Newly Discovered ‘Brain Tsunamis’ Provide Scientific Insight into the Biology of Death

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A new study may give credit to what happens in the brain organ’s biological and irreversible death.

Published in Annals of Neurology, the study inspected the increasing depolarization of the human cerebral cortex and provided insight into how the brain responds to energy depletion.

The depolarization of brain cells is compared to tsunamis in their violence, like sporadic waves passing through the nervous system and causing destruction on a large scale.

Although restoring circulation is the primary goal of emergency treatment, researchers believe that understanding how the brain responds to energy depletion could help predict the time available for resuscitation “until damage.” irreversible ‘occur in the brain.

“This potentially reversible wave of spread typically begins 2 to 5 minutes after the onset of severe ischemia, marking the onset of a toxic intraneuronal change that ultimately results in irreversible damage,” the study said.

New study gives researchers insight into how the brain responds to energy depletion. A picture of a human brain taken by a PET scan, 2019.
FRED TANNEAU / AFP / Getty Images

The methodology employed by the researchers was to make recordings with electrode strips or electrode arrays in patients with devastating brain damage that resulted in the activation of a “Do Not Resuscitate – Comfort Care” command. .

Nine patients underwent what the researchers described as “invasive neurosurveillance” at two separate institutions: four at Charité-Universitätsmedizin in Berlin and five at the University of Cincinnati Medical Center. Written consent was obtained from the legal representatives of the patients.

In 2017, US researchers reported the first known case of brain damage reversal when they treated a drowned 2-year-old girl. After being unable to speak, walk, or respond to voices, doctors used various oxygen treatments that dramatically reversed his brain damage.

According to the study, knowledge of pathological mechanisms informs treatment strategies that complement the restoration of systemic circulation, as neuroprotective interventions could be directed against the wave of depolarization with the aim of prolonging survival time.

While this research may be of great benefit to patients suffering or at risk of brain damage or death as a result of cerebral ischemia, or even potential strokes, it is implied that many more studies need to be done. carried out to better analyze and evaluate an organ as complex as the brain.

“Our results suggest that this occurs with some biological variability following circulatory arrest and cessation of spontaneous brain activity, which may have implications for ethical debates regarding [donation after cardiac death]”The study said.” There are currently no indicators – experimental or clinical – to determine when spreading terminal depolarization becomes irreversible [i.e., when restoration of function is no longer possible], yet the depolarized state after circulatory arrest will not reverse spontaneously in the absence of intervention. “


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