References of "Kirsch, Murielle"
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See detailGeneral Anesthesia: A Probe to Explore Consciousness
BONHOMME, Vincent ULiege; STAQUET, Cécile ULiege; Montupil, Javier ULiege et al

in Frontiers in Systems Neuroscience (2019)

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See detailBOLD power spectral density differentiates patients with pathological consciousness
Alcauter, Sarael; Carrière, Manon ULiege; Raimondo, Federico ULiege et al

Poster (2019, June 10)

Introduction: Functional connectivity has been successfully used to discriminate non-sedated patients with disorders of consciousness (Demertzi et al., 2015). However, on clinical demand, patients are ... [more ▼]

Introduction: Functional connectivity has been successfully used to discriminate non-sedated patients with disorders of consciousness (Demertzi et al., 2015). However, on clinical demand, patients are evaluated under sedation to restrict motion, which considerably limits the classification of patients based on functional connectivity. It has been previously shown that changes of the frequency properties of spontaneous BOLD signal are of cognitive relevance even in sleeping neonates (Alcauter et al., 2015). We therefore aimed at exploring the automatic discrimination of sedated patients in the clinical entities of minimally consciousness state (MCS) and unresponsive wakefulness syndrome (UWS), based on the frequency profile of the BOLD signal. Methods: Forty-four patients with MCS (n=26) or VS/UWS (n=18), based on the Coma Recovery Scale-Revised (CRS-R), were scanned on a 3T MRI scanner. Images of the whole brain were acquired with BOLD-sensitive sequences (300 volumes, TR=2s, TE=30ms, voxel size=3x3x3 mm3) and a T1 (TR=2.3s, TE=2.47ms, voxel size = 1x1x1.2 mm3). Sedative agents (propofol, sevoflurane, or a combination of both) were administered using the minimum necessary dose. Preprocessing of functional images included slice-time correction, realignment, segmentation, normalisation, and smoothing (6mm FWHM). Noise reduction included detection and regression of motion outliers (ART toolbox), anatomical component-based correction, and regression of motion parameters, no temrporal filtering was applied. The average power density between 0.01 and 0.1 Hz (classic frequency band for resting state analyses) was estimated and divided by the total power density, for each voxel. Supervised classification of patients in MCS or UWS was explored with Support Vector Machine classifiier using stratified 5-fold cross-validation. The clusters with significant differences between groups (p<0.005, uncorrected; cluster size > 10 voxels) in the training sets were selected as features. The 5-fold validation was repeated 20 times to estimate the variability of the classification accuracies and the frequency of each voxel being selected as a relevant feature. Results:The average classification accuracy was 79%±5 (SD), with average sensitivity 76%±10, and specificity 81%±9. The most frequently selected regions as features included the superior parietal lobule (Frequency: 100%; MNI x, y, z (mm): -26, -50, 64), putamen (97%; -30, -6, -8), occipital fusiform gyrus (92%; -34, -70, -20), occipital pole (65%; 22, -98, 16), angular gyrus (54%; -60, -58, 32). Conclusions: The power spectral density of the spontaneous BOLD signal under anesthesia allowed to classify individual patients with MCS and UWS with 79% accuracy. The most frequent selected features included association areas in the parietal and occipital lobes and the putamen. Further validation with independent cohorts is needed to generalize the current findings. Taken together, the use of power spectral density may represent an alternative to functional connectivity to classify patients with consciousness disorders under anesthesia, therefore capturing properties of conscious function beyond reportability. [less ▲]

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See detailMapping the functional connectome traits of levels of consciousness
Amico, Enrico ULiege; Marinazzo, Daniele; Di Perri, Carol ULiege et al

in NeuroImage (2017)

Examining task-free functional connectivity (FC) in the human brain offers insights on how spontaneous integration and segregation of information relate to human cognition, and how this organization may ... [more ▼]

Examining task-free functional connectivity (FC) in the human brain offers insights on how spontaneous integration and segregation of information relate to human cognition, and how this organization may be altered in different conditions, and neurological disorders. This is particularly relevant for patients in disorders of consciousness (DOC) following severe acquired brain damage and coma, one of the most devastating conditions in modern medical care. We present a novel data-driven methodology, connICA, which implements Independent Component Analysis (ICA) for the extraction of robust independent FC patterns (FC-traits) from a set of individual functional connectomes, without imposing any a priori data stratification into groups. We here apply connICA to investigate associations between network-traits derived from task-free FC and cognitive features that define levels of consciousness. Three main independent FC-traits were identified and linked to consciousness-related clinical features. The first one represents the functional configuration of an "awake resting" brain, and is associated to the level of arousal. The second FC-trait reflects the disconnection of the visual and sensory-motor connectivity patterns and relates to the ability of communicating with the external environment. The third FC-trait isolates the connectivity pattern encompassing the fronto-parietal and the default-mode network areas as well as the interaction between left and right hemisphere, which are also associated to the awareness of the self and its surroundings. Each FC-trait represents a distinct functional process with a role in the degradation of conscious states in functional brain networks, shedding further light on the functional subcircuits that get disrupted in severe brain-damage. [less ▲]

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See detailSedation of Patients With Disorders of Consciousness During Neuroimaging: Effects on Resting State Functional Brain Connectivity.
KIRSCH, Murielle ULiege; Guldenmund, Pieter; Bahri, Mohamed Ali ULiege et al

in Anesthesia and Analgesia (2017), 124(2),

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See detailPositron Emission Tomography: Basic Principles, New Applications, and Studies Under Anesthesia
KIRSCH, Murielle ULiege; Wannez, Sarah ULiege; Thibaut, Aurore ULiege et al

in International Anesthesiology Clinics (2016)

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See detailThalamic and extrathalamic mechanisms of consciousness after severe brain injury.
Lutkenhoff, Evan; Chiang, Jeffrey; TSHIBANDA, Luaba ULiege et al

in Annals of Neurology (2015)

Abstract OBJECTIVE: What mechanisms underlie the loss and recovery of consciousness after severe brain injury? We sought to establish, in the largest cohort of patients with disorders of consciousness ... [more ▼]

Abstract OBJECTIVE: What mechanisms underlie the loss and recovery of consciousness after severe brain injury? We sought to establish, in the largest cohort of patients with disorders of consciousness (DOC) to date, the link between gold standard clinical measures of awareness and wakefulness, and specific patterns of local brain pathology-thereby possibly providing a mechanistic framework for patient diagnosis, prognosis, and treatment development. METHODS: Structural T1-weighted magnetic resonance images were collected, in a continuous sample of 143 severely brain-injured patients with DOC (and 96 volunteers), across 2 tertiary expert centers. Brain atrophy in subcortical regions (bilateral thalamus, basal ganglia, hippocampus, basal forebrain, and brainstem) was assessed across (1) healthy volunteers and patients, (2) clinical entities (eg, vegetative state, minimally conscious state), (3) clinical measures of consciousness (Coma Recovery Scale-Revised), and (4) injury etiology. RESULTS: Compared to volunteers, patients exhibited significant atrophy across all structures (p < 0.05, corrected). Strikingly, we found almost no significant differences across clinical entities. Nonetheless, the clinical measures of awareness and wakefulness upon which differential diagnosis rely were systematically associated with tissue atrophy within thalamic and basal ganglia nuclei, respectively; the basal forebrain was atrophied in proportion to patients' response to sensory stimulation. In addition, nontraumatic injuries exhibited more extensive thalamic atrophy. INTERPRETATION: These findings provide, for the first time, a grounding in pathology for gold standard behavior-based clinical measures of consciousness, and reframe our current models of DOC by stressing the different links tying thalamic mechanisms to willful behavior and extrathalamic mechanisms to behavioral (and electrocortical) arousal. Ann Neurol 2015. [less ▲]

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See detailThermoplastie bronchique : une réelle avancée dans le traitement de l'asthme
HEINEN, Vincent ULiege; SCHLEICH, FLorence ULiege; DUYSINX, Bernard ULiege et al

in Revue Médicale Suisse (2014), 10(439), 1544-1548

New treatments are needed to improve the care of severe asthmatic patients. Bronchial thermoplasty aims to lessen the airway smooth muscles via the heating of bronchial walls by radiofrequency. The ... [more ▼]

New treatments are needed to improve the care of severe asthmatic patients. Bronchial thermoplasty aims to lessen the airway smooth muscles via the heating of bronchial walls by radiofrequency. The preliminary studies showed a good tolerance and some good efficacy. Randomized controlled trials have been undertaken on moderate to severe asthmatic patients, demonstrating an improvement in quality of life, rate of severe exacerbations and unscheduled medical visits. The main side-effects consist of asthma exacerbations, atelectasis and infections. Bronchial thermoplasty is an innovative treatment with good efficacy and acceptable tolerance for moderate to severe asthmatic patients. More studies are needed to better understand its mechanism of action and more clearly delineate the precise indications of this innovative technique. [less ▲]

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See detailMultiple fMRI system-level baseline connectivity is disrupted in patients with consciousness alterations
Demertzi, Athina ULiege; Gomez, Francisco; Crone, Julia-Sophia et al

in Cortex: A Journal Devoted to the Study of the Nervous System and Behavior (2014), 52

Introduction: In healthy conditions, group-level fMRI resting state analyses identify ten resting state networks (RSNs) of cognitive relevance. Here, we aim to assess the tennetwork model in severely ... [more ▼]

Introduction: In healthy conditions, group-level fMRI resting state analyses identify ten resting state networks (RSNs) of cognitive relevance. Here, we aim to assess the tennetwork model in severely brain-injured patients suffering from disorders of consciousness and to identify those networks which will be most relevant to discriminate between patients and healthy subjects. Methods: 300 fMRI volumes were obtained in 27 healthy controls and 53 patients in minimally conscious state (MCS), vegetative state/unresponsive wakefulness syndrome (VS/ UWS) and coma. Independent component analysis (ICA) reduced data dimensionality. The ten networks were identified by means of a multiple template-matching procedure and were tested on neuronality properties (neuronal vs non-neuronal) in a data-driven way. Univariate analyses detected between-group differences in networks’ neuronal properties and estimated voxel-wise functional connectivity in the networks, which were significantly less identifiable in patients. A nearest-neighbor “clinical” classifier was used to determine the networks with high between-group discriminative accuracy. Results: Healthy controls were characterized by more neuronal components compared to patients in VS/UWS and in coma. Compared to healthy controls, fewer patients in MCS and VS/UWS showed components of neuronal origin for the left executive control network, default mode network (DMN), auditory, and right executive control network. The “clinical” classifier indicated the DMN and auditory network with the highest accuracy (85.3%) in discriminating patients from healthy subjects. [less ▲]

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See detailGlobal breakdown in resting state networks fMRI connectivity in patients with disorders of consciousness
Demertzi, Athina ULiege; Soddu, Andrea ULiege; VANHAUDENHUYSE, Audrey ULiege et al

Conference (2012, July 05)

Patients with disorders of consciousness (DOC: brain death, coma, vegetative/unresponsive, minimally conscious state) show reduced resting state fMRI connectivity in a default mode network as a function ... [more ▼]

Patients with disorders of consciousness (DOC: brain death, coma, vegetative/unresponsive, minimally conscious state) show reduced resting state fMRI connectivity in a default mode network as a function of the level of consciousness.1, 2 Here, we aimed to assess resting state fMRI connectivity in multiple cerebral networks. We further aimed to correlate clinical ͞pain͟scales scores (i.e., Nociception Coma Scale, NCS3) with the functional integrity of the pain-related salience network4 because the issue of pain in DOC is of particular ethical interest.5Methods: 300 fMRI resting state scans were obtained in 28 patients (11 minimally conscious, 12 "vegetative͟/unresponsive, 5 coma) and 22 controls. Seven seed regions were used to identify functional connectivity in the default mode, left and right frontoparietal, salience, sensorimotor, auditory, and visual networks. For salience network, a regression analysis was performed with patients’NCS total score. Results: A group-level correlation between resting state functional connectivity and the level of consciousness was identified for all studied networks. Additionally, patients’ NCS scores showed a positive correlation with functional connectivity in the salience network’s anterior cingulate cortex (ACC). Conclusions: We observed group-level functional connectivity decreases in both primary (visual, auditory) and higher-order associative networks (default mode, right and left fronto-parietal, salience, sensorimotor) possibly accounting for patients diminished consciousness capacities.6 The observed positive correlation between the NCS scores and ACC salience network activity reflects nociception-related processes in these patients measured in the absence of an external stimulus. Our results emphasize the clinical importance of multiple fMRI resting state networks to consciousness. References 1. Boly M, et al. (2009). Hum Brain Mapp 30:2393-2400.2. Vanhaudenhuyse A, et al. (2009). Brain 133:161-171. 3. Schnakers C, et al. (2010). Pain 148:215-219.4. Ploner M, et al. (2010). Proc Natl Acad Sci U S A 107:355-360.5. Demertzi A, et al. (2012). Neuroethics:1-14.6. Baars B, et al. (2003). Trends Neurosci 26:671-675. Preference: Talk Track: Clinical [less ▲]

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See detailResting state networks and consciousness Alterations of multiple resting state network connectivity in physiological, pharmacological and pathological consciousness states
Heine, Lizette ULiege; Soddu, Andrea ULiege; Gomez, Francisco et al

in Frontiers in Psychology (2012), 3

In order to better understand the functional contribution of resting state activity to conscious cognition, we aimed to review increases and decreases in fMRI functional connectivity under physiological ... [more ▼]

In order to better understand the functional contribution of resting state activity to conscious cognition, we aimed to review increases and decreases in fMRI functional connectivity under physiological (sleep), pharmacological (anesthesia) and pathological altered states of consciousness, such as brain death, coma, vegetative state/unresponsive wakefulness syndrome, and minimally conscious state. The reviewed RSNs were the DMN, left and right executive control, salience, sensorimotor, auditory and visual networks. We highlight some methodological issues concerning resting state analyses in severely injured brains mainly in terms of hypothesis-driven seed-based correlation analysis and data-driven independent components analysis approaches. Finally, we attempt to contextualize our discussion within theoretical frameworks of conscious processes. We think that this “lesion” approach allows us to better determine the necessary conditions under which normal conscious cognition takes place. At the clinical level, we acknowledge the technical merits of the resting state paradigm. Indeed, fast and easy acquisitions are preferable to activation paradigms in clinical populations. Finally, we emphasize the need to validate the diagnostic and prognostic value of fMRI resting state measurements in non-communicating brain damaged patients. [less ▲]

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See detailFunctional imaging and impaired consciousness
Vanhaudenhuyse, Audrey ULiege; Boly, Mélanie ULiege; Bruno, Marie-Aurélie ULiege et al

in Schnakers, Caroline; Laureys, Steven (Eds.) Coma and disorders of consciousness (2012)

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See detailFunctional neuroanatomy underlying the clinical subcategorization of minimally conscious state patients.
Bruno, Marie-Aurélie ULiege; Majerus, Steve ULiege; Boly, Mélanie ULiege et al

in Journal of Neurology (2012), 259(6), 1087-98

Patients in a minimally conscious state (MCS) show restricted signs of awareness but are unable to communicate. We assessed cerebral glucose metabolism in MCS patients and tested the hypothesis that this ... [more ▼]

Patients in a minimally conscious state (MCS) show restricted signs of awareness but are unable to communicate. We assessed cerebral glucose metabolism in MCS patients and tested the hypothesis that this entity can be subcategorized into MCS- (i.e., patients only showing nonreflex behavior such as visual pursuit, localization of noxious stimulation and/or contingent behavior) and MCS+ (i.e., patients showing command following).Patterns of cerebral glucose metabolism were studied using [(18)F]-fluorodeoxyglucose-PET in 39 healthy volunteers (aged 46 +/- 18 years) and 27 MCS patients of whom 13 were MCS- (aged 49 +/- 19 years; 4 traumatic; 21 +/- 23 months post injury) and 14 MCS+ (aged 43 +/- 19 years; 5 traumatic; 19 +/- 26 months post injury). Results were thresholded for significance at false discovery rate corrected p < 0.05.We observed a metabolic impairment in a bilateral subcortical (thalamus and caudate) and cortical (fronto-temporo-parietal) network in nontraumatic and traumatic MCS patients. Compared to MCS-, patients in MCS+ showed higher cerebral metabolism in left-sided cortical areas encompassing the language network, premotor, presupplementary motor, and sensorimotor cortices. A functional connectivity study showed that Broca's region was disconnected from the rest of the language network, mesiofrontal and cerebellar areas in MCS- as compared to MCS+ patients.The proposed subcategorization of MCS based on the presence or absence of command following showed a different functional neuroanatomy. MCS- is characterized by preserved right hemispheric cortical metabolism interpreted as evidence of residual sensory consciousness. MCS+ patients showed preserved metabolism and functional connectivity in language networks arguably reflecting some additional higher order or extended consciousness albeit devoid of clinical verbal or nonverbal expression. [less ▲]

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See detailComparison between two intraoperative intravenous loading doses of paracetamol on pain after minor hand surgery: two grams versus one gram.
Cornesse, D.; Senard, Marc ULiege; HANS, Grégory ULiege et al

in Acta Chirurgica Belgica (2010), 110(5), 529-32

BACKGROUND: Paracetamol (acetaminophen) is widely used for postoperative analgesia at a recommended dose of 1 g every six hours in adult patients. Increasing the loading dose to 2 g was suggested to ... [more ▼]

BACKGROUND: Paracetamol (acetaminophen) is widely used for postoperative analgesia at a recommended dose of 1 g every six hours in adult patients. Increasing the loading dose to 2 g was suggested to improve immediate postoperative analgesia without increased toxicity in healthy adult patients. We tested the hypothesis that a loading dose of 2 g of intravenous paracetamol results in better postoperative analgesia after surgery as compared with a dose of 1 g. METHODS: Sixty adult patients scheduled for minor hand surgery under intravenous regional anaesthesia were randomized into two groups. The first group received 1 g of intravenous paracetamol before surgery while the second group received 2 g. Verbal numeric pain score, analgesic consumption, first night sleep quality, and patient's satisfaction were recorded during the first 24 hours. RESULTS: Verbal numeric pain scores during the first 24 hours after surgery were significantly lower in the 2 g paracetamol group as compared to the 1 g paracetamol group. No differences were found between the two groups with regard to rescue analgesic consumption, sleep quality and patient's satisfaction. CONCLUSIONS: An intraoperative loading dose of 2 g paracetamol improves postoperative analgesia after minor hand surgery as compared to 1 g paracetamol. [less ▲]

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See detailMécanismes de l'anesthésie générale: apport de l'imagerie fonctionnelle
Boveroux, Pierre ULiege; Bonhomme, Vincent ULiege; Kirsch, Murielle ULiege et al

in Revue Médicale de Liège (2009), 64(Synthèse 2009), 36-41

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See detailMécanismes de l'anesthésie générale: apport de l'imagerie fonctionnelle
BOVEROUX, Pierre ULiege; BONHOMME, Vincent ULiege; KIRSCH, Murielle ULiege et al

in Revue Médicale de Liège (2008), 64

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See detailComment prédire l'évolution du coma post-anoxique?
Kirsch, Murielle ULiege; Boveroux, Pierre ULiege; Massion, Paul ULiege et al

in Revue Médicale de Liège (2008), 63(5-6), 263-268

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