Nasal Air Puff Promotes Default Mode Network Activity in Mechanically Ventilated Comatose Patients: A Noninvasive Brain Stimulation Approach

Morteza Salimi; Amir Homayoun Javadi; Milad Nazari; Sobhan Bamdad; Farhad Tabasi; Tannaz Parsazadegan; Fahime Ayene; Maede Karimian; Leila Gholami-Mahtaj; Shahin Shadnia; Hamidreza Jamaati; Alireza Salimi; Mohammad Reza Raoufy

doi:10.1016/j.neurom.2021.11.003

Nasal Air Puff Promotes Default Mode Network Activity in Mechanically Ventilated Comatose Patients: A Noninvasive Brain Stimulation Approach

Morteza Salimi, Amir Homayoun Javadi, Milad Nazari, Sobhan Bamdad, Farhad Tabasi, Tannaz Parsazadegan, Fahime Ayene, Maede Karimian, Leila Gholami-Mahtaj, Shahin Shadnia, Hamidreza Jamaati, Alireza Salimi, Mohammad Reza Raoufy

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

3 Citationer (Scopus)

Abstract

OBJECTIVES: Coma state and loss of consciousness are associated with impaired brain activity, particularly gamma oscillations, that integrate functional connectivity in neural networks, including the default mode network (DMN). Mechanical ventilation (MV) in comatose patients can aggravate brain activity, which has decreased in coma, presumably because of diminished nasal airflow. Nasal airflow, known to drive functional neural oscillations, synchronizing distant brain networks activity, is eliminated by tracheal intubation and MV. Hence, we proposed that rhythmic nasal air puffing in mechanically ventilated comatose patients may promote brain activity and improve network connectivity. MATERIALS AND METHODS: We recorded electroencephalography (EEG) from 15 comatose patients (seven women) admitted to the intensive care unit because of opium poisoning and assessed the activity, complexity, and connectivity of the DMN before and during the nasal air-puff stimulation. Nasal cavity air puffing was done through a nasal cannula controlled by an electrical valve (open duration of 630 ms) with a frequency of 0.2 Hz (ie, 12 puff/min). RESULTS: Our analyses demonstrated that nasal air puffing enhanced the power of gamma oscillations (30-100 Hz) in the DMN. In addition, we found that the coherence and synchrony between DMN regions were increased during nasal air puffing. Recurrence quantification and fractal dimension analyses revealed that EEG global complexity and irregularity, typically seen in wakefulness and conscious state, increased during rhythmic nasal air puffing. CONCLUSIONS: Rhythmic nasal air puffing, as a noninvasive brain stimulation method, opens a new window to modifying the brain connectivity integration in comatose patients. This approach may potentially influence comatose patients' outcomes by increasing brain reactivity and network connectivity.

Originalsprog	Engelsk
Tidsskrift	Neuromodulation: Technology at the Neural Interface
Vol/bind	25
Nummer	8
Sider (fra-til)	1351-1363
Antal sider	13
ISSN	1094-7159
DOI	https://doi.org/10.1016/j.neurom.2021.11.003
Status	Udgivet - dec. 2022

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Salimi, M., Javadi, A. H., Nazari, M., Bamdad, S., Tabasi, F., Parsazadegan, T., Ayene, F., Karimian, M., Gholami-Mahtaj, L., Shadnia, S., Jamaati, H., Salimi, A., & Raoufy, M. R. (2022). Nasal Air Puff Promotes Default Mode Network Activity in Mechanically Ventilated Comatose Patients: A Noninvasive Brain Stimulation Approach. Neuromodulation: Technology at the Neural Interface, 25(8), 1351-1363. https://doi.org/10.1016/j.neurom.2021.11.003

@article{965b9ce4fcba4bbabeff50e297be1ada,

title = "Nasal Air Puff Promotes Default Mode Network Activity in Mechanically Ventilated Comatose Patients: A Noninvasive Brain Stimulation Approach",

abstract = "OBJECTIVES: Coma state and loss of consciousness are associated with impaired brain activity, particularly gamma oscillations, that integrate functional connectivity in neural networks, including the default mode network (DMN). Mechanical ventilation (MV) in comatose patients can aggravate brain activity, which has decreased in coma, presumably because of diminished nasal airflow. Nasal airflow, known to drive functional neural oscillations, synchronizing distant brain networks activity, is eliminated by tracheal intubation and MV. Hence, we proposed that rhythmic nasal air puffing in mechanically ventilated comatose patients may promote brain activity and improve network connectivity. MATERIALS AND METHODS: We recorded electroencephalography (EEG) from 15 comatose patients (seven women) admitted to the intensive care unit because of opium poisoning and assessed the activity, complexity, and connectivity of the DMN before and during the nasal air-puff stimulation. Nasal cavity air puffing was done through a nasal cannula controlled by an electrical valve (open duration of 630 ms) with a frequency of 0.2 Hz (ie, 12 puff/min). RESULTS: Our analyses demonstrated that nasal air puffing enhanced the power of gamma oscillations (30-100 Hz) in the DMN. In addition, we found that the coherence and synchrony between DMN regions were increased during nasal air puffing. Recurrence quantification and fractal dimension analyses revealed that EEG global complexity and irregularity, typically seen in wakefulness and conscious state, increased during rhythmic nasal air puffing. CONCLUSIONS: Rhythmic nasal air puffing, as a noninvasive brain stimulation method, opens a new window to modifying the brain connectivity integration in comatose patients. This approach may potentially influence comatose patients' outcomes by increasing brain reactivity and network connectivity.",

keywords = "Coma state, default mode network, nasal air puff, noninvasive brain stimulation",

author = "Morteza Salimi and Javadi, {Amir Homayoun} and Milad Nazari and Sobhan Bamdad and Farhad Tabasi and Tannaz Parsazadegan and Fahime Ayene and Maede Karimian and Leila Gholami-Mahtaj and Shahin Shadnia and Hamidreza Jamaati and Alireza Salimi and Raoufy, {Mohammad Reza}",

year = "2022",

month = dec,

doi = "10.1016/j.neurom.2021.11.003",

language = "English",

volume = "25",

pages = "1351--1363",

journal = "Neuromodulation: Technology at the Neural Interface",

issn = "1094-7159",

publisher = "Wiley-Blackwell Publishing, Inc.",

number = "8",

}

Salimi, M, Javadi, AH, Nazari, M, Bamdad, S, Tabasi, F, Parsazadegan, T, Ayene, F, Karimian, M, Gholami-Mahtaj, L, Shadnia, S, Jamaati, H, Salimi, A & Raoufy, MR 2022, 'Nasal Air Puff Promotes Default Mode Network Activity in Mechanically Ventilated Comatose Patients: A Noninvasive Brain Stimulation Approach', Neuromodulation: Technology at the Neural Interface, bind 25, nr. 8, s. 1351-1363. https://doi.org/10.1016/j.neurom.2021.11.003

Nasal Air Puff Promotes Default Mode Network Activity in Mechanically Ventilated Comatose Patients: A Noninvasive Brain Stimulation Approach. / Salimi, Morteza; Javadi, Amir Homayoun; Nazari, Milad et al.
I: Neuromodulation: Technology at the Neural Interface, Bind 25, Nr. 8, 12.2022, s. 1351-1363.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Nasal Air Puff Promotes Default Mode Network Activity in Mechanically Ventilated Comatose Patients

T2 - A Noninvasive Brain Stimulation Approach

AU - Salimi, Morteza

AU - Javadi, Amir Homayoun

AU - Nazari, Milad

AU - Bamdad, Sobhan

AU - Tabasi, Farhad

AU - Parsazadegan, Tannaz

AU - Ayene, Fahime

AU - Karimian, Maede

AU - Gholami-Mahtaj, Leila

AU - Shadnia, Shahin

AU - Jamaati, Hamidreza

AU - Salimi, Alireza

AU - Raoufy, Mohammad Reza

PY - 2022/12

Y1 - 2022/12

N2 - OBJECTIVES: Coma state and loss of consciousness are associated with impaired brain activity, particularly gamma oscillations, that integrate functional connectivity in neural networks, including the default mode network (DMN). Mechanical ventilation (MV) in comatose patients can aggravate brain activity, which has decreased in coma, presumably because of diminished nasal airflow. Nasal airflow, known to drive functional neural oscillations, synchronizing distant brain networks activity, is eliminated by tracheal intubation and MV. Hence, we proposed that rhythmic nasal air puffing in mechanically ventilated comatose patients may promote brain activity and improve network connectivity. MATERIALS AND METHODS: We recorded electroencephalography (EEG) from 15 comatose patients (seven women) admitted to the intensive care unit because of opium poisoning and assessed the activity, complexity, and connectivity of the DMN before and during the nasal air-puff stimulation. Nasal cavity air puffing was done through a nasal cannula controlled by an electrical valve (open duration of 630 ms) with a frequency of 0.2 Hz (ie, 12 puff/min). RESULTS: Our analyses demonstrated that nasal air puffing enhanced the power of gamma oscillations (30-100 Hz) in the DMN. In addition, we found that the coherence and synchrony between DMN regions were increased during nasal air puffing. Recurrence quantification and fractal dimension analyses revealed that EEG global complexity and irregularity, typically seen in wakefulness and conscious state, increased during rhythmic nasal air puffing. CONCLUSIONS: Rhythmic nasal air puffing, as a noninvasive brain stimulation method, opens a new window to modifying the brain connectivity integration in comatose patients. This approach may potentially influence comatose patients' outcomes by increasing brain reactivity and network connectivity.

AB - OBJECTIVES: Coma state and loss of consciousness are associated with impaired brain activity, particularly gamma oscillations, that integrate functional connectivity in neural networks, including the default mode network (DMN). Mechanical ventilation (MV) in comatose patients can aggravate brain activity, which has decreased in coma, presumably because of diminished nasal airflow. Nasal airflow, known to drive functional neural oscillations, synchronizing distant brain networks activity, is eliminated by tracheal intubation and MV. Hence, we proposed that rhythmic nasal air puffing in mechanically ventilated comatose patients may promote brain activity and improve network connectivity. MATERIALS AND METHODS: We recorded electroencephalography (EEG) from 15 comatose patients (seven women) admitted to the intensive care unit because of opium poisoning and assessed the activity, complexity, and connectivity of the DMN before and during the nasal air-puff stimulation. Nasal cavity air puffing was done through a nasal cannula controlled by an electrical valve (open duration of 630 ms) with a frequency of 0.2 Hz (ie, 12 puff/min). RESULTS: Our analyses demonstrated that nasal air puffing enhanced the power of gamma oscillations (30-100 Hz) in the DMN. In addition, we found that the coherence and synchrony between DMN regions were increased during nasal air puffing. Recurrence quantification and fractal dimension analyses revealed that EEG global complexity and irregularity, typically seen in wakefulness and conscious state, increased during rhythmic nasal air puffing. CONCLUSIONS: Rhythmic nasal air puffing, as a noninvasive brain stimulation method, opens a new window to modifying the brain connectivity integration in comatose patients. This approach may potentially influence comatose patients' outcomes by increasing brain reactivity and network connectivity.

KW - Coma state

KW - default mode network

KW - nasal air puff

KW - noninvasive brain stimulation

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U2 - 10.1016/j.neurom.2021.11.003

DO - 10.1016/j.neurom.2021.11.003

M3 - Journal article

C2 - 35088756

AN - SCOPUS:85128816134

SN - 1094-7159

VL - 25

SP - 1351

EP - 1363

JO - Neuromodulation: Technology at the Neural Interface

JF - Neuromodulation: Technology at the Neural Interface

IS - 8

ER -

Nasal Air Puff Promotes Default Mode Network Activity in Mechanically Ventilated Comatose Patients: A Noninvasive Brain Stimulation Approach

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