Disorder of consciousness related pattern could distinguish minimally conscious state from unresponsive wakefulness syndrome: A F-18-FDG-PET study.

Autor: He Z; Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China., Lu R; Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China., Ge J; Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China., Guan Y; Department of Nuclear Medicine/PET Center, Huashan Hospital, Fudan University, Shanghai, China., Chen Y; Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China., Liu G; Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China., Xie H; Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China., Bai Y; Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China., Wu Y; Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China., Wu J; Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China. Electronic address: junfawu2002@aliyun.com., Jia J; Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; National Center for Neurological Disorders, Shanghai, China. Electronic address: shannonjj@126.com.
Jazyk: angličtina
Zdroj: Brain research bulletin [Brain Res Bull] 2024 Sep; Vol. 215, pp. 111023. Date of Electronic Publication: 2024 Jul 02.
DOI: 10.1016/j.brainresbull.2024.111023
Abstrakt: Background: Accurate evaluation of level of disorder of consciousness (DOC) is clinically challenging.
Objective: This study aimed to establish a distinctive DOC-related pattern (DOCRP) for assessing disease severity and distinguishing unresponsive wakefulness syndrome (UWS) from minimally conscious state (MCS).
Methods: Fifteen patients with DOC and eighteen health subjects with F-18-fluorodeoxyglucose (F-18-FDG) positron emission tomography (PET) were enrolled in this study. All patients were assessed by Coma Recovery Scale-Revised (CRS-R) and all individuals were randomly divided into two cohorts (Cohort A and B). DOCRP was identified in Cohort A and subsequently validated in Cohort B and A+B. We also assessed the discriminatory power of DOCRP between MCS and UWS.
Results: The DOCRP was characterized bilaterally by relatively decreased metabolism in the medial and lateral frontal lobes, parieto-temporal lobes, cingulate gyrus and caudate, associated with relatively increased metabolism in the cerebellum and brainstem. DOCRP expression exhibited high accuracy in differentiating DOC patients from controls (P<0.0001, AUC=1.000), and furthermore could effectively distinguish MCS from UWS (P=0.037, AUC=0.821, sensitivity: 85.7 %, specificity: 75.0 %). Particularly in the subgroup of DOC patients survived global hypoxic-ischemic brain injury, DOCRP expression exhibited even better discriminatory power between MCS and UWS (P=0.046, AUC=1.000).
Conclusions: DOCRP might serve as an objective biomarker in distinguishing between UWS and MCS, especially in patients survived global hypoxic-ischemic brain injury.
Trial Registration Number: ChiCTR2300073717 (Chinese clinical trial registry site, http://www.chictr.org).
Competing Interests: Declaration of Competing Interest The authors declare that there is no conflict of interest.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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