The possibilities for partial rehabilitation of the integrative activity of the brain in patients in a vegetative state

Abstract

An integrated neuroreconstructive approach to stimulating the pathogenetic mechanisms of a vegetative state developed due to a severe traumatic brain injury (TBI) is suggested. It has been shown that a faster and more pronounced therapeutic effect, compared with conventional therapies, could be achieved through the application of transtimpanal chemical vestibular dereception and transcranial micropolarization. The results of neurophysiological in-depth examination in dynamics have shown that over time interregional cortical interactions become more intense, “rigid,” and “tight” in patients with a vegetative state, while the temporal-parietal-occipital areas begin to dominate in the organization of these interactions in the cortex of both hemispheres. It is assumed that the vestibulothalamic tract, owing to its anatomical location, appears to be the least vulnerable under the conditions of brain stem dislocation due to a severe TBI. As a result, vestibular afferentation appears to become a predominant kind of afferentation for generating interregional cortical interactions. A pathological functional system develops on the basis of this afferentation, blocking other functional systems in the damaged brain. The suggested therapies significantly reduce the amount of vestibular afferent inputs and open a possibility for restoring more effective afferent interactions. This significantly facilitates the functioning of the brain as a multimodal analyzer.