Grant: CIHR Fellowship

Brain trauma, stroke, and other acute brain injuries frequently damage the structures in the brain that maintain consciousness, leaving affected individuals in a state of coma. Comatose individuals are unresponsive to stimulation and unable to communicate. It is currently challenging for physicians to accurately predict who will recover from coma, as well as the timing and degree of anticipated recovery. Surrogate decision makers and healthcare professionals must navigate this uncertainty early in patients' trajectories to determine the most appropriate course of treatment. These decisions, which may involve treatment intensity or withdrawal of therapies that support life, have major repercussions on patient outcomes. There is therefore a pressing need to improve the accuracy of recovery prediction in acute coma. In this project, we will leverage changes in the brain's electrical activity during breaks from commonly administered sedative medications to improve prediction of recovery from coma. During the first days after brain injury, we will use electroencephalography, a medical device that records the brain's electrical activity, to analyze changes in comatose participants' brain activity during breaks from sedation. We will then document which participants recovered consciousness and independence in the months following brain injury. We will investigate whether early changes in brain activity during sedation breaks can predict recovery from coma in the long term. We will then integrate other participant characteristics and brain imaging data to improve the accuracy of our predictions. This work could lead to the implementation of an accessible, inexpensive and reliable method to predict recovery at the bedside. In addition to preventing premature withdrawal of therapies that support life, this work could catalyse further research on technologies and therapies to support the rehabilitation process in individuals who have a greater potential for recovery.