Improving Diagnosis and Prognosis in Acute Severe Brain Injury: A Multimodal Imaging Protocol.

Autor:	Kazazian K; Graduate Program in Neuroscience, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.; Brain and Mind Institute, Western University, London, ON, Canada., Norton L; Department of Psychology, King's University College at Western University, London, ON, Canada., Laforge G; Brain and Mind Institute, Western University, London, ON, Canada.; Department of Psychology, Western University, London, ON, Canada., Abdalmalak A; Brain and Mind Institute, Western University, London, ON, Canada.; Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada., Gofton TE; Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada., Debicki D; Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada., Slessarev M; Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada., Hollywood S; Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada., Lawrence KS; Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada., Owen AM; Brain and Mind Institute, Western University, London, ON, Canada.; Department of Psychology, Western University, London, ON, Canada.; Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2021 Dec 06; Vol. 12, pp. 757219. Date of Electronic Publication: 2021 Dec 06 (Print Publication: 2021).
DOI:	10.3389/fneur.2021.757219
Abstrakt:	Multi-modal neuroimaging techniques have the potential to dramatically improve the diagnosis of the level consciousness and prognostication of neurological outcome for patients with severe brain injury in the intensive care unit (ICU). This protocol describes a study that will utilize functional Magnetic Resonance Imaging (fMRI), electroencephalography (EEG), and functional Near Infrared Spectroscopy (fNIRS) to measure and map the brain activity of acute critically ill patients. Our goal is to investigate whether these modalities can provide objective and quantifiable indicators of good neurological outcome and reliably detect conscious awareness. To this end, we will conduct a prospective longitudinal cohort study to validate the prognostic and diagnostic utility of neuroimaging techniques in the ICU. We will recruit 350 individuals from two ICUs over the course of 7 years. Participants will undergo fMRI, EEG, and fNIRS testing several times over the first 10 days of care to assess for residual cognitive function and evidence of covert awareness. Patients who regain behavioral awareness will be asked to complete web-based neurocognitive tests for 1 year, as well as return for follow up neuroimaging to determine which acute imaging features are most predictive of cognitive and functional recovery. Ultimately, multi-modal neuroimaging techniques may improve the clinical assessments of patients' level of consciousness, aid in the prediction of outcome, and facilitate efforts to find interventional methods that improve recovery and quality of life. Competing Interests: AO is the Chief Scientific Officer of Cambridge Brain Sciences, of which the cognitive tests used in this study are marketed by. AO and his collaborators are free to use the platform at no cost for their scientific studies. Research projects do not contribute and are not influenced by the company. There exists no overlap between the current study and the activities of Cambridge Brain Sciences, nor is there any cost to the authors, funding bodies, or participants who are involved in the study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Kazazian, Norton, Laforge, Abdalmalak, Gofton, Debicki, Slessarev, Hollywood, Lawrence and Owen.)
Databáze:	MEDLINE
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