Lateral frontoparietal effective connectivity differentiates and predicts state of consciousness in a cohort of patients with traumatic disorders of consciousness.

Autor: Ihalainen R; Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States of America.; School of Computing, University of Kent, Canterbury, United Kingdom., Annen J; Coma Science Group, GIGA Consciousness Research Unit, University and University Hospital of Liège, Liège, Belgium.; Centre du Cerveau2, University Hospital of Liège, Liège, Belgium.; Department of Data Analysis, University of Ghent, Ghent, Belgium., Gosseries O; Coma Science Group, GIGA Consciousness Research Unit, University and University Hospital of Liège, Liège, Belgium.; Centre du Cerveau2, University Hospital of Liège, Liège, Belgium., Cardone P; Coma Science Group, GIGA Consciousness Research Unit, University and University Hospital of Liège, Liège, Belgium.; Centre du Cerveau2, University Hospital of Liège, Liège, Belgium., Panda R; Coma Science Group, GIGA Consciousness Research Unit, University and University Hospital of Liège, Liège, Belgium.; Centre du Cerveau2, University Hospital of Liège, Liège, Belgium., Martial C; Coma Science Group, GIGA Consciousness Research Unit, University and University Hospital of Liège, Liège, Belgium.; Centre du Cerveau2, University Hospital of Liège, Liège, Belgium., Thibaut A; Coma Science Group, GIGA Consciousness Research Unit, University and University Hospital of Liège, Liège, Belgium.; Centre du Cerveau2, University Hospital of Liège, Liège, Belgium., Laureys S; Coma Science Group, GIGA Consciousness Research Unit, University and University Hospital of Liège, Liège, Belgium.; CERVO Brain Research Centre, de la Canardière, Québec, Canada.; Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang, China., Chennu S; School of Computing, University of Kent, Canterbury, United Kingdom.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Jul 05; Vol. 19 (7), pp. e0298110. Date of Electronic Publication: 2024 Jul 05 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0298110
Abstrakt: Neuroimaging studies have suggested an important role for the default mode network (DMN) in disorders of consciousness (DoC). However, the extent to which DMN connectivity can discriminate DoC states-unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS)-is less evident. Particularly, it is unclear whether effective DMN connectivity, as measured indirectly with dynamic causal modelling (DCM) of resting EEG can disentangle UWS from healthy controls and from patients considered conscious (MCS+). Crucially, this extends to UWS patients with potentially "covert" awareness (minimally conscious star, MCS*) indexed by voluntary brain activity in conjunction with partially preserved frontoparietal metabolism as measured with positron emission tomography (PET+ diagnosis; in contrast to PET- diagnosis with complete frontoparietal hypometabolism). Here, we address this gap by using DCM of EEG data acquired from patients with traumatic brain injury in 11 UWS (6 PET- and 5 PET+) and in 12 MCS+ (11 PET+ and 1 PET-), alongside with 11 healthy controls. We provide evidence for a key difference in left frontoparietal connectivity when contrasting UWS PET- with MCS+ patients and healthy controls. Next, in a leave-one-subject-out cross-validation, we tested the classification performance of the DCM models demonstrating that connectivity between medial prefrontal and left parietal sources reliably discriminates UWS PET- from MCS+ patients and controls. Finally, we illustrate that these models generalize to an unseen dataset: models trained to discriminate UWS PET- from MCS+ and controls, classify MCS* patients as conscious subjects with high posterior probability (pp > .92). These results identify specific alterations in the DMN after severe brain injury and highlight the clinical utility of EEG-based effective connectivity for identifying patients with potential covert awareness.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Ihalainen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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