Michigan: What happens in the moments just before death is widely believed to
be a slowdown of the body’s systems as the heart stops beating and blood
flow ends. But a new laboratory study by the University of Michigan Medical School reveals
a storm of brain activity that erupts as the heart deteriorates that
may play a surprising destabilizing role in heart function. This near-death brain signaling may be targeted to help cardiac
arrest patients survive. Most of the more than 400,000 Americans who
experience cardiac arrest die without immediate help.
“Despite the loss of consciousness and absence of signs of life,
internally the brain exhibits sustained, organized activity and
increased communication with the heart, which one may guess is an effort
to save the heart,” says senior study author Jimo Borjigin, Ph.D., associate professor of neurology and associate professor of molecular and integrative physiology.
However the brain signaling at near-death may, in fact, accelerate
cardiac demise, according to the study published in this week’s PNAS Early Edition.
Researchers with backgrounds in engineering, neuroscience, physiology, cardiology,
chemistry, and pharmacology looked at the mechanism by which the heart
of a healthy person ceases to function within just a few minutes without
oxygen.
While the animal study examined asphyxia-induced cardiac arrest,
sudden cardiac death can also follow fatal cardiac arrhythmias, ischemic
stroke, traumatic brain injury, brain hemorrhage and epilepsy.
For the study, performed in rats, researchers simultaneously examined
the heart and brain during experimental asphyxiation and documented an
immediate release of more than a dozen neurochemicals, along with an
activation of brain-heart connectivity.
Following a steep fall of the heart rate, brain signals strongly
synchronized with the heart rhythm, as visualized beat-by-beat using a
new technology developed in the Borjigin laboratory called electrocardiomatrix.
According to the study, blocking the brain’s outflow significantly delayed ventricular fibrillation,
in which the lower chambers of the heart quiver and the heart cannot
pump any blood. It’s the most serious cardiac rhythm disturbance.
“The study suggests that a pharmacological blockade of the brain’s
electrical connections to the heart during cardiac arrest may improve
the chances of survival in cardiac arrest patients,” Borjigin says.
In previous work,
Borjigin and her colleagues demonstrated significant organized
activation of the brain in animals during cardiac arrest. This new study
provides a neurochemical foundation for the surge in brain activity and
a brain-heart connectivity that may be targeted to lengthen detectable
brain activity.