References of "Demertzi, Athina"
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See detailHypnosis for cingulate-mediated analgesia and disease treatment
Trujillo-Rodriguez, Diana ULiege; FAYMONVILLE, Marie-Elisabeth ULiege; VANHAUDENHUYSE, Audrey ULiege et al

in Vogt, Brendt A (Ed.) Cingulate Cortex (in press)

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See detailDisorders of consciousness: new advances in neuroimaging techniques
Soddu, Andrea ULiege; Bruno, Marie-Aurélie ULiege; VANHAUDENHUYSE, Audrey ULiege et al

in Zanotti, Bruno (Ed.) Vegetative State (in press)

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See detailFunctional reorganization after surgical hemispherotomy for intractable epilepsy
Demertzi, Athina ULiege; Blauwblomme, Thomas; Tacchela, Jean-Marc et al

Poster (2019, June 12)

Introduction: Epilepsy is a chronic neurological condition characterized by seizures that may lead to transient loss of consciousness (1). Hemispherotomy is a surgical procedure which isolates the ... [more ▼]

Introduction: Epilepsy is a chronic neurological condition characterized by seizures that may lead to transient loss of consciousness (1). Hemispherotomy is a surgical procedure which isolates the affected hemisphere, hence leading to seizure freedom. Despite acceptable neurological outcome, cerebral functional reorganization especially of the isolated hemisphere remains debatable. We aimed at exploring plasticity changes after hemispherotomy. We expected no cortical inter-hemispheric transfer of functional connectivity as a result of the structural disconnection between the two hemispheres. We further hypothesized that plasticity would involve cerebellopontino-thalamocortical routes involving the remaining functional hemisphere. Methods: Patients showed drug-resistant lesional epilepsy associated with Rasmussen encephalitis and hemimegalencephaly. They were operated by a midline vertical hemispherotomy (2): complete callosotomy was performed, allowing access to the lateral ventricles. Perithalamic section of the white matter between the frontal and temporal horn disrupted the internal capsule,  mbria, anterior commissure, but left the major intra-hemispheric bundles (superior and inferior longitudinal fasciculi, uncinated fasciculus, cingulum, external capsule) untouched. With this procedure the affected right hemisphere was isolated. MRI was performed 39m after surgery for patient1 (P1) and 31m after surgery for patient 2 (P2). Pseudo-Continuous Arti cial Spin Labelling (ASL) and 300 functional MRI volumes during resting condition were acquired on a GE Sigma 1.5T scanner. Age- and gender-matched control data were used from the National Database for Autism Research (NDAR) (http://ndar.nih.gov). ASL analysis included segmentation, brain extraction, normalization to a 7y-old brain Atlas obtained with Template-OMatic Toolbox, coregistration, realignment, normalization using the deformation  elds obtained during the T1 normalization, and smoothing (10 mm isotropic filter).FMRI analysis included slice-time correction, realignment, segmentation of structural data, normalization of functional and structural data into standard MNI space, smoothing (6mm FWHM) and denoising (cCompCor, regression of motion paramaters, temporal filtering 0.008- 0.09Hz). Functional connectivity was performed using patient-specic spherical regions of interest at the cortical subcortical level. Results: In both patients, the disconnected right hemisphere (RH) showed general hypo-perfusion, and the preserved left hemisphere (LH) had hyper-perfusion mainly in motor and temporal areas. Neither patient showed inter-hemispheric transfer of functional connectivity. Thalamo-cortical connectivity was preserved only in the LHs. Intercerebellar connectivity was present but cerebello-cortical crossings were preserved only in the LHs. P2 further showed right-sided ipsilateral cerebello-cortical connectivity, which was mediated by the effect of the vascular system. Both patients' brain showed preserved yet lateralized network-level organization. Conclusions: After hemispherotomy the two hemispheres function in a disconnected manner. The isolated brain is resilient to support intrinsic functional connectivity which is mediated, yet not fully explained, by the effect of vascularization. These data are relevant for a better comprehension of functional organization after neurosurgery and raise inquiries about the cognitive role of the isolated right hemisphere. [less ▲]

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See detailHealthy Mind
Demertzi, Athina ULiege

Conference given outside the academic context (2019)

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See detailWhat kind of consciousness is retained in noncommunicating states
Demertzi, Athina ULiege

Speech/Talk (2019)

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See detailHuman consciousness is supported by dynamic complex patterns of brain signal coordination
Demertzi, Athina ULiege; Tagliazucchi, Enzo; Dehaene, S et al

in Science Advances (2019), 5(2), 7603

Adopting the framework of brain dynamics as a cornerstone of human consciousness, we determined whether dynamic signal coordination provides specific and generalizable patterns pertaining to conscious and ... [more ▼]

Adopting the framework of brain dynamics as a cornerstone of human consciousness, we determined whether dynamic signal coordination provides specific and generalizable patterns pertaining to conscious and unconscious states after brain damage. A dynamic pattern of coordinated and anticoordinated functional magnetic resonance imaging signals characterized healthy individuals and minimally conscious patients. The brains of unresponsive patients showed primarily a pattern of low interareal phase coherence mainly mediated by structural connectivity, and had smaller chances to transition between patterns. The complex pattern was further corroborated in patients with covert cognition, who could perform neuroimaging mental imagery tasks, validating this pattern’s implication in consciousness. Anesthesia increased the probability of the less complex pattern to equal levels, validating its implication in unconsciousness. Our results establish that consciousness rests on the brain’s ability to sustain rich brain dynamics and pave the way for determining specific and generalizable fingerprints of conscious and unconscious states. [less ▲]

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See detailWhat kind of consciousness is retained in noncommunicating states?
Demertzi, Athina ULiege

Scientific conference (2018, December 13)

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See detailTutorial "Single-case evaluation of consciousness: same patient, different modalities": fMRI-based assessment of a single patient
Demertzi, Athina ULiege; Annen, Jitka ULiege; Chatelle, Camille ULiege et al

Conference (2018, June 24)

Tutorial: Patients with disorders of consciousness are by definition unable to communicate. This makes the evaluation of their state of consciousness a major challenge. To date, there are not standardized ... [more ▼]

Tutorial: Patients with disorders of consciousness are by definition unable to communicate. This makes the evaluation of their state of consciousness a major challenge. To date, there are not standardized guidelines as to how a post-comatose patient can be evaluated by means of assisting technologies. With this tutorial, we bring together specialists from three expert centers dealing with intensive evaluation of the state of consciousness in patients sustaining severe brain injuries. Our aim is to illustrate how we can infer a clinical diagnosis by integrating different data from behavioral and brain function as measured with different technological modalities. Specifically, we will discuss the case of a patient for whom behavioral, electrophysiological and neuroimaging data have been acquired with the aim to provide a global diagnosis of the state of consciousness. We will show how each of these evaluations are performed in step-by-step manner. Each presenter will further illustrate the methodological challenges and pragmatic solutions towards the inference of valid conclusions. In order to integrate the results into a global diagnostic category, we wish to engage the audience to participate interactively towards the composition of a final diagnostic report, as we typically do at our clinical sites [less ▲]

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See detailDynamic inter-regional coordination patterns as specific predictors of consciousness
Demertzi, Athina ULiege; Tagliazucchi, Enzo; Dehaene, Stanislas et al

Poster (2018, June 17)

Background and aims: To date, specific signatures of conscious states in humans remain elusive. Contemporary theories concur that such markers can be traced to temporally evolving brain processes instead ... [more ▼]

Background and aims: To date, specific signatures of conscious states in humans remain elusive. Contemporary theories concur that such markers can be traced to temporally evolving brain processes instead of static descriptions of brain activity. Methods: Dynamic fMRI connectivity patterns (states) by means of clustering of phase-based coherence was estimated on 47 healthy and 112 patients diagnosed in vegetative state/unresponsive wakefulness syndrome (VS/UWS) or in a minimally conscious state (MCS). To validate whether the patterns captured properties of awareness, out-of-sample generalization was performed on patients with cognitive-motor dissociation (i.e. lacking overt conscious behaviour yet evidenced using functional neuroimaging), and on anesthetised patients, under the premise that complex signatures would disappear uniformly across all subjects. Results: A pattern of long-range positive/negative coherence had a higher probability of occurring in healthy and MCS patients. A pattern of low inter-areal coordination, mostly similar to anatomy, was more likely to occur in VS/UWS. Inter-state transitioning was flexible for healthy and MCS and more rigid for VS/UWS patients. Unconscious patients were more likely to avoid the exploration of the complex connectivity state. The generalization to cognitive-motor dissociation predicted the occurrence of the complexconnectivity state. The generalization to propofol anaesthesia showed an equalization of occurrence probabilities of all patterns regardless of clinical diagnosis. Conclusion: The dynamics of inter-areal coordination contain information specific to conscious awareness. The rigid and less metastable dynamics in VS/UWS could account for the limited mental capacities in these patients. The minute identification of these patterns and their external manipulation could account for non-invasive restoration of consciousness. [less ▲]

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See detailQuestions éthiques dans la prise en charge des patients sévèrement cérébrolésés
Demertzi, Athina ULiege

Scientific conference (2018, June 08)

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See detailRegional brain volumetry and brain function in severely brain-injured patients
Annen, Jitka ULiege; Frasso, Gianluca; Crone, Julia et al

in Annals of Neurology (2018)

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See detailTracking Consciousness in noncommunicating states
Demertzi, Athina ULiege

Speech/Talk (2018)

Does the notion of consciousness fascinate you? Join our one-day masterclass in which six leading experts will guide you through one of the most exciting fields of research today. Your host will be ... [more ▼]

Does the notion of consciousness fascinate you? Join our one-day masterclass in which six leading experts will guide you through one of the most exciting fields of research today. Your host will be acclaimed author Michael Brooks. Consciousness has perplexed philosophers for centuries: what is this strange mental world that seems so essential to being human? Finding an answer has proved elusive, yet in the past two decades the flourishing of neuroscience has revealed intriguing clues about its nature. [less ▲]

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See detailAssessing consciousness in the absence of communication
Demertzi, Athina ULiege

Conference (2018, March 02)

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See detailBrain activity in coma & related states
Demertzi, Athina ULiege; Laureys, Steven ULiege

Speech/Talk (2018)

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See detailAttitudes towards personhood in the locked-in syndrome: from third- to first- person perspective and interpersonal significance
Nizzi, Marie-Christine; Blandin, Veronique; Demertzi, Athina ULiege

in Neuroethics (2018)

Personhood is ascribed on others, such that someone who is recognized to be a person is bestowed with certain civils rights and the right to decision-making. A rising question is how severely brain ... [more ▼]

Personhood is ascribed on others, such that someone who is recognized to be a person is bestowed with certain civils rights and the right to decision-making. A rising question is how severely brain-injured patients who regain consciousness can also regain their personhood. The case of patients with locked-in syndrome (LIS) is illustrative to this matter. Upon restoration of consciousness, patients with LIS find themselves in a state of profound demolition of their bodily functions. From the third-person perspective, it can be expected that LIS patients might experience a differential personal identity and maybe lose their status of persons. However, from the patients’ standpoint, it is uncontested that they retain their personal identity and they consider themselves as persons. We here assist this perspective by including self-reports from patients with LIS aimed at identifying the primary expectations of patients for their care by non-medical professionals. Based on these first-hand reports, we argue that personhood in LIS is progressively regained as the widening circle of others recognizes them as persons. [less ▲]

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See detailPanel discussion "Human Brain Project for brain medicine – where do we go to?"
Demertzi, Athina ULiege

Diverse speeche and writing (2018)

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See detailPrevalence of coma-recovery scale-revised signs of consciousness in patients in minimally conscious state
Wannez, Sarah ULiege; Gosseries, Olivia ULiege; Azzolini, Deborah et al

in Neuropsychological Rehabilitation (2018), 28(8), 1350-1359

Different behavioural signs of consciousness can distinguish patients with an unresponsive wakefulness syndrome from patients in minimally conscious state (MCS). The Coma Recovery Scale-Revised (CRS-R) is ... [more ▼]

Different behavioural signs of consciousness can distinguish patients with an unresponsive wakefulness syndrome from patients in minimally conscious state (MCS). The Coma Recovery Scale-Revised (CRS-R) is the most sensitive scale to differentiate the different altered states of consciousness and eleven items detect the MCS. The aim of this study is to document the prevalence of these items. We analysed behavioural assessments of 282 patients diagnosed in MCS based on the CRS-R. Results showed that some items are particularly frequent among patients in MCS, namely fixation, visual pursuit, and reproducible movement to command, which were observed in more than 50% of patients. These responses were also the most probably observed items when the patients only showed one sign of consciousness. On the other hand, some items were rarely or never observed alone, e.g., object localisation (reaching), object manipulation, intelligible verbalisation, and object recognition. The results also showed that limiting the CRS-R assessment to the five most frequently observed items (i.e., fixation, visual pursuit, reproducible movement to command, automatic motor response and localisation to noxious stimulation) detected 99% of the patients in MCS. If clinicians have only limited time to assess patients with disorders of consciousness, we suggest to evaluate at least these five items of the CRS-R. © 2017, © 2017 Informa UK Limited, trading as Taylor & Francis Group. [less ▲]

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See detailSurvival and consciousness recovery are better in the minimally conscious state than in the vegetative state
Faugeras, Frédéric; Rohaut, Benjamin; Valente, Melanie et al

in Brain Injury (2018), 32(1), 72-77

BACKGROUND The prognosis value of early clinical diagnosis of consciousness impairment is documented by an extremely limited number of studies, whereas it may convey important information to guide medical ... [more ▼]

BACKGROUND The prognosis value of early clinical diagnosis of consciousness impairment is documented by an extremely limited number of studies, whereas it may convey important information to guide medical decisions. OBJECTIVE We aimed at determining if patients diagnosed at an early stage (<90 days after brain injury) as being in the minimally conscious state (MCS) have a better prognosis than patients in the vegetative state/Unresponsive Wakefulness syndrome (VS/UWS), independent of care limitations or withdrawal decisions. METHODS Patients hospitalized in ICUs of the Pitié-Salpêtrière Hospital (Paris, France) from November 2008 to January 2011 were included and evaluated behaviourally with standardized assessment and with the Coma Recovery Scale-Revised as being either in the VS/UWS or in the MCS. They were then prospectively followed until 1July 2011 to evaluate their outcome with the GOSE. We compared survival function and outcomes of these two groups. RESULTS Both survival function and outcomes, including consciousness recovery, were significantly better in the MCS group. This difference of outcome still holds when considering only patients still alive at the end of the study. CONCLUSIONS Early accurate clinical diagnosis of VS/UWS or MCS conveys a strong prognostic value of survival and of consciousness recovery. [less ▲]

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See detailThe ethics in the management of patients with disorders of consciousness
Demertzi, Athina ULiege

in Schnakers, Caroline; Laureys, Steven (Eds.) Coma and Disorders of Consciousness (2018)

The ethical issues accrued from the study and management of patients with disorders of consciousness are variant and multifaceted. The medical, public and legal controversies are partly shaped by how ... [more ▼]

The ethical issues accrued from the study and management of patients with disorders of consciousness are variant and multifaceted. The medical, public and legal controversies are partly shaped by how different people think about pain perception and end of life. Uniform ethical frameworks need to be shaped in order to guide clinicians and caregivers in terms of clinical outcome, prognosis and medical management. [less ▲]

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