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Forschungsdatenbank PMU-SQQUID

Intrinsic functional connectivity differentiates minimally conscious from unresponsive patients.
Demertzi, A; Antonopoulos, G; Heine, L; Voss, HU; Crone, JS; de Los Angeles, C; Bahri, MA; Di Perri, C; Vanhaudenhuyse, A; Charland-Verville, V; Kronbichler, M; Trinka, E; Phillips, C; Gomez, F; Tshibanda, L; Soddu, A; Schiff, ND; Whitfield-Gabrieli, S; Laureys, S;
Brain. 2015; 138(Pt 9):2619-2631
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Kronbichler Martin
Trinka Eugen

Abstract

1 month post-insult) for whom the clinical diagnosis with the Coma Recovery Scale-Revised was congruent with positron emission tomography scanning. Group-level functional connectivity was investigated for the default mode, frontoparietal, salience, auditory, sensorimotor and visual networks using a multiple-seed correlation approach. Between-group inferential statistics and machine learning were used to identify each network"s capacity to discriminate between patients in minimally conscious state and vegetative state/unresponsive wakefulness syndrome. Data collected from 22 patients scanned in two other centres (Salzburg: 10 minimally conscious state, five vegetative state/unresponsive wakefulness syndrome; New York: five minimally conscious state, one vegetative state/unresponsive wakefulness syndrome, one emerged from minimally conscious state) were used to validate the classification with the selected features. Coma Recovery Scale-Revised total scores correlated with key regions of each network reflecting their involvement in consciousness-related processes. All networks had a high discriminative capacity (>80%) for separating patients in a minimally conscious state and vegetative state/unresponsive wakefulness syndrome. Among them, the auditory network was ranked the most highly. The regions of the auditory network which were more functionally connected in patients in minimally conscious state compared to vegetative state/unresponsive wakefulness syndrome encompassed bilateral auditory and visual cortices. Connectivity values in these three regions discriminated congruently 20 of 22 independently assessed patients. Our findings point to the significance of preserved abilities for multisensory integration and top-down processing in minimal consciousness seemingly supported by auditory-visual crossmodal connectivity, and promote the clinical utility of the resting paradigm for single-patient diagnostics.


Useful keywords (using NLM MeSH Indexing)

Adolescent

Adult

Aged

Aged, 80 and over

Brain/blood supply*

Brain/pathology

Child

Coma/pathology

Consciousness Disorders/pathology*

Female

Humans

Image Processing, Computer-Assisted

Male

Middle Aged

Neural Pathways/blood supply*

Neural Pathways/pathology

Oxygen/blood

Persistent Vegetative State/pathology*

Rest

Severity of Illness Index

Young Adult


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