
the
TPO
zones
(
TP
1
,
TP
2
).
Linked
earlobe
electrodes
were
used
as
the
reference.
The
examination
lasted
for
15
min
on
average.
The
results
of
multichannel
EEG
recording
were
pro-
cessed
by
cross
correlation
(CC
EEG)
and
coherence
(Coh
EEG)
analyses.
During
the
entire
examination,
the
matrices
(20
x
20)
of
CC
EEG
from
all
derivations
in
pairs
and
the
coherence
matrices
(20
x
20)
of
Coh
EEG
were
calculated
every
4
s
from
the
background
EEG
record
("epoch
analysis")
in
each
of
the
major
frequency
ranges
of
the
EEG
oscillations:
A,
0.5-3.5
Hz;
0,
4.0-
7.5
Hz;
a,
8.0-12.5
Hz;
and
13,
13.0-30.0
Hz.
Thus,
five
matrices
were
calculated
for
each
of
the
subsequent
epochs
of
EEG
analysis:
one
matrix
of
cross
correlation
and
four
matrices
of
Coh
EEG.
Using
these
algorithms,
30
to
60
epochs
of
EEG
analysis
were
processed
for
each
subject.
The
element-by-element
values
of
the
recorded
cor-
relation
matrices
of
multichannel
EEG
were
averaged
both
within
the
studied
functional
state
for
each
subject
and
within
the
groups
of
subjects
selected
by
the
level
of
consciousness
depression
with
the
calculation
of
the
mean
values,
CC
and
Coh
EEG
dispersion.
The
intervals
of
significance
of
the
mean
CC
and
Coh
EEG
values
were
determined
by
Student's
criterion
at
p
<
0.05.
Fisher's
z
transformation
was
used
in
all
operations
with
correlation
and
coherence
coefficients.
The
changes
in
the
spatial
organization
of
distant
EEG
relations
in
patients
from
different
groups
relative
to
the
data
from
the
group
of
clinically
healthy
subjects
(the
control)
were
estimated
by
subtraction
from
the
numerical
values
of
each
cell
in
the
middle
CC
and
Coh
EEG
matrices,
averaged
in
the
group
of
examined
patients,
and
of
the
respective
numerical
values
of
ele-
ments
of
the
matrices
averaged
in
the
groups
of
healthy
subjects.
Thus,
the
difference
CC
and
Coh
EEG
matri-
ces
were
formed,
and
their
elements
reflected
the
pecu-
liarities
of
disorders
in
the
spatial
EEG
organization
in
patients
with
different
levels
of
depression
of
conscious-
ness.
For
the
construction
of
equipotential
mappings
of
the
changes
in
the
distant
interaction
ofbioelectric
potentials
in
each
EEG
derivation,
the
CC
EEG
values
were
aver-
aged
in
individual
columns
(corresponding
to
different
derivations)
of
the
difference
matrices
(characterizing
the
peculiarities
of
disorders
in
the
spatial
EEG
organiza-
tion
in
patients
compared
to
the
control
data),
with
allowance
for
the
sign
of
CC
EEG
changes.
Thus,
the
mean
value
(for
all
19
connections
of
the
given
cortical
zone
with
other
zones)
of
changes
in
the
distant
EEG
interaction
in
patients
of
each
group
relative
to
the
results
obtained
in
healthy
subjects
was
determined.
The
averaged
CC
EEG
matrices
in
each
group
were
processed
by
factor
analysis
(using
the
modified
centroid
algorithm)
[12,
13].
The
quantity
of
general
factors
and
their
contributions
to
factor
dispersion
were
estimated,
and
the
loads
of
the
respective
EEG
on
each
factor
were
calculated.
In
terms
of
factor
analysis,
multichannel
EEG
can
be
presented
as
an
array
of
radius
vectors,
with
the
cosine
of
the
angle
between
two
vectors
being
proportional
to
the
coefficient
of
correlation
between
the
respective
EEG;
thus,
the
closer
the
EEG
vectors
in
the
factor
space,
the
higher
the
statistical
similarity
of
EEG
processes.
The
reflection
of
EEG
radius
vectors
in
the
multidimensional
factor
space
was
a
basis
for
constructing
the
patterns
of
projections
of
radius
vectors
(corresponding
to
20
EEG
derivations)
on
the
surface
of
factors
I—III,
as
well
as
fac-
tors
II—III.
This
construction
provided
efficient
visual-
ization
of
the
whole
array
of
system-defined
interactions
of
activities
of
different
areas
of
the
cerebral
cortex
(based
on
the
cross
correlation
analysis
of
multichannel
EEG)
and
estimation
of
the
degree
of
contribution
of
the
main
integrative
brain
systems
to
the
spatiotemporal
organiza-
tion
of
cortical
activity
[13-16].
HUMAN
PHYSIOLOGY
Vol.
36
No.
5
2010
DISORDERS
OF
THE
SPATIOTEMPORAL
ORGANIZATION
537
RESULTS
According
to
clinical
estimates,
all
patients
with
supratentorial
brain
compression
as
a
result
of
severe
CCI
were
divided
into
three
groups
depending
on
the
level
of
depression
of
consciousness,
and
the
presence
and
inten-
sity
of
disorders
in
brainstem
reflexes
and
vital
functions.
The
first
group
(Stupor)
included
nine
patients
with
initial
stages
of
the
depression
of
consciousness:
moder-
ate
and
deep
stupor
(five
and
four
patients,
respectively).
The
brainstem
reflexes
and
vital
functions
in
these
patients
were
intact.
Mostly
left-side
location
of
brain
contusion
foci
and/or
intracranial
(epidural
and
subdu-
ral)
hematomas
was
diagnosed
in
six
patients;
the
other
three
patients
had
right-side
location.
Thus,
the
left-side
cortical—subcortical
brain
injuries
were
dominant
in
the
Stupor
group.
It
should
be
noted
that
contusion
foci
in
the
frontal
areas
were
verified
in
six
out
of
nine
patients
of
this
group.
The
Spoor—Coma
I
group
included
nine
patients
with
more
pronounced
depression
of
consciousness:
spoor
(n
=
4)
and
coma
I
(n
=
5).
In
all
subjects
of
this
group,
the
changes
in
brainstem
reflexes
were
minimal
and
represented
mainly
upward
gaze
palsy
and
slight
sup-
pression
of
photoreactions.
The
vital
functions
in
all
patients
were
compensated.
The
left-
and
right-side
loca-
tion
of
intracranial
(epidural
and
subdural)
hematomas
and/or
brain
lesion
foci
(cortical—subcortical
location)
was
revealed
in
six
and
three
patients,
respectively.
Thus,
left-side
brain
injuries
were
prevalent
in
the
Spoor—
Coma
I
group,
as
in
the
Stupor
group.
Isolated
crushing
foci
of
the
frontal
areas
with
unilateral
location
were
ver-
ified
only
in
two
patients
of
this
group.
An
EEG
exami-
nation
of
all
patients
was
carried
out
after
cranioactomy
on
the
side
of
brain
compression
and
pathological
sub-
strate
removal.
The
Coma
II
group
included
nine
patients
with
pro-
nounced
depression
of
consciousness,
coma
II.
Subjects
of
this
group
were
shown
to
have
coarse
disorders
of
brainstem
reflexes
(absence
of
photoreactions,
different
levels
of
depression
of
corneal
reflexes,
decerebrate
movements
in
response
to
pain
stimulus)
and
instability
of
vital
functions.
The
right-side,
left-side,
and
bilateral
location
of
intracranial
(epidural
and
subdural)
hemato-
mas
and/or
brain
lesion
foci
(of
cortical—subcortical
location)
in
this
group
occurred
in
five,
three,
and
one
patient,
respectively.
Thus,
subjects
with
right-side
brain
injury
were
prevalent
in
this
group.
The
crushing
foci
in
the
frontal
areas
were
verified
in
three
cases
only.
The
EEG
examination
of
all
patients
was
performed
after
decompression
cranioactomy
on
the
side
of
brain
com-
pression.
The
analysis
of
EEG
results
showed
that
patients
with
different
intensities
of
the
clinical
signs
of
supratentorial
brain
compression
exhibited
the
changes
in
spatial
orga-
nization
of
interregional
EEG
relations
typical
of
each
of
the
three
isolated
groups.
Patients
of
the
Stupor
group
showed
considerable
changes
in
the
interregional
interactions
of
the
bioelec-
trical
activity
of
both
cerebral
hemispheres
compared
to
the
control.
As
one
can
see
from
the
mapping
of
differ-
ences
from
the
norm
(Fig.
1,
Stupor),
the
decreasing
in
the
values
of
the
EEG
correlations
was
the
most
marked
in
the
temporal
areas
of
both
hemispheres,
particularly
on
the
left,
while
their
increasing
compared
to
the
norm
was
the
most
marked
in
the
frontal
and
occipital
areas
of
the
brain.
The
lowering
of
interregional
interactions
between
cortical
potentials
in
these
patients
was
recorded
mostly
for
the
postero-
(T
5
,
T
6
),
mid-
(T
3
,
T
4
),
and
anterotem-
poral
(T
1
,
T
2
)
areas
of
the
temporal
parts
of
both
hemi-
spheres
and
(to
a
lesser
degree)
for
the
inferior
frontal
areas
(F
7
,
F
8
).
At
the
same
time,
as
follows
from
the
data
presented
on
the
scheme
of
changes
in
the
EEG
correla-
tions
(Fig.
2,
CC
EEG),
the
antero-
and
mid-temporal
and
inferior
frontal
EEG
derivations
of
both
hemi-
spheres
were
characterized
mainly
by
the
reduction
of
ipsilateral
(relatively
short)
EEG
relations,
while
the
pos-
terotemporal
and
parietal
derivations
were
characterized
by
the
reduction
of
interhemispheric
EEG
relations.
The
maximum
decreases
in
the
CC
EEG
values
compared
to
the
control
values
of
—0.29
attained
on
average
in
patients
of
the
Stupor
group.
Note
that
the
scheme
of
changes
in
distant
EEG
relations
(Fig.
2,
CC
EEG)
presents
only
significant
changes
at
p
<
0.001.
In
turn,
the
exceeding
of
the
normal
level
of
interre-
gional
interactions
between
the
cortical
areas
in
patients
of
this
group
was
typical
of
the
long
longitudinal
(intra-
and
inter-hemispheric)
EEG
relations
of
the
anterior
and
posterior
cortical
areas
of
both
hemispheres
(Fig.
2,
CC
EEG).
These
were
mainly
the
connections
between
the
activities
of
pre-
and
postfrontal
areas
and
the
activity
of
parietal
and
occipital
areas
of
both
hemispheres
and
TFO
zones.
The
maximum
excesses
of
CC
EEG
values
compared
to
the
control
reached
0.23.
In
patients
of
the
Spoor—Coma
I
group,
the
maxi-
mum
level
of
changes
in
the
interregional
interactions
of
cortical
areas
was
much
higher
than
in
the
Stupor
group:
CC
EEG
changes
reached
(compared
to
the
norm)
±0.43
(p
<
0.05).
The
topography
of
disorders
in
the
spa-
tial
structure
of
interregional
interactions
also
consider-
ably
differed
from
that
typical
of
the
patients
from
the
Stupor
group
(Fig.
1,
Spoor—Coma
I).
In
comparison
with
the
control,
patients
of
the
Spoor—Coma
I
group
showed
a
decrease
in
distant
EEG
relations
for
the
fron-
tal,
central,
and
temporal
areas
of
both
hemispheres,
which
was
especially
evident
on
the
right
(Fig.
1).
As
one
can
see
from
the
scheme
of
changes
in
distant
EEG
rela-
tions
(Fig.
2,
CC
EEG),
the
level
of
interhemispheric
EEG
relations
decreased
mainly
in
the
above
(particu-
larly
frontal)
areas.
Along
with
the
decrease
in
the
level
of
EEG
correla-
tions
in
patients
from
the
Spoor—Coma
I
group,
the
nor-
mal
reference
level
of
EEG
relations
was
exceeded
mainly
in
the
posterior
parts
of
the
hemispheres,
mostly
the
left
one
(Fig.
1,
Spoor—Coma
I).
At
the
same
time,
intensification
of
intrahemispheric
EEG
relations
was
shown
mostly
in
the
left
hemisphere
(Fig.
2,
Spoor—
HUMAN
PHYSIOLOGY
Vol.
36
No.
5
2010
Spoor-coma
I
LD`
538
KLIMASH
et
al.
(a)
Stupor
I,
II
+0.2
0
O
LI
LI
LI
I I
61
CI
0.2
Fp
1
Fp
2
F
3
F
4
F
7
F
8
C
3
C
4
T
1
T
2
T
3
T
4
P
3
P
4
T
5
T6
Tp
1
Tp
2
0
1
0
2
(b)
Fp
1
Fp
2
F
3
F
4
F
7
F
8
C
3
C
4
T
1
T
2
T
3
T
4
P
3
P
4
T
5
T
6
Tp
1
Tp
2
0
1
0
2
Coma
II
Fp
2
F
3
F
4
F
7
F
8
C
3
C
4
T
1
T
2
T
3
T
4
P
3
P
4
T
5
T6
Tp
1
Tp
2
01
02
+0.2
0
0.2
+0.2
0
0.2
n
F
7
F
3
T
1
T3
T
5
P
3
TP0
1
0
1
F
8
F
4
T
2
P4
TP0
2
0
2
(d)
(c)
Fp1
Fp
2
C3
C4
0.20
0.15
0.10
0.05
0
0.05
0.10
0.15
0.20
Fig.
1.
Changes
in
the
spatial
organization
of
the
brain
bioelectric
potential
field
in
patients
with
different
levels
of
depression
of
con-
sciousness
as
a
result
of
craniocerebral
injury
(Stupor
I,
II;
Spoor-coma
I;
Coma
II).
(a)
Diagrams
of
the
average
(relative
to
the
given
derivation)
differences
from
the
normative
value
of
EEG
cross
correlations
(CC
EEG)
calcill
ted
for
20
monopolar
derivations.
Gray
and
black
upward
columns
show
the
increase
and
decrease
in
CC
EEG,
respectively.
Vertical:
levels
of
the
average
differences
from
the
norm
of
CC
EEG
values
of
each
derivation
with
EEG
of
19
other
derivations.
Horizontal:
designations
of
EEG
derivations
are
in
accor-
dance
with
the
scheme
(Fig.
lc);
(b)
mappings
constructed
by
the
data
from
the
respective
diagrams
(Fig.
la).
The
mappings
represent
the
average
changes
in
the
levels
of
EEG
cross
correlation
under
depression
of
consciousness
compared
to
the
norm
(according
to
the
gradation
scale,
Fig.
1d).
HUMAN
PHYSIOLOGY
Vol.
36
No.
5
2010
DISORDERS
OF
THE
SPATIOTEMPORAL
ORGANIZATION
539
Coma
I,
CC
EEG),
which
was
particularly
typical
of
EEG
relations
of
occipital
areas
and
TFO
zones
with
the
activity
of
frontal
and
temporal
areas.
In
the
right
hemi-
sphere,
the
intensification
of
EEG
relations
was
much
less
generalized
and
limited
mainly
by
the
increase
in
EEG
relations
of
the
occipital
area
(with
the
predomi-
nant
intensification
of
interhemispheric
interactions)
and
the
TFO
zone,
where
mainly
intensification
of
intra-
hemispheric
interactions
with
the
frontal
areas
was
noted.
As
follows
from
these
data,
the
patients
with
depression
of
consciousness
to
the
level
of
spoor
and
coma
I
have
joint
disorders
of
distant
EEG
relations
with
a
significant
decrease
in
interhemispheric
interactions,
particularly
of
the
frontal,
central,
and
temporal
parts
of
both
hemispheres,
but
with
the
long
longitudinal
intra-
hemispheric
EEG
relations
in
excess
of
the
normal
level
mainly
in
the
left
hemisphere.
The
Coma
II
patients
showed
both
similarities
and
certain
differences
in
the
intensity
and
topology
of
changes
in
the
spatiotemporal
organization
of
EEG,
compared
to
the
changes
revealed
in
the
Spoor—Coma
I
group.
As
in
the
Spoor—Coma
I
group,
the
decrease
in
distant
EEG
relations
in
the
Coma
II
group
compared
to
the
control
was
typical
of
the
frontal,
central,
and
tempo-
ral
parts
of
both
hemispheres.
However,
the
range
of
maximum
reduction
of
distant
EEG
relations,
in
con-
trast
to
Spoor—Coma
I
group,
was
shifted
to
the
left
hemisphere
(Fig.
1,
Coma
II).
At
the
same
time,
the
dis-
orders
of
distant
interactions
in
patients
of
the
Coma
II
group,
as
in
the
Spoor—Coma
I
group,
were
most
evident
for
the
interhemispheric
connections
of
the
frontal
areas
(Fig.
2,
CC
EEG).
The
level
of
changes
in
the
interre-
gional
interactions
of
cortical
areas
compared
to
the
ref-
erence
data
(at
p
<
0.001)
was
the
highest
in
Coma
II
patients
from
among
all
three
groups:
the
changes
in
CC
EEG
reached
±0.45.
It
should
also
be
noted
that
the
decrease
in
interhemispheric
interactions
between
the
posterior
parts
of
the
hemispheres,
especially
the
TFO
zones,
in
the
Coma
II
group
(Fig.
2)
was
somewhat
more
pronounced
than
in
patients
of
the
Spoor—Coma
I
group.
Exceeding
the
normative
level
of
EEG
correlations
in
the
Coma
II
patients,
as
in
the
Spoor—Coma
I
patients,
was
typical
in
general
of
the
long
longitudinal,
mostly
intrahemispheric
EEG
relations
between
the
posterior
and
anterior
cortical
areas
of
both
hemispheres
(Fig.
2,
CC
EEG).
However,
Coma
II
patients
showed
more
intense
intrahemispheric
EEG
relations
of
the
right
hemisphere
but not
of
the
left
one,
as
occurred
in
the
Spoor—coma
I
patients.
The
structure
of
topographic
changes
in
the
EEG
relations
in
the
left
hemisphere
of
Coma
II
patients
was
similar
to
the
changes
in
the
right
hemisphere
of
Spoor-Coma
I
patients;
however,
besides
the
intensification
of
the
EEG
relations
of
the
occipital
area
and
the
TFO
zone,
Coma
II
patients
also
showed
an
intensification
of
intrahemispheric
interactions
between
the
lower
frontal,
and
middle-
and
posterotemporal
areas.
Thus,
patients
with
deep
depression
of
consciousness
to
the
coma
II
level,
as
patients
in
a
spoor
and
in
coma
I,
exhibited
differently
directed
changes
in
the
interregional
interactions
between
different
cortical
areas,
which
were
expressed
both
by
a
marked
decrease
in
distant
EEG
relations
(particularly
interhemispheric)
and
significant
excess
of
the
normative
level
of
interactions
of
the
ante-
rior
and
posterior
cortical
areas,
predominantly
within
each
hemisphere.
These
changes
in
the
organization
of
the
system-defined
interaction
of
cortical
areas
are
most
pronounced
and
characterized
by
the
almost
mirror
sym-
metry
of
lateralization
of
the
maximum
changes
com-
pared
to
the
data
for
patients
in
a
spoor
and
in
coma
I
under
a
decrease
and
increase
in
interregional
interac-
tions
relative
to
the
control.
The
results
of
EEG
coherence
analysis
provide
a
more
complete
and
comprehensive
estimation
of
the
changes
in
the
interregional
relations
of
cortical
areas
observed
in
different
frequency
bands
of
EEG
oscilla-
tions
in
patients
with
different
levels
of
depression
of
con-
sciousness
(Fig.
2).
It
is
worth
mentioning
that
the
changes
in
the
spatial
structure
of
interregional
EEG
relations
in
different
fre-
quency
bands
in
the
states
of
stupor,
spoor—coma
I,
and
coma
II
in
many
respects
coincide
with
the
changes
described
above
based
on
the
consideration
of
disorders
in
the
total
EEG
correlations
(i.e.,
containing
fluctua-
tions
of
the
potentials
of
all
major
frequency
bands).
The
initial
stages
of
consciousness
depression
(Fig.
2,
Stupor
I,
II)
are
characterized
by
a
weakening
of
the
intrahemispheric
(relatively
short)
coherent
EEG
rela-
tions
of
the
temporal
and
inferior
frontal
areas
with
the
central,
parietal,
and
postfrontal
areas
manifesting
itself
most
markedly
within
the
left
hemisphere
in
all
fre-
quency
bands.
The
weakening
of
interhemispheric
EEG
relations
between
the
prefrontal
areas
was
also
observed
in
all
frequency
ranges,
and
the
weakening
of
the
level
of
EEG
coherence
of
bilateral—symmetrical
parietal
areas
between
each
other
and
with
the
posterotemporal
areas
of
both
hemispheres
is
observed
in
the
a,
0
and
A
fre-
quency
bands
(Fig.
2).
Along
with
a
reduction
of
the
dis-
tant
connections
of
EEG
oscillations
in
different
fre-
quency
bands
in
a
stupor,
coherent
relations
of
cortical
bioelectric
potential
fluctuations,
mostly
EEG
relations
of
areas
of
the
right
hemisphere,
also
intensify
compared
to
the
background,
particularly
in
the
13
band.
In
this
fre-
quency
band,
the
level
of
EEG
coherent
connections
exceeding
the
normal
one
was
particularly
typical
of
con-
nections
between
the
activity
of
the
antero-
and
mid-
temporal,
central,
and
parietal
areas
and
the
TFO
zone
of
the
right
hemisphere
with
the
activity
of
prefrontal
and
postfrontal
areas
of
both
hemispheres.
Patients
of
the
Spoor—Coma
I
group
exhibited
in
all
four
frequency
bands
(especially
the
a
band)
a
consider-
able
decrease
in
the
Coh
level
between
the
EEG
of
the
frontal
areas
of
both
hemispheres:
between
both
bilat-
eral—symmetrical
and
nonsymmetrical
areas
of
the
fron-
tal
lobes
(Fig.
2).
Besides,
the
interhemispheric
EEG
relations
decrease
in
the
a,
0,
and
A
frequency
bands
not
HUMAN
PHYSIOLOGY
Vol.
36
No.
5
2010
CC
EEG
1
...-
-
N.
F
2
p
t
8
F3
d
3
6
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pl
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I,
II
a
7,....
1'
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I
4
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TP2
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I
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PI
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T3
4
T
4
T
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6
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II
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TI
4
T
P
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T
6
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0
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0.26
0.30
0.31
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-
DISORDERS
OF
THE
SPATIOTEMPORAL
ORGANIZATION
541
only
between
the
anterior,
posterior,
and
inferior
frontal
cortical
areas
but
also
between
the
central
and
anterotemporal
areas
of
the
hemispheres.
A
certain
weakening
of
bilateral
connections
is
also
observed
in
other
areas
of
the
brain
between
the
posterotemporal
and
parietal
areas
and
the
TFO
zones,
particularly
in
the
A
and
0
frequency
bands
of
EEG.
This
group
of
patients
shows
a
noticeable
intensification
of
coherent
EEG
rela-
tions,
mainly
the
intrahemispheric
connections
of
activ-
ity
between
the
posterior
and
anterior
areas
of
the
hemi-
spheres,
more
marked
in
the
slow-wave
frequency
ranges
(especially
the
0
band)
in
the
left
hemisphere.
The
most
pronounced
changes
in
the
spatial
organi-
zation
of
interregional
connections
by
the
Coh
EEG
data
were
revealed
in
patients
of
the
Coma
II
group.
Along
with
certain
similarities
in
topology
and
degree
of
mani-
festation
with
the
changes
described
above
for
the
Spoor—Coma
I
patients,
the
decrease
in
interhemi-
spheric
EEG
relations
of
both
anterior
and
posterior
cor-
tical
areas
during
coma
II
was
more
typical
of
the
a
band
(Fig.
2).
It
is
important
to
emphasize
the
differences
revealed
in
patients
of
this
group
in
the
topography
of
the
spatial
structure
of
increasing
coherent
EEG
relations,
particularly
in
the
slow-wave
frequency
bands.
In
the
A
and
0
bands,
coma
II
patients
clearly
show
a
generalized
intensification
of
interhemispheric
"direct"
and
"diago-
nal"
EEG
relations
between
the
inferior
frontal
and
tem-
poral
areas
of
the
left
and
right
hemispheres,
being
weakly
expressed
in
patients
with
spoor
and
coma
I.
For
the
coma
II
patients,
one
should
also
note
the
intensifica-
tion,
in
all
EEG
frequency
ranges,
of
the
intra-
and
inter-
hemispheric
coherent
EEG
relations
of
the
occipital
areas
and
TFO
zones
with
the
anterior
areas
of
both
hemispheres
typical
of
patients
of
the
Spoor—Coma
I
group;
however,
a
greater
intensification
of
these
connec-
tions
in
the
right
hemisphere
is
observed
in
the
case
of
coma
II.
A
comparison
of
the
most
informative
data
character-
izing
Coh
EEG
changes
at
different
levels
of
depression
of
consciousness
(from
stupor
to
coma
II),
it
would
be
reasonable
to
suggest
that
each
of
the
studied
EEG
fre-
quency
ranges
exhibits
significant
peculiarities.
At
the
same
time,
it
should
be
emphasized
that
coma
II
patients
show
the
greatest
decrease
in
the
level
of
coherence
of
a
oscillations,
i.e.,
oscillations
of
the
basic
healthy
(nor-
mal)
human
EEG
rhythm.
The
excessive
normative
Coh
EEG
level
was
also
more
typical
of
coma
II
patients;
however,
this
pathological
excess
of
interregional
interac-
tions
was
especially
represented
in
the
slow-wave
fre-
quency
range:
the
0
and
A
bands.
Thus,
analysis
of
the
results
of
the
correlation
and
coherence
EEG
analysis
in
patients
with
different
levels
of
consciousness
depression
reveals
significant
disorders
in
the
spatiotemporal
organization
of
bioelectrical
brain
activity,
which
may
be
similar
for
patients
of
all
three
groups
or
have
certain
peculiarities,
with
the
maximum
manifestation
of
changes
in
the
comatose
state.
For
more
complete
assessment
of
disorders
in
the
activity
of
the
brain
as
an
integral
formation
in
patients
with
different
levels
of
brain
structure
lesion
and
depres-
sion
of
consciousness,
we
have
performed
the
factor
analysis
of
EEG
data
with
representation
of
EEG
pro-
cesses
as
an
array
of
radius
vectors
in
the
multidimen-
sional
factor
space
(Fig.
3).
Normally,
the
spatially
organized
structure
of
the
brain's
bioelectric
potential
field
during
vector
represen-
tation
of
multichannel
EEG
in
the
three-dimensional
space
of
common
factors
(I,
II,
and
III)
largely
reflects
the
ability
of
the
brain
to
stably
maintain
the
system
of
basal
intercentral
relations
serving
as
a
background
for
rapid
function-specific
processes
and
reactions
[15,
17,
18].
These
system-defined factors
that
are
common
for
all
EEG
derivations
make
it
possible
to
judge
the
effect
of
the
principal
integrative
brain
systems
on
the
distant
orga-
nization
of
bioelectrical
activity
of
cortical
areas
[15].
As
one
can
see
from
Fig.
3,
the
subjects
from
the
con-
trol
group
show
a
rather
strict,
spatially
ordered
structure
of
the
interregional
relationship
between
the
cortical
bio-
electric
potentials
of
both
hemispheres
typical
of
clini-
cally
healthy
people,
described
previously
in
some
of
our
studies
[13-15,
18-20].
Each
of
the
radius
vectors
corre-
sponding
to
separate
EEG
processes
is
not
located
chaot-
ically
but
takes
its
own
strictly
specified
place
in
the
factor
space
determined
by
the
organization
of
the
system-
defined
interactions
between
oscillations
of
bioelectric
potentials
of
the
given
cortical
area
and
bioelectrical
activity
of
other
areas.
Normally,
the
representation
of
EEG
processes
as
radius
vectors
has
considerable
topo-
logical
similarity
with
the
scalp
location
of
electrodes,
which
holds
true
for
the
subjects
of
the
given
control
group
(Fig.
3,
Norm,
projections
onto
the
plane
of
fac-
tors
II
and
III).
Patients
with
different
levels
of
consciousness
depres-
sion
show
a
significant
dysfunction
of
the
morphofunc-
tional
systems
of
intracerebral
integration
responsible
for
the
organization
of
ordered
interactions
between
differ-
ent
cortical
areas
of
both
hemispheres
and
cortical—sub-
cortical
interrelations.
This
is
reflected
in
the
three-
dimensional
factor
space
in
the
peculiarities
of
disorders
in
the
normal
distribution
of
EEG
radius
vectors
relative
to
the
axes
of
this
space:
system-defined
factors
I,
II,
and
III
(Fig.
3).
One
should
also
note
the
decrease
in
the
level
of
distant
EEG
relations
of
the
inferior
frontal
and
tem-
poral
areas
of
both
hemispheres
with
the
EEG
of
other
Fig.
2.
The
change
in
the
interregional
interactions
ofbioelectrical
activity
of
different
cortical
areas
ofthe
brain
in
patients
with
different
levels
of
depression
of
consciousness
(Stupor
I,
II;
Spoor-Coma
I;
Coma
II).
On
the
left
CC
EEG,
the
schemes
of
changes
in
the
spatial
structure
of
EEG
cross-correlations.
On
the
right:
the
schemes
of
changes
in
coherent
connections
of
bioelectric
potential
fluctuations
in
the
major
EEG
frequency
ranges
(A,
0,
a,
(3).
The
schemes
represent
significant
changes
in
EEG
cross
correlations
and
coherent
connections
compared
to
the
data
in
the
control
group,
p
<
0.05.
The
increase
and
decrease
in
the
level
of
these
connections
are
shown
by
the
gray
and
black
lines,
respectively,
according
to
the
scale
in
the
lower
part
of
the
figure.
HUMAN
PHYSIOLOGY
Vol.
36
No.
5
2010
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I
Norm
Stupor
I, II
Spoor-coma
I
coma
II
DISORDERS
OF
THE
SPATIOTEMPORAL
ORGANIZATION
543
cortical
areas,
which
is
reflected
on
the
plane
of
factor
I
and
II
in
a
considerable
deviation
of
the
respective
EEG
radius
vectors
from
the
axis
of
factor
I.
It
should
be
emphasized
that
the
topography
and
intensity
of
disorders
in
the
spatial
organization
of
the
system-defined
interaction
between
different
cortical
areas
of
the
right
or
left
hemisphere
are
maximally
man-
ifested
when
patients
are
divided
into
two
subgroups
in
each
of
the
groups
under
study,
depending
on
the
lateral-
ization
of
traumatic
brain
injury.
In
this
context,
Fig.
3
presents
the
results
of
the
factor
analysis
of
multichannel
EEG
in
each
group
of
patients
separately
for
the
patients
with
left-side
and
right-side
location
of
brain
injuries.
In
Coma
II
patients
with
left-side
injuries,
the
topog-
raphy
of
the
most
marked
deviations
of
EEG
vector
rep-
resentations
from
the
normal
images
(i.e.,
typical
of
sub-
jects from
the
control
group)
also
corresponded
to
the
cortical
areas
of
the
left
hemisphere
(Fig.
3a,
Coma
II).
Disorders
in
the
ordered
distributions
of
EEG
vectors
were
particularly
typical
of
the
inferior
frontal
areas,
antero-,
mid-,
and
posterotemporal
cortical
areas
of
the
temporal
lobe,
which
was
reflected
in
the
plane
of
factors
I
and
III
in
a
significant
deviation
from
the
axis
of
factor
I
of
the
EEG
radius
vectors
of
derivations
F
7
,
T
1
,
T
3
,
and
T
5
.
Note
that
EEG
vectors
of
the
inferior
frontal
and
anterotemporal
derivations
(F
7
,
T
1
)
almost
snuggle
down
to
the
axis
of
factor
III.
In
the
case
of
right-side
lateralization
of
brain
injuries
in
coma
II,
the
most
pronounced
distortions
of
EEG
vector
representations
were
revealed
on
the
right
(Fig.
3b,
Coma
II,
projections
to
the
surface
of
factor
I
and
III).
In
this
case,
the
maximum
deviations
from
the
factor
I
axis
were
typical
of
EEG
radius
vectors
of
the
inferior
frontal
antero-,
mid-,
and
posterotemporal
cortical
areas,
but
in
the
right
hemisphere
(F
8
,
T
2
,
T
4
,
T
6
).
During
spoor
and
coma
I,
distortions
of
the
vector
representations
of
the
spatial
structure
of
system-defined
interactions
between
cortical
areas
had
a
strong
resem-
blance
to
disorders
revealed
in
the
coma
II
patients
with
homologous
lateralization
of
the
injuries
(Figs.
3a,
3b,
Spoor-coma
I).
However,
they
were
slightly
less
pro-
nounced.
In
stupor
patients
with
moderate
brain
injuries,
the
changes
in
the
spatial
structure
of
interregional
connec-
tions
of
the
brain
bioelectric
potentials
(manifested
as
distortions
of
projections
of
EEG
vectors
to
the
planes
of
factors
I
and
III)
were
also
relatively
similar
but
much
less
evident
than
in
patients
in
the
comatose
state
(Figs.
3a,
3b,
Stupor).
Comparison
of
distributions
of
the
projections
of
EEG
vectors
to
the
plane
of
factors
II
and
III
in
Fig.
3,
which
are
typical
of
subjects
from
the
control
group
and
for
patients
from
the
three
groups
under
study,
demon-
strates
a
gradual
(depending
on
the
degree
of
impairment
of
consciousness)
increase
in
dysfunction
in
the
activity
of
telencephalon
associative
systems
and
thalamocortical
systems
of
intracerebral
integration
underlying
the
provi-
sion
of
ordered
system-defined
interactions
of
cortical
bioelectrical
activity
in
the
frontal—occipital
direction
of
both
hemispheres.
It
is
reflected
in
the
shorter
projections
of
EEG
radius
vectors
in
the
plane
of
factors
II
and
III
along
the
axis
of
factor
II,
which
is
particularly
evident
in
the
states
of
coma
I
and
coma
II.
Analysis
of
the
data
presented
in
Fig.
3
also
shows
a
gradual
increase
(in
the
Spoor—Coma
I
and
Coma
II
patients,
compared
to
the
reference
normal
data)
in
the
length
of
EEG
vector
projections
along
the
axis
of
factor
III
on
the
plane
of
factors
II
and
III,
with
simultaneous
enhancement
of
their
deviations
from
the
axis
of
factor
II.
The
changes
in
the
lengths
of
EEG
vector
projections
are
most
evidently
demonstrated
during
the
study
of
the
results
of
EEG
factor
analysis
separately
in
the
cases
of
right-side
or
left-side
lateralization
of
traumatic
brain
injuries
(Figs.
3a,
3b).
In
unconscious
patients,
devia-
tions
from
the
axis
of
factor
II
and
an
increase
in
the
lengths
of
the
EEG
vector
projections
were
particularly
typical
of
the
frontal
and
temporal
areas
and
TPO
zones
(of
the
left
or
right
hemisphere
depending
on
the
location
of
the
injury).
Such
changes
in
the
lengths
of
EEG
vector
projections
determine
the
apparent
increase
in
the
weight
of
factor
III
(see
table),
which
reflects
the
activity
of
inte-
grative
systems
providing
the
processes
of
interhemi-
spheric
interaction.
This
phenomenon,
in
spite
of
con-
siderable
depression
of
cerebral
electrogenesis,
is
also
displayed
by
the
significant
enhancement
of
the
inter-
hemispheric
coherence
of
EEG
waves
in
spoor,
coma
I,
and
coma
II
(Fig.
2),
which
may
be
conditioned
by
the
apparent
intensification
of
phase
opposition
(reciproc-
ity)
of
slow-wave
activity
oscillations
in
bilateral—sym-
metrical
areas
of
the
cortex
of
both
hemispheres
typical
of
these
groups
of
patients.
It
should
be
emphasized
that
the
changes
in
the
inter-
hemispheric
system-defomed
interaction
are
also
typical
of
the
frontal
areas
of
the
cortex.
Figure
3
shows
this
as
a
significant
deviation
from
the
axis
of
factor
II
of
EEG
vectors
in
the
pairs
of
bilateral—symmetrical
areas
of
the
frontal
cortex
(Fp
1
and
Fp
2
,
F
3
and
F
4
,
F
7
and
F
8
),
which
is
particularly
evident
in
patients
from
the
Coma
II
group
Fig.
3.
Disturbances
in
spatial
orderliness
of
the
structure
of
interregional
EEG
relations
in
patients
with
different
levels
of
depression
of
consciousness.
The
data
on
geometrical
interpretation
of
the
results
of
multichannel
EEG
factor
analysis
in
the
group
of
clinically
healthy
subjects
(Norm)
and
in
the
groups
of
patients
(Stupor
I;
Spoor-Coma
I;
Coma
II)
are
presented:
(a)
with
the
left-side
location
of
injuries;
(b)
with
the
right-side
location
of
injuries.
Subjects
ofthe
control
group
demonstrate
noticeable
topological
similarity
in
posi-
tions
of
EEG
radius
vectors
in
the
three-dimensional
factor
space
with
location
of
EEG
derivations
on
the
scalp,
while
the
patients
of
each
group
demonstrate
apparent
disorders
in
the
ordered
structure
of
interregional
interactions
of
cortical
bioelectric
potentials.
Pro-
jections
of
EEG
radius
vectors
corresponding
to
different
derivations
are
presented
(according
to
the
bottom
left
scheme)
on
the
plane
of
factors
I,
III
and
II,
III.
Radius
vectors
indicated
by
gray
and
black
lines
correspond
to
EEG
derivations
from
the
right
and
left
hemi-
sphere,
respectively.
HUMAN
PHYSIOLOGY
Vol.
36
No.
5
2010
544
KLIMASH
et
al.
Changes
in
the
contributions
of
common
factors
(I,
II,
III,
IV,
V,
VI)
to
spatial
organization
of
the
brain
bioelectric
potential
field
in
patients
with
different
levels
of
impairment
of
consciousness
under
severe
CCI
Group
of
subjects
Factor
weight
I
II
III
IV
V
VI
Total
weight
Norm
0.432
0.220
0.147
0.027
0.028
0.018
0.872
Stupor,
left
0.411
0.143
0.155 0.035
0.040
0.022
0.806
Stupor,
right
0.426
0.202
0.121
0.038
0.031
0.018
0.836
Spoor-Coma
I,
left
0.406
0.092
0.217
0.042
0.039
0.022
0.818
Spoor-Coma
I,
right
0.423
0.098
0.225
0.031
0.032
0.019
0.828
Coma
II,
left
0.348
0.103
0.291
0.032
0.034
0.018
0.826
Coma
II,
right
0.393
0.098
0.201
0.033
0.040
0.035
0.800
Note:
The
maximum
and
minimum
values
of
contributions
of
each
factor
are
in
bold
and
light
italic,
respectively.
with
the
left-hemispheric
injuries
ofbrain
tissues
(Fig.
3a,
Coma
II).
In
spoor
and
coma
I,
disorders
in
the
interhemi-
spheric
interactions
of
activity
of
the
prefrontal
and
post-
frontal
areas
(FA
and
Fp
2
,
F3
and
F
4
)
were
less
evident;
however,
for
the
inferior
frontal
areas
(F
7
and
F
8
),
they
were
maintained
nearly
to
the
same
extent
as
during
coma
II
(probably,
because
derivations
from
these
corti-
cal
areas
notably
average
also
the
activity
of
anterotem-
poral
areas).
In
the
case
of
stupor,
interhemispheric
interactions
were
obviously
even
less
disturbed,
but
devi-
ation
from
the
axis
of
factor
II
of
the
respective
EEG
vec-
tors
for
the
prefrontal
and
post-frontal
areas
was
still
greater
than
in
the
control.
It
should
be
noted
that
a
certain
topographical
order-
liness
of
the
spatial
organization
of
the
distant
interrela-
tions
of
bioelectric
potentials
of
different
cortical
areas
of
both
hemispheres
is
maintained
both
during
stupor
and
during
moderate
and
deep
comas
in
spite
of
the
crude
disturbances
of
the
spatial
organization
of
the
system-
defined
interaction
between
different
cortical
areas
of
the
right
and
left
hemispheres
(Fig.
3).
In
these
patients,
as
in
subjects
of
the
control
group,
the
EEG
vectors
corre-
sponding
to
the
derivations
from
the
left
hemisphere
are
combined
on
the
same
side
of
the
factor
II
axis,
demon-
strating
almost
mirror
symmetry
with
EEG
from
the
right
hemisphere.
The
EEG
vectors
corresponding
to
the
anterior
derivations
are
grouped
together
on
the
same
side
of
the
factor
III
axis,
while
those
corresponding
to
the
posterior
derivations
are
grouped
on
the
other
side
of
the
factor
III
axis,
with
the
relative
maintenance
of
the
topographical
correspondence
of
their
location
within
each
hemisphere.
Consequently,
these
data
may
show
that
dislocation
brain
injuries
typical
of
the
patients
from
the
distinguished
groups
are
characterized
by
the
absence
of
terminal
disorders
in
the
activity
of
basic
neurophysio-
logical
systems
responsible
for
the
processes
of
total
brain
integration.
DISCUSSION
Comparison
of
our
own
data
and
the
data
in
the
liter-
ature
on
the
changes
in
spatiotemporal
relations
of
corti-
cal
brain
activity
at
different
levels
of
depression
of
con-
sciousness
in
patients
with
severe
CCI
shows
that
the
observed
changes
are
expressed
in
both
a
weakening
and
selective
intensification
of
certain
interregional
EEG
relations.
It
seems
correct
to
make
an
attempt
at
estab-
lishing
the
dependence
between
the
location
and
degree
of
manifestation
of
the
changes
in
the
spatial
structure
of
the
brain's
bioelectric
potential
field
and
the
depth
of
consciousness
depression.
Specifically,
in
the
case
of
moderate
and
deep
stupors
with
the
clinical
signs
of
a
patient's
disorientation
in
his/her
own
personality
and
in
the
environment
and
with
difficulties
in
verbal
contact,
a
significant
weakening
of
statistical
EEG
relations
of
the
inferior
frontal
and
tem-
poral
areas
of
both
hemispheres
was
observed
mainly
in
the
left
hemisphere,
with
a
particularly
apparent
decrease
in
the
intrahemispheric
EEG
relations
from
derivations
corresponding
to
Broca's
and
lAtimicke's
centers.
A
sim-
ilar
but
less
pronounced
weakening
of
EEG
relations
was
found
in
symmetrical
areas
of
the
right
hemisphere.
Besides,
there
was
a
decrease
in
the
system-defined
inter-
action
between
the
posterotemporal
and
parietal
areas
of
both
hemispheres.
It
may
be
supposed
that
the
weaken-
ing
of
EEG
relations
of
these
areas
particularly
deter-
mines
the
difficulty
in
understanding
and
producing
speech
typical
of
the
initial
stages
of
the
depression
of
consciousness.
HUMAN
PHYSIOLOGY
Vol.
36
No.
5
2010
DISORDERS
OF
THE
SPATIOTEMPORAL
ORGANIZATION
545
The
revealed
phenomenon
of
the
weakening
of
EEG
cross
correlation
and
coherence
in
the
temporal
areas
mainly
of
the
left
and,
to
a
lesser
extent,
the
right
hemi-
sphere
is
obviously
evidence
for
a
decrease
during
stupor
in
the
functional
abilities
of
cortical
structures
connected
through
the
arcuate
fasciculus
(including
Broca's
and
Wernicke's
centers
in
the
left
hemisphere).
Since
the
activation
of
this
fasciculus
(revealed
by
the
modern
modification
of
magnetic
tomography,
DTI)
is
mani-
fested
much
stronger
in
men
in
the
left
hemisphere
[21]
and
that
eight
out
of
the
nine
examined
patients
were
men,
the
apparent
weakening
of
the
intrahemispheric
correlation
and
coherent
EEG
relations
between
deriva-
tions
F
3
,
F
7
,
T
1
,
T
3
,
C
3
,
T
5
,
and
P
3
of
the
left
hemisphere
revealed
in
the
clinical
presentation
of
stupor
(Figs.
2,
4c,
4d)
can
be
considered
to
be
an
additional
argument
for
the
difficulty
of
interregional
interaction
of
the
structures
related
to
the
speech
function.
Comparison
of
changes
in
the
level
of
distant
EEG
relations
in
the
state
of
stupor
(compared
to
the
norm)
places
an
emphasis
also
on
the
apparent
weakening
of
intra-
and
interhemispheric
EEG
relations
between
the
posterotemporal
and
parietal
derivations
(T
5
,
T
6
and
P
3
,
P
4
)
in
the
left
and
right
hemispheres,
which
is
observed
during
the
CC
EEG
analysis
and,
to
a
lesser
extent,
Coh
EEG
analysis
in
all
frequency
ranges
except
for
the
13
band
(Figs.
2,
4c,
4d).
These
peculiarities
of
the
reorganization
of
the
brain's
bioelectric
potential
field
observed
at
the
initial
stages
of
the
depression
of
consciousness
as
a
result
of
severe
CCI
are
in
agreement
with
the
concepts
of
neurologists
and
neuropsychologists
on
the
interaction
between
the
fron-
tal,
parietal,
and
temporal
areas
in
the
implementation
of
specifically
human
functions.
Duus
[22]
,
when
analyzing
the
peculiar
features
of
clinical
manifestations
of
the
damage
of
associative
zones
of
the
left
hemisphere,
emphasizes
the
exceptional
importance
of
the
tertiary
associative
region,
including
areas
39
and
40
and
the
integrity
of
connections
providing
the
interaction
of
this
region
with
the
frontal
and
temporal
areas
(Fig.
4).
In
Duus's
opinion,
this
tertiary
region
may
be
the
material
substrate
for
the
most
complex
forms
of
human
percep-
tion
and
cognition,
which
is
in
agreement
with
the
con-
cepts
developed
previously
by
Luria
[23]
and
Shevchenko
[24].
One
should
note
the
significant
similarity
of
the
tra-
jectories
of
the
functional
interaction
of
the
frontal,
pari-
etal,
and
temporal
cortical
areas
of
both
hemispheres
related
to
the
implementation
of
specifically
human
functions,
specified
by
Duus
(Fig.
4a),
with
our
patterns
of
the
weakening
of
the
correlation
and
coherent
con-
nections
between
EEG
in
these
cortical
areas
in
the
stu-
por
patients.
It
is
interesting
that
the
pattern
revealed
by
modern
methods
of
neuroimaging
(fMRI)
during
the
analysis
of
the
activation
of
the
nerve
tracts
related
to
the
implemen-
tation
of
speech
function
in
clinically
healthy
subjects
(Fig.
4b)
[25]
also
demonstrates
a
certain
topological
similarity
with
the
results
obtained
in
patients
with
a
depression
of
the
higher
psychic
functions
(Figs.
4c,
4d)
and
with
Duus's
theoretical
concepts
on
the
morpho-
functional
connections
of
telencephalon,
which
underlie
their
implementation
(Fig.
4a).
At
the
initial
stages
of
the
depression
of
conscious-
ness,
comparative
analysis
of
the
results
of
both
the
cor-
relation
and
coherent
EEG
analyses
(in
the
basic
fre-
quency
bands)
reveals
the
weakening
of
bilateral
EEG
relations
of
prefrontal
cortical
areas
(Fig.
2).
The
struc-
ture
of
the
brain's
bioelectric
potential
field
significantly
changes
as
the
depression
of
consciousness
grows.
Subse-
quently,
a
rather
pronounced
weakening
of
the
intra-
and
interhemispheric
interactions
of
the
frontal
cortical
areas
is
observed.
A
decrease
in
the
functional
capacity
of
the
frontal
lobes
and
a
reduction
of
the
interhemispheric
interactions
of
these
brain
regions
observed
during
the
depression
of
consciousness
in
patients
with
CCI
is
related
to
a
reduction
of
brainstem
activating
effects,
which
is
confirmed
by
clinical—physiological
observa-
tions
of
some
authors
[5,
26-28].
The
electroencephalographic
phenomena
that
we
have
observed
in
patients
with
different
levels
of
the
depression
of
consciousness
often
include
not
only
a
decrease
in
statistical
EEG
relations
(which,
in
fact,
may
be
due
to
the
weakening
of
the
functional
interactions
of
the
respective
cortical
areas)
but
also
the
significant
intensification
of
connections.
Apparently,
it
would
be
wrong
to
identify
the
intensification
of
statistical
interre-
lations
of
the
bioelectrical
activity
of
cortical
structures
under
a
depression
of
consciousness
with
the
enhance-
ment
of
their
functional
interaction.
It
seems
that
in
many
cases,
especially
in
comatose
states,
this
fact
can
be
rightfully
explained
as
a
consequence
of
the
lowering
of
the
level
of
corticipetal
afferentation.
The
revealed
inten-
sification
of
coherence
of
EEG
oscillations
in
the
A
and
0
bands
between
the
derivations
located
above
the
regions
of
traumatic
brain
injury
was
mentioned
by
other
researchers
as
well
[29-31].
It
is
known
that
the
involvement
of
brainstem
struc-
tures
in
pathological
process
is
displayed
in
EEG
by
intensification
of
the
events
of
synchronization
of
rhythms
in
the
0
and
A
frequency
bands
[32,
33].
In
our
observations,
intensification
of
the
synchronization
of
rhythms
in
the
slow
wave
range
was
displayed
by
the
higher
level
of
Coh
EEG
in
these
bands
in
patients
with
moderate
and
deep
comas.
At
the
same
time,
the
Coh
level
of
mostly
intrahemispheric
EEG
relations
increased
in
the
patients
with
spoor
and
coma
I,
while
that
of
inter-
hemispheric
EEG
relations
increased
in
the
patients
with
coma
II.
The
state
of
the
pronounced
depression
of
conscious-
ness
(coma
II)
is
characterized
by
a
greater,
compared
to
patients
with
spoor
and
coma
I,
intensification
of
inter-
hemispheric
EEG
relations
in
the
A
and
particularly
0
bands
(Fig.
2).
We
note
that
no
significant
intensification
of
interhemispheric
coherent
EEG
relations
is
revealed
in
the
a
or
13
bands
of
EEG
in
coma
II.
The
analysis
of
the
results
of
the
study
of
reorganiza-
tion
of
the
brain
system's
activity
in
the
states
with
a
pro-
gressing
depression
of
consciousness
obtained
on
the
HUMAN
PHYSIOLOGY
Vol.
36
No.
5
2010
T3
T5
546
KLIMASH
et
al.
(a)
(b)
44
6
4
22
40
39
W
:
N4
z
-
,.•
19
18
(c)
Stupor
I,
II
(d)
Coh
EEG
(a)
Fpl~
Fp2
Fpl
CC
EEG
Fp2
F3
F
F4
T1
T3
C3
6
`TP2
F8
T1
1
C4
C3
T5
;21kle
6
k
I
I
1W
4
1
111
P3
01
Fig.
4.
Comparison
of
the
(a,
b)
spatial
structure
of
pathways
of
morphofunctional
interaction
of
the
cortical
areas
related
to
the
implementation
of
specifically
human
activities
with
(c,
d)
topographic
patterns
of
disorders
in
EEG
cross
correlations
and
coherence
connections
taking
place
at
the
initial
stages
of
consciousness
depression:
moderate
and
deep
stupor.
It
is
noticeable
that
(a)
the
scheme
of
functional
interactions
between
the
areas
of
cortical
representation
of
speech
and
response
hand
and
sym-
metrical
areas
of
the
right
hemisphere
(according
to
Duus
[22])
and
(b)
the
pattern
of
activation
of
nervous
tracts
related
to
imple-
mentation
of
the
speech
function
revealed
byfMR/in
clinically
healthy
subjects
(according
to
Keller
et
al.
[25])
demonstrate
con-
siderable
topological
similarity
with
(c,
d)
the
patterns
of
disorders
in
distant
EEG
relations
in
patients
with
suppression
of
the
higher
psychic
functions.
In
(a),
the
numerals
indicate
Brodmann's
areas.
Other
symbols
are
as
in
Fig.
2.
HUMAN
PHYSIOLOGY
Vol.
36
No.
5
2010
DISORDERS
OF
THE
SPATIOTEMPORAL
ORGANIZATION
547
basis
of
the
factor
analysis
of
multichannel
EEG
in
patients
with
the
dislocation
syndrome
has
shown
severe
impairment
of
the
activity
of
basic
integrative
brain
sys-
tems
responsible
for
the
organization
of
an
ordered
sys-
tem-defined
interaction
of
different
cortical
and
subcor-
tical
areas.
Our
studies
[15,
18,
34]
have
shown
that
factor
I
reflects
the
balance
between
diffusive
activating
and
syn-
chronizing
effects
on
the
cortex
of
brainstem
regions
mediated
by
the
nonspecific
nuclei
of
the
thalamus.
Fac-
tor
II
estimates
the
level
of
involvement
of
the
long
asso-
ciation
tracts
of
the
neocortex
(as
well
as
thalamofrontal
and
thalamoparietal
associative
systems)
in
the
coordina-
tion
of
the
bioelectrical
activity
of
cortical
areas
in
the
frontal—occipital
direction
of
each
hemisphere.
The
weight
of
factor
III
carries
information
about
the
contri-
bution
of
the
commissural
pathways
of
telencephalon
and
mesodiencephalic
structures
in
the
organization
of
paired
activity
of
the
hemispheres.
The
factor
weights
may
be
used
for
the
quantitative
assessment
of
the
degree
of
involvement
of
some
integra-
tive
system
in
the
total
brain
activity
under
normal
condi-
tions
and
at
different
levels
of
the
depression
of
con-
sciousness
(see
table).
As
one
can
see
from
the
table,
the
patients
of
all
three
groups,
as
compared
to
the
reference
normal
data,
show
a
gradual
decrease
in
the
weight
of
factor
I
and
a
considerable
decrease
in
the
weight
of
fac-
tor
II,
along
with
a
significant
increase
in
the
weight
of
factor
III.
The
largest
changes
in
factor
weights,
com-
pared
to
their
values
in
the
control
group,
were
especially
typical
of
patients
in
unconscious
states
(spoor,
and
coma
I
and
II).
Note
that
deepening
of
the
impairment
of
conscious-
ness
in
patients
is
accompanied
by
an
increase
in
the
weights
of
factors
W,
V,
and
VI.
Normally,
the
weight
of
factor
IV
and
other
subsequent
factors
hardly
ever
exceeds
5%;
however,
as
we
have
noted
previously
[15],
the
weights
of
these
factors
may
increase
when
a
subject
stays
under
extreme
conditions
for
a
long
time.
The
increase
in
factor
weights,
in
spite
of
their
low
values,
may
be
indicative
of
the
emergence,
in
the
case
of
cerebral
pathology,
of
some
additional
atypical
system-defined
interrelations
between
the
activities
of
cortical
areas.
The
gradual
decrease
in
the
weight
of
factor
I
with
an
increasing
level
of
the
depression
of
consciousness
from
0.432
in
a
healthy
state
to
0.348
in
coma.
II
(see
table)
may
be
evidence
of
considerable
weakening
of
brainstem
activating
effects
on
the
cortex
of
the
hemispheres
medi-
ated
by
the
nonspecific nuclei
of
the
thalamus.
Appar-
ently,
it
may
also
slightly
intensify
synchronization
of
the
slow-wave
activity,
which
is
particularly
typical
of
coma
I
and
coma
II
patients
(Fig.
2).
The
marked
decrease
in
the
weight
of
factor
II
from
0.220
in
good
health
to
0.092
in
coma
I
and
0.098
in
coma.
II
(see
table,
Fig.
3)
suggests
a
significant
distur-
bance
of
the
ordered
system-defined
interactions
of
the
bioelectrical
activity
of
the
cortex
in
the
frontal—occipital
direction
of
both
hemispheres.
This
misalignment
of
the
activities
of
the
anterior
and
posterior
regions
of
the
hemispheres
against
the
background
of
the
functional
deactivation
of
the
cortex
and
subcortical
structures
may
be
related
to
a
considerable
suppression
of
integrative
functions
of
the
telencephalon
associative
systems
(pri-
marily,
frontal—occipital
interactions
carried
out
through
fibers
of
the
upper
longitudinal
fasciculus
[28])
and
thalamocortical
(particularly
thalamofrontal)
integrative
systems.
Probably,
the
dysfunction
of
these
mechanisms
of
intracerebral
integration
in
comatose
states
results
in
a
pronounced
depression
of
the
activity
of
the
frontal
cor-
tical
areas
and
a
decrease
in
their
contribution
to
the
sys-
tem-defined
organization
of
the
frontal—occipital
inter-
actions.
The
considerable
increase
in
the
weight
of
factor
III
in
patients
(of
all
three
groups)
may
reflect
the
presence
of
peculiar
disorders
in
the
activity
of
integrative
brain
sys-
tems
carrying
out
the
processes
of
the
interhemispheric
integration
of
the
activities
of
cortical
and
subcortical
structures
of
telencephalon
via
commissural
pathways
and
bilateral
connections
of
the
thalamus
and
other
deep
structures.
However,
these
disorders
may
be
related
to
a
pathological
rearrangement
of
the
activity
of
brain
struc-
tures
of
different
topological
levels,
namely,
brainstem,
thalamencephalon,
and
telencephalon,
responsible
for
the
organization
of
interhemispheric
interactions
(the
third
factor),
and
need
more
detailed
consideration.
It
is
known
that
pronounced
cerebral
compression
(coma
II)
results
in
a
considerable
depression
of
the
activities
of
brainstem
and
diencephalic
structures
[4,
11,
33]
providing
synchronous
interhemispheric
interactions
[6,
10].
At
the
same
time,
the
system
supporting
"direct"
bilateral
connections
via
the
commissural
pathways
of
telencephalon
may
be
to
a
great
extent
"released"
from
the
competing
effects
of
the
mesodiencephalic
systems
supporting
interhemispheric
interactions.
These
reorga-
nizations
may
fmally
result
in
an
increase,
relative
to
the
norm,
of
reciprocal
interactions
between
symmetrical
cortical
areas
of
the
hemispheres,
which
is
demonstrated
by
the
enhanced
weight
of
factor
III.
During
EEG
recording,
it
is
manifested
by
the
nearly
complete
phase
opposition
of
oscillations
of
slow-wave
cortical
activity
in
the
inferior
frontal
and
temporal
derivations
of
both
hemispheres,
which
is
visible
to
the
naked
eye.
The
increase
in
the
phase
opposition
of
cortical
activity
oscil-
lations
of
symmetrical
areas
in
both
hemispheres
was
noted
by
Dubikaytis
[35]
during
the
analysis
of
the
changes
in
the
mechanical
trajectories
of
the
waves
of
electrical
activity
of
the
cortex
in
patients
with
severe
CCI.
Obviously,
precisely
the
stable
antiphase
relations
of
fluctuations
of
the
slow-wave
activity
in
symmetrical
areas
of
both
hemispheres
in
patients
with
coma
II
result
in
a
significant
increase
in
interhemispheric
EEG
coher-
ence
(Fig.
2).
HUMAN
PHYSIOLOGY
Vol.
36
No.
5
2010
548
KLIMASH
et
al.
CONCLUSIONS
The
revealed
specific
characteristics
of
a
disorder
in
the
spatial
organization
ofbioelectrical
cortical
activity
in
patients
with
a
different
intensity
of
dislocation
syn-
drome
as
a
result
of
CCI
reflect
fundamental
pathologi-
cal
changes
in
the
activities
of
basic
morphofunctional
systems
of
intracerebral
integration.
In
particular,
the
observed
weakening
of
nonspecific
activating
effects
from
brainstem
regions
was
expressed
in
the
shift
of
the
main
rhythmical
activity
toward
slow
frequencies,
along
with
a
considerable
decrease
in
the
level
of
coherence
of
EEG
oscillations
in
the
a
and
13
bands.
In
addition,
the
revealed
disorder
in
the
system-defined
organization
of
interrelations
between
the
potentials
of
the
frontal
and
occipital
areas
could
be
explained
by
the
suppression
of
the
activity
of
associative
systems
of
intercortical
and
thalamocortical
integration.
The
data
obtained
suggest
that,
against
a
background
of
the
suppressed
activity
of
mesodiencephalonic
structures
normally
making
a
con-
siderable
contribution
to
the
organization
of
the
syner-
gism
of
interhemispheric
interaction
(due
to
the
syn-
chronous
ascending
effects
on
the
cortex
of
both
hemi-
spheres),
in
unconscious
states
under
functional
deactivation
of
the
cortex
and
subcortical
structures,
there
is
a
certain
liberation
of
the
activity
of
the
system
providing
direct
interhemispheric
connections
through
the
commissural
pathways
of
the
telencephalon.
In
our
opinion,
this
liberation
from
the
effects
of
the
competing
mesodiencephalic
system
providing
synchronous
inter-
hemispheric
interactions
causes
the
facilitation
of
the
conductance
of
reciprocal
effects
of
one
hemisphere
on
the
other
through
commissural
pathways,
which
is
dem-
onstrated
by
the
appearance
in
deep
coma
patients
of
sta-
ble
reciprocal
relations
of
activity
fluctuations
in
sym-
metrical
(especially
temporal)
areas
of
the
cortex
of
both
hemispheres.
Such
stable,
almost
antiphase
relations
of
fluctuations
of
slow-wave
activity
basic
for
these
patients
are
also
reflected
in
the
significant
increase
in
coherence
between
the
bioelectric
potential
fluctuations
in
the
0
and
A
bands
in
these
cortical
areas
of
the
left
and
right
hemi-
spheres.
The
results
also
show
that
a
certain
spatial
order
of
organization
of
distant
interrelations
of
bioelectric
potentials
of
different
cortical
areas
in
both
hemispheres
is
generally
maintained
under
stupor
and
depression
of
consciousness
at
the
levels
typical
of
spoor,
coma
I,
and
coma
II,
in
spite
of
significant
disorders
in
the
psycho-
physiolgical
processes
of
the
higher
nervous
activity
and
the
activity
of
basic
integrative
brain
systems.
It
may
be
evidence
not
so
much
of
the
decomposition
or
complete
destruction
of
the
coordinated
activity
of
basic
neuro-
physiological
systems
providing
the
processes
of
the
inte-
gration
of
the
whole
brain
but
of
its
significant
patholog-
ical
reorganization,
despite
the
crude
distraction
of
their
morphofunctional
structure
under
the
brain
dislocation.
REFERENCES
1.
Rusinov,
V
S.,
Grindel',
O.M.,
and
Boldyreva,
G.N.,
Study
of
the
Dynamics
of
Intercentral
Relations
in
the
Cortex
of
Cerebral
Hemispheres
by
the
Methods
of
EEG
Spectral
Analysis),
in
Mekhanizmy
deyaternosti
golovnogo
mozga
(Mechanisms
of
Brain
Activity),
Tbilisi:
Metsniereba,
1975,
p.
365.
2.
Grindel',
O.M.,
The
Optimal
Level
of
EEG
Coherence
and
Its
Significance
in
Estimation
of
the
Functional
State
of
Human
Brain,
7]i.
Vyssh.
Nervn.
Deyat.,
1980,
vol.
30,
no.
1,
p.
60.
3.
Kane,
N.M.,
Moss,
T.H.,
Curry,
S.H.,
and
Butler,
S.R.,
Quantitative
Electroencephalographic
Evaluation
of
Non-fatal
and
Fatal
Traumatic
Coma,
Electroencephalogr.
Clin.
Neurophysiol.,
1998,
vol.
106,
no.
3,
p.
244.
4.
Boldyreva,
G.N.,
Elektricheskaya
aktivnost'
mozga
pri
porazhenii
dientsefarnykh
i
limbicheskikh
struktur
(Electri-
cal
Brain
Activity
after
an
Injury
of
Diencephalic
and
Limbic
Structures),
Moscow:
Nauka,
2000.
5.
Boldyreva,
G.N.,
Sharova,
E.V.,
and
Dobronravova,
I.S.,
The
Role
of
Regulatory
Brain
Structures
in
Formation
of
Human
EEG,
Fiziol.
Chel.,
2000,
vol.
26,
no.
5,
p.
19.
6.
Boldyreva,
G.N.,
Zhavoronkova,
LA
,
Sharova,
E.V.,
and
Dobronravova,
I.S.,
Intercentral
EEG
Relations
as
Reflection
of
System
Organization
of
the
Human
Brain
in
Health
and
Disease,
Zh.
Vyssh.
Nervn.
Deyat.,
2003,
vol.
53,
no.
4,
p.
391.
7.
Boldyreva,
G.N.,
Sharova,
E.V.,
Zhavoronkova,
L.A.,
and
Dobrokhotova,
TA.,
Reflection
of
Different
Levels
of
Human
Brain
Activity
Regulation
in
Spectral—Coherent
Parameters,
Zh.
Vyssh.
Nervn.
Deyat.,
1992,
vol.
42,
no.
3,
p.
439.
8.
Zhavoronkova,
L.A.
and
Dobronravova,
I.S.,
Compari-
son
of
the
Dynamics
of
Interhemispheric
Asymmetry
of
Human
EEG
Coherence
after
Neoplastic
Lesion
of
Diencephalic
and
Hemispheric
Brain
Structures
under
Different
Conditions
of
Cerebral
Compensation,
Zh.
Vyssh.
Nervn.
Deyat.,
1993,
vol.
43,
no.
6,
p.
1099.
9.
Sharova,
E.V.,
Borodkin,
S.M.,
Gogitidze,
N.V.,
Luky-
anov,
VI.,
and
Mukhanov,
T.K.,
Functional
Significance
of
Characteristics
of
Spatial—Time
EEG
Organization
in
Patients
with
Craniocerebral
Injuries,
Fiziol.
Chel.,
1992,
vol.
18,
no.
6,
p.
22.
10.
Zhavoronkova,
L.A.,
Maksakova,
0.A.,
Smirnova,
N.Ya.,
et
al.,
The
Dynamics
of
Interhemispheric
Relationship
of
EEG
Coherence
as
a
Reflection
of
Rehabilitation
Process
in
Patients
after
Severe
Craniocerebral
Injury,
Fiziol.
Chel.,
2001,
vol.
27,
no.
2,
p.
5.
11.
Konovalov,
A.N.,
Likhterman,
L.B.,
and
Potapov,
A.A.,
lainicheskoe
rukovodstvo
po
cherepno-mozgovoi
travme
(Clinical
Guide
on
Craniocerebral
Injury),
Moscow:
Antidor,
1998,
vol.
1.
12.
Harman,
H.,
Sovremenny
faktorny
analiz
(Modern
Factor
Analysis),
Moscow:
Statistika,
1972.
13.
Tsitseroshin,
M.N.,
The
Analysis
of
Statistical
Relation-
ship
of
Brain
Bioelectric
potential
Fluctuations
in
the
Three-Dimensional
Factor
Space,
Avtometriya,
1986,
no.
6,
p.
89.
14.
Shepoval'nikov,
A.N.
and
Tsitseroshin,
M.N.,
Spatial
Order
of
Functional
Organization
of
the
Whole
Brain,
Fiziologiya
cheloveka,
1987,
vol.
13,
no.
6,
p.
892
[Hum.
Physiol.
(Engl.
Transl.)
1988,
vol.
13,
no.
6,
p.
3711.
HUMAN
PHYSIOLOGY
Vol.
36
No.
5
2010
DISORDERS
OF
THE
SPATIOTEMPORAL
ORGANIZATION
549
15.
Tsitseroshin,
M.N.
and
Shepoval'nikov,
A.N.,
Stanovlenie
integrativnoi
funktsii
mozga
(Formation
of
Integrative
Brain
Function),
Bechtereva,
N.P.,
Ed.,
St.
Petersburg:
Nauka,
2009.
16.
RF
Patent
2177716,
2000.
17.
Tsitseroshin,
M.N.
and
Pogosyan,
A.A.,
On
Manifesta-
tion
of
the
Activity
of
Integrative
Mechanisms
in
Bioelec-
trical
Activity
of
the
Brain,
Biofizika,
1993,
vol.
38,
no.
2,
p.
344.
18.
Shepoval'nikov,
A.N.
and
Tsitseroshin,
M.N.,
Evolutional
Aspects
of
Formation
of
human
Brain
Integrative
Activity,
Ross.
Fiziol.
Zh.
im.
I.M.
Sechenova,
1999,
vol.
85,
no.
10,
p.
11.
19.
Shepoval'nikov,
A.N.,
Tsitseroshin,
M.N.,
Rozhkov,
VP.,
et
al.,
Interregional
Cortical
Interaction
at
Different
Stages
of
Natural
Sleep
and
the
Hypnotic
State:
EEG
Evi-
dence,
Fiziologiya
cheloveka,
2005,
vol.
31,
no.
2,
p.
45
[Hum.
Physiol.
(Engl.
Transl.),
2005,
vol.
31,
no.
2,
p.
150].
20.
Ivonin,
AA,
Tsitseroshin,
M.N.,
Pogosyan,
A.A.,
and
Shuvaev,
VT,
Genetic
Determination
of
Neurophysio-
logical
Mechanisms
of
Cortical—Subcortical
Integration
of
Bioelectrical
Brain
Activity,
Ross.
Fiziol.
Zh.
im.
LM.
Sechenova,
2002,
vol.
88,
no.
10,
p.
1330
[Neurosci.
Behay.
Physiol.,
2004,
vol.
34,
no.
4,
p.
369].
21.
Catani,
M.,
Symmetries
in
Human
Brain
Language
Path-
ways
Correlate
with
Itrbal
Recall,
Proc.
Natl.
Acad.
Sci.
USA,
2007,
vol.
104,
no.
43,
p.
17163.
22.
Duus,
P.,
Topicheskii
diagnoz
v
nevrologii
(Topographical
Diagnosis
in
Neurology),
Moscow:
VAZAR-FERRO,
1997.
23.
Luriya,
A.R.,
Yazyk
i
soznanie
(Language
and
Conscious-
ness),
Moscow:
Mosk.
Gos.
Univ.,
1979.
24.
Shevchenko,
Yu.G.,
Razvitie
kory
mozga
cheloveka
v
svete
onto-filogeneticheskikh
sootnoshenii
(Ontogenetic
and
Phylogenetic
Aspects
of
Development
of
the
Human
Brain
Cortex),
Moscow:
Meditsina,
1972.
25.
Keller,
S.S.,
Crow,
T,
Foundas,
A.,
et
al.,
Brocas
Area:
Nomenclature,
Anatomy,
Topology
and
Asymmetry,
Brain
Lang.,
2009,
vol.
109,
p.
29.
26.
Sharova,
E.V.,
Kulikov,
MA,
Barkalaya,
D.B.,
and
Amcheslayskii,
VG.,
Intercentral
Relations
of
Cortical
Bioelectrical
Activity
of
the
Human
Brain
after
Surgery
on
Brainstem
Formations,
Zh.
Vyssh.
Nervn.
Deyat.
im.
I.P.
Pavlova,
1991,
vol.
4,
no.
2,
p.
246.
27.
Kapur,
S.,
Craik,
EI.M.,
Jones,
C.,
et
al.,
Functional
Role
of
the
Prefrontal
Cortex
in
Memory
Retrieval:
a
PET
Study,
Neuroreport,
1995,
vol.
6,
p.
1880.
28.
Goldberg,
E.,
Upravlyayushchii
mozg:
Lobnye
doli,
lider-
stvo
i
tsivilizatsiya
(The
Controlling
Brain:
Frontal
Lobes,
Leadership,
and
Civilization),
Moscow:
Smysl,
2003.
29.
Thatcher,
R.W.,
Biver,
C.,
McAlaster,
R.,
and
Salazar,
A.,
Biophysical
Linkage
between
MRI
and
EEG
Coherence
in
Closed
Head
Injury,
Neuroimage,
1998,
vol.
8,
no.
4,
p.
307.
30.
Spiegel,
A.,
Tonner,
PH.,
and
Renna,
M.,
Altered
States
of
Consciousness:
Processed
EEG
in
Mental
Disease,
Best
Pract.
Res.
Clin.
Anesthesia,
2006,
vol.
20,
no.
1,
p.
57.
31.
Nenadovic,
V,
Hutchison,
J.S.,
Dominguez,
L.G.,
Otsubo,
H.,
Gray,
M.P.,
Sharma,
R.,
Belkas,
J.,
and
Perez-Velazquez,
J.L.,
Fluctuations
in
Cortical Synchro-
nization
in
Pediatric
Traumatic
Brain
Injury,
J.
Neu-
rotrauma,
2008,
vol.
25,
no.
6,
p.
615.
32.
Schaul,
N.,
Gloor,
P.,
and
Gotman,
J.,
The
EEG
in
Deep
Midline
Lesions,
Neurology,
1981,
vol.
31,
no.
2,
p.
157.
33.
Grindel',
0.M.,
Elektroentsefalogramma
cheloveka
pri
cherepno-mozgovoi
travme
(Human
Electroencephalo-
gram
at
Craniocerebral
Injury),
Moscow:
Nauka,
1988.
34.
Tsitseroshin,
M.N.,
Ivonin,
A.A.,
Pogosyan,
A.A.,
et
al.,
The
Role
of
the
Genotype
in
the
Development
of
Neuro-
physiological
Mechanisms
Involved
in
the
Spatial
Inte-
gration
of
the
Neocortex
Bioelectrical
Activity,
Fiziol.
Chel.,
2003,
vol.
29,
no.
4,
p.
5
[Hum.
Physiol.
(Engl.
Transl.),
2003,
vol.
29,
no.
4,
p.
393].
35.
Dubikaitis,
VV,
Spatiotemporal
Characteristics
of
Human
Electroencephalogram,
its
Physiological
and
Diagnostic
Significance
at
Focal
Brain
Injuries,
Extended
Abstract
of
Dr.
Sci.
(Med.)
Dissertation,
Leningrad,
1976.
HUMAN
PHYSIOLOGY
Vol.
36
No.
5
2010