Functional PET Neuroimaging in Consciousness Evaluation: Study Protocol
Ensuring a robust and reliable evaluation of coma deepness and prognostication of neurological outcome is challenging. We propose to develop PET neuroimaging as a new diagnostic and prognosis tool for comatose patients using a recently published methodology to perform functional PET (fPET). This exa...
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MDPI AG
2023-06-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/13/12/2026 |
| _version_ | 1797595310511357952 |
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| author | Tom Paunet Denis Mariano-Goulart Jeremy Deverdun Emmanuelle Le Bars Marjolaine Fourcade Florentin Kucharczak |
| author_facet | Tom Paunet Denis Mariano-Goulart Jeremy Deverdun Emmanuelle Le Bars Marjolaine Fourcade Florentin Kucharczak |
| author_sort | Tom Paunet |
| collection | DOAJ |
| description | Ensuring a robust and reliable evaluation of coma deepness and prognostication of neurological outcome is challenging. We propose to develop PET neuroimaging as a new diagnostic and prognosis tool for comatose patients using a recently published methodology to perform functional PET (fPET). This exam permits the quantification of task-specific changes in neuronal metabolism in a single session. The aim of this protocol is to determine whether task-specific changes in glucose metabolism during the acute phase of coma are able to predict recovery at 18 months. Participation will be proposed for all patients coming for a standard PET-CT in our center in order to evaluate global cerebral metabolism during the comatose state. Legally appointed representative consent will be obtained to slightly modify the exam protocol: (1) <sup>18</sup>F-fluorodeoxyglucose (<sup>18</sup>F-FDG) bolus plus continuous infusion instead of a simple bolus and (2) more time under camera to perform dynamic acquisition. Participants will undergo a 55-min fPET session with a 20% bolus + 80% infusion protocol. Two occurrences of three block (5-min rest, 10-min auditory stimulation and 10-min emotional auditory stimulation) will be performed after reaching equilibrium of FDG arterial concentration. We will compare the regional brain metabolism at rest and during the sessions of auditory and emotional auditory stimulation to search for a determinant of coma recovery (18 months of follow-up after the exam). Emotional auditory stimulation should induce an activation of: the auditory cortex, the consciousness areas and the neural circuitry for emotion (function to coma deepness). An activation analysis will be carried out to highlight regional brain activation using dedicated custom-made software based on Python statistical and image processing toolboxes. The association between activation levels and the Coma Recovery Scale-Revisited (CRS-R) will be assessed using multivariate analysis. If successful, the results from this study will help improve coma prognosis evaluation based on the pattern of neuronal metabolism at the onset of the pathology. The study protocol, rationale and methods are described in this paper. |
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| language | English |
| last_indexed | 2024-03-11T02:34:32Z |
| publishDate | 2023-06-01 |
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| series | Diagnostics |
| spelling | doaj.art-2faccdfbba8e4803bbfe698e79d4365f2023-11-18T10:00:04ZengMDPI AGDiagnostics2075-44182023-06-011312202610.3390/diagnostics13122026Functional PET Neuroimaging in Consciousness Evaluation: Study ProtocolTom Paunet0Denis Mariano-Goulart1Jeremy Deverdun2Emmanuelle Le Bars3Marjolaine Fourcade4Florentin Kucharczak5Department of Nuclear Medicine, Gui de Chauliac Hospital, Montpellier University Hospital Center, University of Montpellier, 34090 Montpellier, FranceDepartment of Nuclear Medicine, Gui de Chauliac Hospital, Montpellier University Hospital Center, University of Montpellier, 34090 Montpellier, FranceI2FH, Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Hospital Center, University of Montpellier, 34090 Montpellier, FranceI2FH, Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Hospital Center, University of Montpellier, 34090 Montpellier, FranceDepartment of Nuclear Medicine, Gui de Chauliac Hospital, Montpellier University Hospital Center, University of Montpellier, 34090 Montpellier, FranceDepartment of Nuclear Medicine, Gui de Chauliac Hospital, Montpellier University Hospital Center, University of Montpellier, 34090 Montpellier, FranceEnsuring a robust and reliable evaluation of coma deepness and prognostication of neurological outcome is challenging. We propose to develop PET neuroimaging as a new diagnostic and prognosis tool for comatose patients using a recently published methodology to perform functional PET (fPET). This exam permits the quantification of task-specific changes in neuronal metabolism in a single session. The aim of this protocol is to determine whether task-specific changes in glucose metabolism during the acute phase of coma are able to predict recovery at 18 months. Participation will be proposed for all patients coming for a standard PET-CT in our center in order to evaluate global cerebral metabolism during the comatose state. Legally appointed representative consent will be obtained to slightly modify the exam protocol: (1) <sup>18</sup>F-fluorodeoxyglucose (<sup>18</sup>F-FDG) bolus plus continuous infusion instead of a simple bolus and (2) more time under camera to perform dynamic acquisition. Participants will undergo a 55-min fPET session with a 20% bolus + 80% infusion protocol. Two occurrences of three block (5-min rest, 10-min auditory stimulation and 10-min emotional auditory stimulation) will be performed after reaching equilibrium of FDG arterial concentration. We will compare the regional brain metabolism at rest and during the sessions of auditory and emotional auditory stimulation to search for a determinant of coma recovery (18 months of follow-up after the exam). Emotional auditory stimulation should induce an activation of: the auditory cortex, the consciousness areas and the neural circuitry for emotion (function to coma deepness). An activation analysis will be carried out to highlight regional brain activation using dedicated custom-made software based on Python statistical and image processing toolboxes. The association between activation levels and the Coma Recovery Scale-Revisited (CRS-R) will be assessed using multivariate analysis. If successful, the results from this study will help improve coma prognosis evaluation based on the pattern of neuronal metabolism at the onset of the pathology. The study protocol, rationale and methods are described in this paper.https://www.mdpi.com/2075-4418/13/12/2026<sup>18</sup>F-FDGPETconstant infusionglucose metabolismstimulifunctional PET |
| spellingShingle | Tom Paunet Denis Mariano-Goulart Jeremy Deverdun Emmanuelle Le Bars Marjolaine Fourcade Florentin Kucharczak Functional PET Neuroimaging in Consciousness Evaluation: Study Protocol Diagnostics <sup>18</sup>F-FDG PET constant infusion glucose metabolism stimuli functional PET |
| title | Functional PET Neuroimaging in Consciousness Evaluation: Study Protocol |
| title_full | Functional PET Neuroimaging in Consciousness Evaluation: Study Protocol |
| title_fullStr | Functional PET Neuroimaging in Consciousness Evaluation: Study Protocol |
| title_full_unstemmed | Functional PET Neuroimaging in Consciousness Evaluation: Study Protocol |
| title_short | Functional PET Neuroimaging in Consciousness Evaluation: Study Protocol |
| title_sort | functional pet neuroimaging in consciousness evaluation study protocol |
| topic | <sup>18</sup>F-FDG PET constant infusion glucose metabolism stimuli functional PET |
| url | https://www.mdpi.com/2075-4418/13/12/2026 |
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