Parametrization of the dying brain: A case report from ICU bed-side EEG monitoring
Background: Cortical high-frequency activation immediately before death has been reported, raising questions about an enhanced conscious state at this critical time. Here, we analyzed an electroencephalogram (EEG) from a comatose patient during the dying process with a standard bedside monitor and s...
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Elsevier
2025-01-01
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| Series: | NeuroImage |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1053811924004774 |
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| author | Sebastian Zinn Srdjan Z. Dragovic Jan A. Kloka Laurent M. Willems Sebastian Harder Stephan Kratzer Kai D. Zacharowski Gerhard Schneider Paul S. García Matthias Kreuzer |
| author_facet | Sebastian Zinn Srdjan Z. Dragovic Jan A. Kloka Laurent M. Willems Sebastian Harder Stephan Kratzer Kai D. Zacharowski Gerhard Schneider Paul S. García Matthias Kreuzer |
| author_sort | Sebastian Zinn |
| collection | DOAJ |
| description | Background: Cortical high-frequency activation immediately before death has been reported, raising questions about an enhanced conscious state at this critical time. Here, we analyzed an electroencephalogram (EEG) from a comatose patient during the dying process with a standard bedside monitor and spectral parameterization techniques. Methods: We report neurophysiologic features of a dying patient without major cortical injury. Sixty minutes of frontal EEG activity was recorded using the Sedline™ monitor. Quantitative metrics of the frequency spectrum, the non-oscillatory 1/f characteristic, and signal complexity with Lemple-Ziv-Welch and permutation entropy were calculated. In addition to comparing the EEG trajectories over time, we provide a comparison to EEG records obtained from other studies with well-known vigilance states (sleep, anesthesia, and wake). Results: Although we observed changes in high-frequency activation during the dying process, larger alterations of the aperiodic EEG components were also noted. These changes differed dramatically when compared to EEG records representative of wake, slow-wave sleep, or anesthesia. Although still fundamentally unique, the neuronal activity present in the dying brain is more similar to REM sleep than any other state we tested. Conclusion: Even in patients with coma, temporal dynamics in quantitative EEG features (including the aperiodic components) can be observed in the final hour before death. |
| format | Article |
| id | doaj-art-422ba2448dbf4fcd928cb15c1862b06d |
| institution | Kabale University |
| issn | 1095-9572 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage |
| spelling | doaj-art-422ba2448dbf4fcd928cb15c1862b06d2025-01-11T06:38:34ZengElsevierNeuroImage1095-95722025-01-01305120980Parametrization of the dying brain: A case report from ICU bed-side EEG monitoringSebastian Zinn0Srdjan Z. Dragovic1Jan A. Kloka2Laurent M. Willems3Sebastian Harder4Stephan Kratzer5Kai D. Zacharowski6Gerhard Schneider7Paul S. García8Matthias Kreuzer9Department of Anesthesiology, Columbia University Medical Center, 10032 New York, NY, USA; Goethe University Frankfurt, University Hospital, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, 60590 Frankfurt am Main, Germany; Corresponding author at: Columbia University Medical Center, Department of Anesthesiology, 622 West 168th Street, New York 10032, NY, USA.Department of Anesthesiology and Intensive Care Medicine, Technical University of Munich, School of Medicine and Health, 81675 Munich, GermanyGoethe University Frankfurt, University Hospital, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, 60590 Frankfurt am Main, GermanyGoethe University Frankfurt, University Hospital, Department of Neurology, Epilepsy Center Frankfurt Rhine-Main, 60590 Frankfurt am Main, GermanyGoethe University Frankfurt, Head of the IRB of the Faculty of Medicine, 60590 Frankfurt am Main, GermanyHessing Stiftung, Department of Anesthesiology, 86199 Augsburg, GermanyGoethe University Frankfurt, University Hospital, Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, 60590 Frankfurt am Main, GermanyDepartment of Anesthesiology and Intensive Care Medicine, Technical University of Munich, School of Medicine and Health, 81675 Munich, GermanyDepartment of Anesthesiology, Columbia University Medical Center, 10032 New York, NY, USADepartment of Anesthesiology and Intensive Care Medicine, Technical University of Munich, School of Medicine and Health, 81675 Munich, GermanyBackground: Cortical high-frequency activation immediately before death has been reported, raising questions about an enhanced conscious state at this critical time. Here, we analyzed an electroencephalogram (EEG) from a comatose patient during the dying process with a standard bedside monitor and spectral parameterization techniques. Methods: We report neurophysiologic features of a dying patient without major cortical injury. Sixty minutes of frontal EEG activity was recorded using the Sedline™ monitor. Quantitative metrics of the frequency spectrum, the non-oscillatory 1/f characteristic, and signal complexity with Lemple-Ziv-Welch and permutation entropy were calculated. In addition to comparing the EEG trajectories over time, we provide a comparison to EEG records obtained from other studies with well-known vigilance states (sleep, anesthesia, and wake). Results: Although we observed changes in high-frequency activation during the dying process, larger alterations of the aperiodic EEG components were also noted. These changes differed dramatically when compared to EEG records representative of wake, slow-wave sleep, or anesthesia. Although still fundamentally unique, the neuronal activity present in the dying brain is more similar to REM sleep than any other state we tested. Conclusion: Even in patients with coma, temporal dynamics in quantitative EEG features (including the aperiodic components) can be observed in the final hour before death.http://www.sciencedirect.com/science/article/pii/S1053811924004774DeathElectroencephalographyBrain activityUnresponsive comaEnd-of-lifeFOOOF |
| spellingShingle | Sebastian Zinn Srdjan Z. Dragovic Jan A. Kloka Laurent M. Willems Sebastian Harder Stephan Kratzer Kai D. Zacharowski Gerhard Schneider Paul S. García Matthias Kreuzer Parametrization of the dying brain: A case report from ICU bed-side EEG monitoring NeuroImage Death Electroencephalography Brain activity Unresponsive coma End-of-life FOOOF |
| title | Parametrization of the dying brain: A case report from ICU bed-side EEG monitoring |
| title_full | Parametrization of the dying brain: A case report from ICU bed-side EEG monitoring |
| title_fullStr | Parametrization of the dying brain: A case report from ICU bed-side EEG monitoring |
| title_full_unstemmed | Parametrization of the dying brain: A case report from ICU bed-side EEG monitoring |
| title_short | Parametrization of the dying brain: A case report from ICU bed-side EEG monitoring |
| title_sort | parametrization of the dying brain a case report from icu bed side eeg monitoring |
| topic | Death Electroencephalography Brain activity Unresponsive coma End-of-life FOOOF |
| url | http://www.sciencedirect.com/science/article/pii/S1053811924004774 |
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