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A comparative clinical and encephalographic study on manifestation of the choline and dopamine deficiency syndromes in consciousness recovery after severe traumatic brain injury

Purpose: to describe and compare the severity of clinical signs of choline and dopamine deficiency and their EEG manifestation in consciousness recovery of patients with sTBI. 
Material and methods: The data of dynamic and clinical EEG studies of 98 patients (68 
men, 30 women) with severe traumatic brain injury were analysed. The patients were aged 
13 to 57 y.o. (mean 31 ± 12 y.o). The observation period ranged from 3 weeks to 20 months after trauma. The analysis assessed the neurological status and mental activity in patients, including EEG studies with a dynamic pattern assessment. 
Results: the EEG pattern of dopamine deficiency syndrome featured emerging synchronised beta activity at 13-14 Hz with a significant rise in the frontal and anterior temporal regions, concurrent with a general decrease of biopotential amplitude, EEG flattening and smoothing differences between zones, as well as more or less pronounced theta rhythms. In patients with choline deficiency syndrome, alpha activity of 7–8 sec (no matter how unstable, disorganized and slow) came to be most characteristic, even in cases of deeply depressed consciousness (coma). Alpha activity was combined with an increased diffuse fast activity or polymorphic (rhythmic) groups of theta-delta waves in the EEG pattern during a general disorganization of biopotentials.