Efficacy of acupuncture to regain consciousness in patients with traumatic brain injury: a systematic review and meta-analysis

Background:Traumatic brain injury(TBI)is a leading cause of death and disability worldwide,and consciousness disorder is a common problem in TBI patients.Acupuncture has been used to improve neurological deficits in patients with TBI.This meta-analysis aims to evaluate the effects and safety of acupuncture in improving consciousness in patients with TBI when compared with other therapies.Methods:A systematic search was conducted in electronic databases PubMed,EMBASE,Web of Science,the Cochrane Central Register of Controlled Trials,Allied and Complementary Medicine Database,WHO International Clinical Trials Registry Platform,ClinicalTrials.gov,and Google Scholar for randomized controlled trials that investigated the effect of acupuncture on patients with TBI.From the inception of databases to March 2023.Results:A total of 653 participants were included in nine trials.We found that acupuncture adjunct to routine treatment significantly improved the wakeup rate of patients in TBI when compared with routine treatment alone(relative risk=1.36,95%confidence interval:1.16 to 1.59,I2=4.78%,P=0).Additionally,we found that acupuncture is significantly associated with reduced impaired consciousness after TBI when adjunct to medicine therapy.As a safe intervention,acupuncture can also improve the activities of daily living for people with TBI(mean difference=15.71,95%confidence interval:9.19 to 22.22,I2=0%,P=0).Conclusion:Acupuncture can improve consciousness and braise wakeup of patients with TBI when adjunct to conventional treatment compared with routine treatment alone.Further high-quality studies are needed to confirm these findings and to determine the optimal acupuncture treatment parameter for TBI.

God Is a Porcupine—Brain, Consciousness and Spacetime Physics

Whereas the human body requires a vast numbers of atoms to maintain its intricate anatomical functions, we assert that the human brain requires “something extra” to carry out its higher mental and emotional functions. Recently, neuroscientists are beginning to suspect brain cells are not fast enough, or intricate enough, to correlate complex spatiotemporal information into cognitive understanding. They conclude that spacetime fields may be necessary to assist the brain during neurological processing—in much the same way magnetic and electric fields are essential for the propagation of light. This “something extra,” we argue, is spacetime itself—where structures in the brain, called facilitators (somewhat like Descartes pineal gland), have evolved biologically in such a way, so as to be able to store and retrieve spacetime quanta for the formation and generation of consciousness and memory. In this way, cognition is not a thing complete. Rather it is emergent, and accumulates as discretized spacetime quanta in the brain so rapidly, we perceive our own awareness to be continuous, events spontaneous. In this paper, we consider spacetime to be a field (like all quantum fields), which can be excited into quanta particles called gravitons. We then apply this quanta excitation to help explain the brain’s cognitive processes. If the brain has indeed evolved to interact with discretized spacetime, then with the advent of improved functional imaging equipment, we might be able to map detailed correlations between neural processes, conscious experience and spacetime. In so doing, it might be possible to learn more about the fundamental workings of spacetime itself.

Brain Network Studies in Chronic Disorders of Consciousness:Advances and Perspectives

Neuroimaging has opened new opportunities to study the neural correlates of consciousness, and provided additional information concerning diagnosis, prognosis, and therapeutic interventions in patients with disorders of consciousness. Here, we aim to review neuroimaging studies in chronic disorders of consciousness from the viewpoint of the brain network, focusing on positron emission tomogra- phy, functional MRI, functional near-infrared spectroscopy, electrophysiology, and diffusion MRI. To accelerate basic research on disorders of consciousness and provide a panoramic view of unconsciousness, we propose that it is urgent to integrate different techniques at various spatiotemporal scales, and to merge fragmented findings into a uniform ＂Brainnetome＂ （Brain-net-ome） research framework.

Clinical Decision on Disorders of Consciousness After Acquired Brain Injury:Stepping Forward

Major advances have been made over the past few decades in identifying and managing disorders of consciousness(DOC)in patients with acquired brain injury(ABI),bringing the transformation from a conceptualized definition to a complex clinical scenario worthy of scientific exploration.Given the continuously-evolving framework of precision medicine that integrates valuable behavioral assessment tools,sophisticated neuroimaging,and electrophysiological techniques,a considerably higher diagnostic accuracy rate of DOC may now be reached.During the treatment of patients with DOC,a variety of intervention methods are available,including amantadine and transcranial direct current stimulation,which have both provided class II evidence,zolpidem,which is also of high quality,and non-invasive stimulation,which appears to be more encouraging than pharmacological therapy.However,heterogeneity is profoundly ingrained in study designs,and only rare schemes have been recommended by authoritative institutions.There is still a lack of an effective clinical protocol for managing patients with DOC following ABI.To advance future clinical studies on DOC,we present a comprehensive review of the progress in clinical identification and management as well as some challenges in the pathophysiology of DOC.We propose a preliminary clinical decision protocol,which could serve as an ideal reference tool for many medical institutions.

Possibility for Recognition of Psychic Brain Activity with Continuous Wavelet Analysis of EEG

The brain is a unique organization in nature, possessing the ability for psychic activity, which manifests itself in thoughts, feelings and emotions. In present days, numbers of mathematical methods for analysis of electroencephalogram (EEG) were developed with continuous wavelet transform being one of the most successive approaches for studying of brain activity. This paper is aimed to develop methods for investigation of psychic brain activity with help of continuous wavelet analysis of EEG. Ability of human to realize semantic content of the image presented on the screen was tested. Experiment was accompanied with simultaneous EEG recording, which was held with developed software and PC-based experimental setup. The information capabilities of continuous wavelet transform-based method for EEG analysis were improved for the recognition of specific patterns in human brain activity. Comparative wavelet analysis was carried out for EEG recordings at the moment of awareness of the semantic content of the image and for EEG recordings in the absence of conscious (subjective) perception of the semantic content of the image. Significant differences were shown in the alpha rhythm of EEG for the moments of awareness of the semantic content of the image and for the moments of absence of conscious perception. Continuous wavelet analysis of EEG showed that the alpha rhythm is the main EEG rhythm, which can be used to estimate the presence of subjective perception of the visual image. Significant differences were shown in the alpha rhythm of EEG for the moments of awareness of the semantic content of the image and for the moments of absence of conscious perception. Conducted studies allow to conclude that revealing of brain activity related to visual image awareness is possible through analysis of EEG.

Recovery from prolonged disorders of consciousness:A dual-center prospective cohort study in China

BACKGROUND Recent innovations in intensive care have improved the prognosis of patients with severe brain injuries and brought more patients with disorders of consciousness(DoC).Data are lacking regarding the long-term outcomes of those patients in China.It is necessary to study the long-term outcomes of patients with prolonged DoC in light of many factors likely to influence crucial decisions about their care and their life.AIM To present the preliminary results of a DoC cohort.METHODS This was a two-center prospective cohort study of inpatients with vegetative state(VS)/unresponsive wakefulness syndrome(UWS).The study outcomes were the recovery from VS/UWS to minimally conscious state(MCS)and the long-term status of patients with prolonged DoC considered in VS/UWS or MCS for up to 6 years.The patients were evaluated using the Glasgow coma scale,coma recovery scale-revised,and Glasgow outcome scale.The endpoint of follow-up was recovery of full consciousness or death.The changes in the primary clinical outcome improvement in clinical diagnosis were evaluated at 12 mo compared with baseline.RESULTS The study population included 93 patients(62 VS/UWS and 31 MCS).The postinjury interval range was 28-634 d.Median follow-up was 20 mo(interquartile range,12-37 mo).At the endpoint,33 transitioned to an emergence from MCS or full consciousness,eight had a locked-in syndrome,and there were 35 patients remaining in a VS/UWS and 11 in an MCS.Seven(including one locked-in syndrome)patients(7.5%)died within 12 mo of injury.Compared with the unresponsive group(n=52)at 12 mo,the responsive group(n=41)had a higher proportion of males(87.8%vs 63.5%,P=0.008),shorter time from injury(median,40.0 d vs 65.5 d,P=0.006),higher frequency of vascular etiology(68.3%vs 38.5%,P=0.007),higher Glasgow coma scale score at admission(median,9 vs 6,P<0.001),higher coma recovery scale-revised score at admission(median,9 vs 2.5,P<0.001),at 1 mo(median,14 vs 5,P<0.001),and at 3 mo(median,20 vs 6,P<0.001),lower frequency of VS/UWS(36.6%vs 90.0%,P<0.001),and more favorable Glasgow outcome scale outcome(P<0.001).CONCLUSION Patients with severe DoC,despite having strong predictors of poor prognosis,might recover consciousness after a prolonged time of rehabilitation.An accurate initial diagnosis of patients with DoC is critical for predicting outcome and a long-term regular follow-up is also important.

The Molecularly Fielding Psychophysical Nature of the Brain Mental Activity

The brain is a unique organization in nature, having the psychic activity, which is expressed in subjective states: thoughts, feelings, emotions. Knowledge of the nature of mental activity of the brain is the most urgent and the most challenging task of physiology. Historically the neurophysiology developed on the basis of physical and chemical laws discovered in an inanimate nature. Our investigation is devoted towards the origin of a human subjective state, and presents a new methodology for studying of the nature psychic brain activity. We have established the existence of physical phenomena unique for the living brain so-called “psychogenic field”, which reflects the expressed psychic state of human brain. The subjective state of a human being was shown to affect remotely the physicochemical properties of the blood. An original schematic diagram is presented to describe the formation of the brain psychic activity. This approach is based on the feedback influence of a psychogenic field on neuronal molecular processes (self-induction in the brain). We propose a paradigm for the origin of psychic state and possible existence of the fields, which are unique for the brain. The presented scheme and paradigm of systemic organization of psychic activity of the brain are a prerequisite for the subsequent development of the theory consciousness.

Transcutaneous auricular vague nerve stimulation improved brain connection activity on patients of disorders of consciousness: a pilot study

OBJECTIVE:To evaluate the clinical effect of transcutaneous auricular vagus nerve nerve stimulation(ta VNS)on disorders of consciousness(DOC)patients with Coma Recovery Scale-Revised(CRS-R)and cerebral cortex activity by electroencephalogram(EEG)detection.METHODS:Randomized controlled methods were used to evaluate the clinical effect of ta VNS on patients with DOC.Twelve patients with initial CRS-R of 6-10 were randomly divided into the treatment group of ta VNS and control group of transcutaneous non-auricular vague nerve stimulation(tn VNS).According to clinical diagnosis,the treatment group was divided into vegetative state(VS)group and minimally conscious state(MCS)group.RESULTS:The energy of delta and beta bands is positively correlated with the brain activity of patients.ta VNS has different regulatory effects on patients with different conscious States.In ta VNS group,the energy of delta band in local brain regions changed significantly.Significant changes in brain connection activity were limited to local brain regions.While in patients with MCS in the ta VNS group,delta and beta band energy significantly changed in multiple brain regions and crossbrain connection activity also changed significantly.CONCLUSION:These findings suggest that ta VNS may be a related extra method for arousing patients’awakening by improving brain connection activity.And the effect is remarkable in MCS patients.

To Knowledge of the Origin of the Brain Mental Activity

This paper is devoted towards the origin of a human subjective state, and we present a methodology for studying the origin of brain activity. We were first to reveal that the subjective states of a human being can be subjected to an objective remote registration. Recently we have established the existence of the so-called “psychogenic field”, which reflects the subjective state of human brain. The subjective state of a human being was shown to affect remotely the physicochemical properties of the blood. The interaction of neurophysiological and subjective processes is described in the context of systemic organization of a goal-directed behavior. An original schematic diagram is presented to describe the formation of a subjective brain state. This approach is based on the feedback influence of a psychogenic field on neuronal molecular processes (self-induction in the brain). We propose a paradigm for the origin of a subjective state and possible existence of physical phenomena and brain fields, which are unique for the active brain.

Visual Fixation Assessment in Patients with Disorders of Consciousness Based on Brain-Computer Interface

Visual fixation is an item in the visual function subscale of the Coma Recovery Scale-Revised （CRS-R）. Sometimes clinicians using the behavioral scales find it difficult to detect because of the motor impairment in patients with disorders of consciousness （DOCs）. Brain- computer interface （BCI） can be used to improve clinical assessment because it directly detects the brain response to an external stimulus in the absence of behavioral expres- sion. In this study, we designed a BCI system to assist the visual fixation assessment of DOC patients. The results from 15 patients indicated that three showed visual fixation in both CRS-R and BCI assessments and one did not show such behavior in the CRS-R assessment but achieved significant online accuracy in the BCI assessment. The results revealed that electroencephalography-based BCI can detect the brain response for visual fixation. Therefore, the proposed BCI may provide a promising method for assisting behavioral assessment using the CRS-R.

N-methyl-D-aspartate receptor subtype 3A promotes apoptosis in developing mouse brain exposed to hyperoxia

In the present study, 7 day postnatal C57/BL6 wild-type mice （hyperoxia group） and 7 day postnatal N-methyI-D-aspartate receptor subtype 3A knockout mice （NR3A KO group） were exposed to 75% oxygen and 15% nitrogen in a closed container for 5 days. Wild-type mice raised in normoxia served as controls. TdT-mediated dUTP nick end labeling （TUNEL）/neuron-specific nuclear protein （NeuN） and 5-bromo-2＇-deoxyuridine （BrdU）/NeuN immunofluorescence staining showed that the number of apoptotic cells and the number of proliferative cells in the dentate subgranular zone significantly increased in the hyperoxia group compared with the control group. However, in the same hyperoxia environment, the number of apoptotic cells and the number of proliferative cells significantly decreased in the NR3A KO group compared with hyperoxia group. TUNEL＋/NeuN＋ and BrdU＋/NeuN~ cells were observed in the NR3A KO and the hyperoxia groups. These results demonstrated that the NR3A gene can promote cell apoptosis and mediate the potential damage in the developing brain induced by exposure to non-physiologically high concentrations of oxygen.

Remote-Field Manifestations of Mental Activity of the Human Brain

The aim of the present study is to investigate mental activity of the brain. The article deals with external remote-field manifestation of the subjective state of a person. There are statistically significant results obtained which demonstrate contactless remote influence of the subjective state of a person on erythrocyte sedimentation rate in different blood groups, Rh-positive and Rh-negative blood, and under different conditions of exposure. The authors set up a hypothesis of the existence of molecular structures in the blood, which can provide a remote response to expressed subjective state of a person.

Implications of rare neurological disorders and perceptual errors in natural and synthetic consciousness

Recent theories on natural and synthetic consciousness overlook the geometric structure necessary for awareness of 3-dimensional space, as strikingly illustrated by left-neglect disorder. Furthermore, awareness of 3-dimensional space entails some surprisingly tenacious optical illusions, as demonstrated by an experiment in the text. Awareness of linear time is also crucial and complex. As a consequence, synthetic consciousness cannot be realized by simply intercomnecting a large number of electronic circuits constructed from ordinary chips and transistors. Since consciousness is a subjective experience, there is no sufficient condition for consciousness that can be experimentally confirmed. The most we can hope for is agreement on the necessary conditions for consciousness. Toward that end, this paper reviews some relevant clinical phenomena.

Consciousness and Near-Death Experiences: Access to a Known World

Near-death or death-like experiences are a natural, albeit uncommon, phenomenon due to the temporary and reversible decoupling or dissociation of the Psychosoma from its material counterpart, the physical body. Indeed, these “psychophysical events” are fundamental in clinical conditions that lead to unconsciousness in individuals declared clinically dead or who have come very close to physical death. In addition, Consciousness is fundamental in the occurrence of these experiences. In fact, Consciousness, a higher order field, is the entity that vibrationally dissociates from the physical body and is also the protagonist of the entire chain of events of near-death experiences, as well as out-of-body experiences. Undoubtedly, matter is a creation of the Universal Intelligent Principle and the primary cause of all things. Thus, Consciousness is the basis of all existence, of primordial reality. Vehicle of manifestation of Consciousness, the Psychosoma is a morphogenetic, vaporous, translucent, luminous body which is also made up of all organs, including the immaterial brain [mind] and the other electromagnetic systems of the human body. The Psychosoma is, therefore, the connection bridge between Consciousness, a complex subtle field, non-electromagnetic, responsible for all phenomena of near-death experiences in connection with the dense field of gross matter, the physical body. For example, the Consciousness is the one who sees, feels pain and welcomes its family members on the verge of death during the near-death experience in any vibrational dimension, even being perceived by the Psychosoma. Here it is important to remember that dimension is not a place. It’s a vibration. It’s a frequency. The main objective of this article is to approach innovative and comprehensive concepts about the role of Consciousness in near-death experiences as well as to try to overcome limiting paradigms that prevents the progress of science. In addition, concepts based on quantum holography and information theory were raised here. Following this reasoning, I start with the formulation of a hypothesis about the role of Consciousness in near-death and out-of-body experiences. Thus, we propose a new and unique approach to Consciousness in order to investigate the role of Mind and its relationship with life and death. In this way, we intend to introduce new concepts for discussion and not give the last word to the currently unanswered questions of Consciousness regarding its interaction with the environment;with death and life and finally with respect to its origin. Finally, a selective bibliographic research was carried out in English language databases with the purpose of making the study design compatible, which presents specific concepts of a subject that had been little studied until then.

Coherence Field Theory: Quantum Coherence as the Basis for a Model of Brain Function

A general definition of quantum coherence is developed from analysis of superposition, entanglement, chemical bonding behavior, and basic phenomena of classical mechanics. Various properties of atoms can be better explained if these particles are matter waves that embody a spectrum ranging from relatively coherent to decoherent states. It is demonstrated that quantum coherence so defined can comprehensively explain signal transmission in neurons and dynamics of the brain’s emergent electric field, including potential support for the claim that conscious volition is to some degree real rather than an illusion. Recent research in a physiological context suggests that electromagnetic radiation interacts with molecular structure to comprise integrated energy fields. A mechanism is proposed by which quantum coherence as accelerating electric currents in neurons may result in a broadened spectrum of electromagnetic radiation capable of interacting with molecular complexes in the brain and perhaps elsewhere in an organism to influence vibrational and structural properties. Research should investigate whether a consequent energy field is the basic perceptual substrate, with at least some additive electromagnetic wavelengths of this field involved in generating image percepts insofar as they arise from the body, and electromagnetic vibrations the signature of a more diverse phenomenon by which somewhat nondimensional features of perception such as sound, touch, taste, smell, interoceptive sensations, etc. partially arise. If examination of the brain reveals this organ to be composed of a coherence field, structured at least in part by broadened spectrums of EM radiation interacting with molecular components, this has major implications for furthering our model of the matter/mind interface and possibly physical reality in total.

Revealing True and False Brain States Based on Wavelet Analysis of Electroencephalogram

Statement of the Problem: As you know, there exist two different states in the brain’s mental activity: true and false. In recent years, a progressive method of wavelet transformation of the electroencephalogram (EEG) has been developed, which enabled us to establish the fundamental possibility of direct objective registration of the human brain’s mental activity. Earlier, we created an experimental model and software for recognizing true and false mental responses of a person based on the EEG wavelet transformation and described it in the article. The developed experimental model and information software made it possible to compare the two mental states of brain activity by electroencephalographic indicators, one of which is false and the other is true. The goal is to develop a fundamentally new information technology for recognizing true and false states in the brain’s mental activity based on the wavelet transformation of the electroencephalogram. Results: It was revealed that the true and false states of the brain can be distinguished using the method of continuous wavelet transformation and calculation of the EEG wavelet energy. It is shown that the main differences between true and false mental responses are observed in the delta and alpha ranges of the EEG. In the EEG delta rhythm, the wavelet energy is reliably higher in case of a false answer compared to a true one. In the EEG alpha rhythm, the wavelet energy is significantly higher with a true answer than a false one. Practical significance of the research: The data obtained open up the fundamental possibility of identifying true and false mental states of the brain on the basis of continuous wavelet transformation and calculation of the EEG wavelet energy.

What is Mind,What is Consciousness,and Where This Resides

The main purpose of this paper is to respond to the questions what is mind and consciousness and where this resides.The answers are based on the frontline Informational Model of Human Body and Living Structures(IMHBLS),which shows that mind and consciousness can be described by the activity of the Informational System of the Human Body and Living Structures(ISHBLS),consisting of seven informational components,each of them with specific activity and functions,inter-correlated to support the immaterial/informational manifestation of the body expressed by mind and consciousness.The basic concept of matter-related and virtual information results as a consequence of the operability of the physics,chemistry,biologic,or mathematics laws,which actually act as informational operators,such processes are informationally driven and manifested finally as a“media-like functions”of mind and consciousness,on the“screen/display”of prefrontal cortex.The mind is therefore described as the capacity of every individual to access the data field of own life experience,where the thought acts as an informational operator,which can activate the required information from internal/external reality.Consciousness is the result of the info-representation of the explored reality,accumulated by the momentary connection,and compared/combined with the life experience,serving as judgment reference/criteria.The question is discussed in relation with the localization of consciousness,showing that this resides in the brain,as a result of the activity of ISHBLS.The discussion on the experimental evidences concerning the minimal basic components necessary and sufficient to sustain consciousness,compared with the results of the informational model,indicates the cortico-thalamus axis,in a full agreement each other.One of the basic findings is that the activation of consciousness is operated in two steps,one consisting in a feed-forward reception and another in feedback perception for recognition of the info-significance,which is fully supported by the recently reported experimental results.The phenomena of intuition,inspiration,premonition,“deja vue”,retrocausality,and intentionality are discussed.This model unifies the eastern and western concepts/models on consciousness and mind,explaining the energetic Yung/Yin Chinese model by YES/NO-informational Bit-type behavior,the Plato’s ideas/forms by“information”concept as a participating component of reality,Aristotle’s materialist view with matter structuration(assisted by information),and archaic model of the seven“chakras”at human,as vital informational centers connected with the body.

Risk factors for brain injury in patients with exertional heatstroke:A 5-year experience

Purpose:Minimal data exist on brain injury in patients with exertional heatstroke(EHS)in developing country.In this study,we explored the risk factors for brain injury induced by EHS 90-day after onset.Methods:A retrospective cohort study of patients with EHS was conducted in the intensive care unit of the General Hospital of Southern Theater Command of PLA in China from April 2014 to June 2019.Patients were divided into non-brain injury(fully recovered)and brain injury groups(comprising deceased patients or those with neurological sequelae).The brain injury group was further subdivided into a death group and a sequela group for detailed analysis.General information,neurological performance and information on important organ injuries in the acute stage were recorded and analysed.Multivariable logistic regression was used to identify risk factors for brain injury after EHS and mortality risk factors for brain injury,and Kaplan-Meier survival curve was used to evaluate the effect of the neurological dysfunction on survival.Results:Out of the 147 EHS patients,117 were enrolled,of which 96(82.1%)recovered,13(11.1%)died,and 8(6.8%)experienced neurological sequelae.Statistically significant differences were found between non-brain injury and brain injury groups in age,hypotension,duration of consciousness disorders,time to drop core body temperature below 38.5℃,lymphocyte counts,platelet counts,procalcitonin,alanine aminotransferase,aspartate aminotransferase,creatinine,cystatin C,coagulation parameters,international normalized ratio,acute physiology and chronic health evaluation II scores,sequential organ failure assessment(SOFA)scores,and Glasgow coma scale scores(all p<0.05).Multivariate logistic regression showed that age(OR=1.090,95%CI:1.02-1.17,p=0.008),time to drop core temperature(OR=8.223,95%CI:2.30-29.40,p=0.001),and SOFA scores(OR=1.676,95%CI:1.29-2.18,p<0.001)are independent risk factors for brain injury induced by EHS.The Kaplan-Meier curves suggest significantly prolonged survival(p<0.001)in patients with early Glasgow coma scale score>8 and duration of consciousness disorders≤24 h.Conclusions:Advanced age,delayed cooling,and higher SOFA scores significantly increase the risk of brain injury post-EHS.These findings underscore the importance of rapid cooling and early assessment of organ failure to improve outcomes in EHS patients.

Current Status of Neuromodulatory Therapies for Disorders of Consciousness

Treatment for disorders of consciousness （DOCs） is still a Gordian knot. Evidence-based guidelines on the treatment of DOC patients are not currently available, while neuromodulation techniques are seen as a potential treatment. Multiple neuromodulation therapies have been applied. This article reviews the most relevant studies in the literature in order to describe a clear picture of the current state of neuromodulation therapies that could be used to treat DOC patients. Both invasive and noninvasive brain stimulation is discussed. Significant behavioral improvements in prolonged DOCs under neuromodulation therapies are rare. The efficacy of various such therapies remains a matter of debate. Further clinical investigations of existing techniques in larger samples properly controlling for spontaneous recovery are needed, and new approaches are awaited.