Measures of metabolism and complexity in the brain of patients with disorders of consciousness
| Autor: | Olivier Bodart, Silvia Casarotto, Sarah Wannez, Steven Laureys, Mélanie Boly, Adenauer G. Casali, Marcello Massimini, Giulio Tononi, Aurore Thibaut, Olivia Gosseries, Mario Rosanova, Jitka Annen |
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| Rok vydání: | 2017 |
| Předmět: |
Male
0301 basic medicine medicine.medical_treatment Electroencephalography lcsh:RC346-429 0302 clinical medicine Image Processing Computer-Assisted PCI perturbational complexity index Brain injury Unresponsive wakefulness syndrome minimally conscious state media_common Disorders of consciousness education.field_of_study medicine.diagnostic_test EMCS emergence from the minimally conscious state Brain Regular Article Middle Aged Magnetic Resonance Imaging MCS* non-behavioural minimally conscious state Neurology Consciousness Disorders lcsh:R858-859.7 Female Psychology Adult Positron emission tomography medicine.medical_specialty Cognitive Neuroscience media_common.quotation_subject Population lcsh:Computer applications to medicine. Medical informatics Young Adult 03 medical and health sciences Fluorodeoxyglucose F18 medicine Humans Radiology Nuclear Medicine and imaging Intensive care medicine education lcsh:Neurology. Diseases of the nervous system UWS unresponsive wakefulness syndrome Magnetic resonance imaging FDG 18F-fluorodeoxyglucose CRS-R Coma Recovery Scale-Revised medicine.disease Oxygen Transcranial magnetic stimulation SPM statistical parametric mapping 030104 developmental biology LIS locked-in syndrome Brain Injuries Positron-Emission Tomography fMRI functional MRI Conventional PCI TMS–EEG transcranial magnetic stimulation coupled with high-density EEG Neurology (clinical) Consciousness DOC disorders of consciousness Neuroscience MCS minimally conscious state 030217 neurology & neurosurgery |
| Zdroj: | NeuroImage: Clinical NeuroImage: Clinical, Vol 14, Iss C, Pp 354-362 (2017) NeuroImage : Clinical |
| ISSN: | 2213-1582 |
| DOI: | 10.1016/j.nicl.2017.02.002 |
| Popis: | Background Making an accurate diagnosis in patients with disorders of consciousness remains challenging. 18F-fluorodeoxyglucose (FDG)–PET has been validated as a diagnostic tool in this population, and allows identifying unresponsive patients with a capacity for consciousness. In parallel, the perturbational complexity index (PCI), a new measure based on the analysis of the electroencephalographic response to transcranial magnetic stimulation, has also been suggested as a tool to distinguish between unconscious and conscious states. The aim of the study was to cross-validate FDG–PET and PCI, and to identify signs of consciousness in otherwise unresponsive patients. Methods We jointly applied the Coma Recovery Scale-Revised, FDG–PET and PCI to assess 24 patients with non-acute disorders of consciousness or locked-in syndrome (13 male; 19–54 years old; 12 traumatic; 9 unresponsive wakefulness syndrome, 11 minimally conscious state; 2 emergence from the minimally conscious state, and 2 locked-in syndrome). Results FDG–PET and PCI provided congruent results in 22 patients, regardless of their behavioural diagnosis. Notably, FDG–PET and PCI revealed preserved metabolic rates and high complexity levels in four patients who were behaviourally unresponsive. Conclusion We propose that jointly measuring the metabolic activity and the electrophysiological complexity of cortical circuits is a useful complement to the diagnosis and stratification of patients with disorders of consciousness. Highlights • A cross validation of brain complexity measures with metabolic imaging is proposed. • TMS–EEG and 18F-FDG PET provided congruent result in post-comatose patients. • Unresponsive patients with high complexity also show preserved metabolic activity. • These patients thus probably have a specific cognitive-motor dissociation. • TMS–EEG and PET have potential clinical impact in the diagnosis of these patients. |
| Databáze: | OpenAIRE |
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