Measures of metabolism and complexity in the brain of patients with disorders of consciousness
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 pert...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-01-01
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| Series: | NeuroImage: Clinical |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213158217300360 |
| _version_ | 1818827395179741184 |
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| author | Olivier Bodart Olivia Gosseries Sarah Wannez Aurore Thibaut Jitka Annen Melanie Boly Mario Rosanova Adenauer G. Casali Silvia Casarotto Giulio Tononi Marcello Massimini Steven Laureys |
| author_facet | Olivier Bodart Olivia Gosseries Sarah Wannez Aurore Thibaut Jitka Annen Melanie Boly Mario Rosanova Adenauer G. Casali Silvia Casarotto Giulio Tononi Marcello Massimini Steven Laureys |
| author_sort | Olivier Bodart |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-19T00:42:52Z |
| format | Article |
| id | doaj.art-566ed4942d7149bd9be7eb1743761729 |
| institution | Directory Open Access Journal |
| issn | 2213-1582 |
| language | English |
| last_indexed | 2024-12-19T00:42:52Z |
| publishDate | 2017-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | NeuroImage: Clinical |
| spelling | doaj.art-566ed4942d7149bd9be7eb17437617292022-12-21T20:44:25ZengElsevierNeuroImage: Clinical2213-15822017-01-0114C35436210.1016/j.nicl.2017.02.002Measures of metabolism and complexity in the brain of patients with disorders of consciousnessOlivier Bodart0Olivia Gosseries1Sarah Wannez2Aurore Thibaut3Jitka Annen4Melanie Boly5Mario Rosanova6Adenauer G. Casali7Silvia Casarotto8Giulio Tononi9Marcello Massimini10Steven Laureys11Giga-Consciousness, Coma Science Group, and Neurology Department, University and University Hospital of Liege, BelgiumGiga-Consciousness, Coma Science Group, and Neurology Department, University and University Hospital of Liege, BelgiumGiga-Consciousness, Coma Science Group, and Neurology Department, University and University Hospital of Liege, BelgiumGiga-Consciousness, Coma Science Group, and Neurology Department, University and University Hospital of Liege, BelgiumGiga-Consciousness, Coma Science Group, and Neurology Department, University and University Hospital of Liege, BelgiumGiga-Consciousness, Coma Science Group, and Neurology Department, University and University Hospital of Liege, BelgiumDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, ItalyDepartment of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, ItalyDepartment of Psychiatry, University of Wisconsin, Madison, WI, USADepartment of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, ItalyGiga-Consciousness, Coma Science Group, and Neurology Department, University and University Hospital of Liege, BelgiumBackground: 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.http://www.sciencedirect.com/science/article/pii/S2213158217300360Transcranial magnetic stimulationElectroencephalographyPositron emission tomographyDisorders of consciousnessUnresponsive wakefulness syndrome minimally conscious stateBrain injury |
| spellingShingle | Olivier Bodart Olivia Gosseries Sarah Wannez Aurore Thibaut Jitka Annen Melanie Boly Mario Rosanova Adenauer G. Casali Silvia Casarotto Giulio Tononi Marcello Massimini Steven Laureys Measures of metabolism and complexity in the brain of patients with disorders of consciousness NeuroImage: Clinical Transcranial magnetic stimulation Electroencephalography Positron emission tomography Disorders of consciousness Unresponsive wakefulness syndrome minimally conscious state Brain injury |
| title | Measures of metabolism and complexity in the brain of patients with disorders of consciousness |
| title_full | Measures of metabolism and complexity in the brain of patients with disorders of consciousness |
| title_fullStr | Measures of metabolism and complexity in the brain of patients with disorders of consciousness |
| title_full_unstemmed | Measures of metabolism and complexity in the brain of patients with disorders of consciousness |
| title_short | Measures of metabolism and complexity in the brain of patients with disorders of consciousness |
| title_sort | measures of metabolism and complexity in the brain of patients with disorders of consciousness |
| topic | Transcranial magnetic stimulation Electroencephalography Positron emission tomography Disorders of consciousness Unresponsive wakefulness syndrome minimally conscious state Brain injury |
| url | http://www.sciencedirect.com/science/article/pii/S2213158217300360 |
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