Preservation of Brain Activity in Unresponsive Patients Identifies MCS Star
| Autor: | Thibaut, Aurore, Panda, Rajanikant, Annen, Jitka, Sanz, Leandro R. D., Naccache, Lionel, Martial, Charlotte, Chatelle, Camille, Aubinet, Charlène, Bonin, Estelle A. C., Barra, Alice, Briand, Marie‐Michèle, Cecconi, Benedetta, Wannez, Sarah, Stender, Johan, Laureys, Steven, Gosseries, Olivia |
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| Přispěvatelé: | Centre Hospitalier Universitaire de Liège (CHU-Liège), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Bispebjerg Hospital, University of Copenhagen = Københavns Universitet (KU), HAL-SU, Gestionnaire, Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), University of Copenhagen = Københavns Universitet (UCPH) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology Consciousness Persistent Vegetative State Brain Middle Aged behavioral disciplines and activities humanities Young Adult Positron-Emission Tomography Humans Female Research Articles [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology Research Article Aged |
| Zdroj: | Annals of Neurology Annals of Neurology, Wiley, 2021, ⟨10.1002/ana.26095⟩ Annals of Neurology, 2021, ⟨10.1002/ana.26095⟩ |
| ISSN: | 0364-5134 1531-8249 |
| DOI: | 10.1002/ana.26095⟩ |
| Popis: | International audience; ObjectiveBrain-injured patients who are unresponsive at the bedside (ie, vegetative state/unresponsive wakefulness syndrome – VS/UWS) may present brain activity similar to patients in minimally conscious state (MCS). This peculiar condition has been termed “non-behavioural MCS” or “MCS*”. In the present study we aimed to investigate the proportion and underlying brain characteristics of patients in MCS*.MethodsBrain 18F-fluorodeoxyglucose Positron Emission Tomography (FDG-PET) was acquired on 135 brain-injured patients diagnosed in prolonged VS/UWS (n = 48) or MCS (n = 87). From an existing database, relative metabolic preservation in the fronto-parietal network (measured with standardized uptake value) was visually inspected by three experts. Patients with hypometabolism of the fronto-parietal network were labelled “VS/UWS”, while its (partial) preservation either confirmed the behavioural diagnosis of “MCS” or, in absence of behavioural signs of consciousness, suggested a diagnosis of “MCS*”. Clinical outcome at 1-year follow-up, functional connectivity, grey matter atrophy, and regional brain metabolic patterns were investigated in the three groups (VS/UWS, MCS* and MCS).Results67% of behavioural VS/UWS presented a partial preservation of brain metabolism (ie, MCS*). Compared to VS/UWS patients, MCS* patients demonstrated a better outcome, global functional connectivity and grey matter preservation more compatible with the diagnosis of MCS. MCS* patients presented lower brain metabolism mostly in the posterior brain regions compared to MCS patients.InterpretationMCS* is a frequent phenomenon that is associated with better outcome and better brain preservation than the diagnosis of VS/UWS. Complementary exams should be provided to all unresponsive patients before taking medical decisions. ANN NEUROL 2021 |
| Databáze: | OpenAIRE |
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