References of "Martial, Charlotte"
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See detailIs oral feeding compatible with an unresponsive wakefulness syndrome?
MELOTTE, Evelyne ULiege; MAUDOUX, Audrey ULiege; DELHALLE, Sabrina ULiege et al

in Journal of Neurology (in press)

The aim of the study is to explore the possibility of oral feeding in unresponsive wakefulness syndrome/vegetative state (UWS/VS) patients. Method: We reviewed the clinical information of 68 UWS/VS ... [more ▼]

The aim of the study is to explore the possibility of oral feeding in unresponsive wakefulness syndrome/vegetative state (UWS/VS) patients. Method: We reviewed the clinical information of 68 UWS/VS patients (mean age 45 ± 11; range 16-79 years) searching for mention of oral feeding. UWS/VS diagnosis was made after repeated behavioural assessments using the Coma Recovery Scale–Revised. Patients also had complementary neuroimaging evaluations (positron emission tomography, functional magnetic resonance imaging and electroencephalography and diffusion tensor imaging). Results: Out of the 68 UWS/VS patients, only two could resume oral feeding (3%). The first patient had oral feeding (only liquid and semi liquid) in addition to gastrostomy feeding and the second one could achieve full oral feeding (liquid and mixed solid food). Clinical assessments concluded that they fulfilled the criteria for a diagnosis of UWS/VS. Results from neuroimaging and neurophysiology were typical for the first patient with regard to the diagnosis of UWS/VS but atypical for the second patient. Conclusion: Oral feeding that implies a full and complex oral phase could probably be considered as a sign of consciousness. However, we actually do not know which components are necessary to consider the swallowing conscious as compared to reflex. We also discussed the importance of swallowing assessment and management in all patients with altered state of consciousness. [less ▲]

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See detailDiagnostic, pronostic et traitements des troubles de la conscience
Cassol, Helena ULiege; Aubinet, Charlène ULiege; Thibaut, Aurore ULiege et al

in NPG. Neurologie - Psychiatrie - Gériatrie (in press)

Les progrès de la médecine et des soins intensifs ont conduit à une augmentation du nombre de patients survivant à une lésion cérébrale sévère. Bien que certains patients récupèrent rapidement, d’autres ... [more ▼]

Les progrès de la médecine et des soins intensifs ont conduit à une augmentation du nombre de patients survivant à une lésion cérébrale sévère. Bien que certains patients récupèrent rapidement, d’autres demeurent dans un état de conscience altérée (ECA). Ces derniers peuvent évoluer du coma vers un état végétatif/syndrome d'éveil non répondant (EV/ENR), puis vers un état de conscience minimale (ECM). Dans cette revue, nous proposons tout d’abord de décrire les différentes méthodes, comportementales et de neuro-imagerie, utilisées dans le diagnostic des patients en ECA. Nous décrirons ensuite les facteurs susceptibles d’influencer le pronostic et la récupération de ces patients, ainsi que les traitements et la prise en charge qui peuvent être proposés dans le but d’améliorer leur état de conscience. Enfin, nous clôturerons cette revue avec une réflexion sur les considérations éthiques et les questions de fin de vie. [less ▲]

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See detailQualitative thematic analysis of the phenomenology of near-death experiences
Cassol, Helena ULiege; Pétré, Benoît ULiege; Degrange, Sophie ULiege et al

in PLoS ONE (in press)

Near-death experiences (NDEs) refer to profound psychological events that can have an important impact on the experiencers’ (NDErs) lives. Previous studies have shown that NDEs memories are ... [more ▼]

Near-death experiences (NDEs) refer to profound psychological events that can have an important impact on the experiencers’ (NDErs) lives. Previous studies have shown that NDEs memories are phenomenologically rich. In the present study, we therefore aimed to extract the common themes (referred to as “features” in the NDE literature) reported by NDErs by analyzing all the concepts stored in the narratives of their experiences. A qualitative thematic analysis has been carried out on 34 cardiac arrest survivors’ NDE narratives. Our results shed the light on the structure of the narratives by identifying 10 “time-bounded” themes which refer to isolated events encountered during the NDE and 1 “transversal” theme which characterizes the whole narrative and generally appears as a retrospective comment of self-reflection on the experience. The division of narratives into themes provides us with detailed information about the vocabulary used by NDErs to describe their experience. This established thematic method enables a rigorous description of the phenomenon, ensuring the inclusion of all self-reported manifestations of themes in narratives. [less ▲]

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See detailTranscranial direct current stimulation unveils covert consciousness
Thibaut, Aurore ULiege; Chatelle, Camille ULiege; VANHAUDENHUYSE, Audrey ULiege et al

in Brain Stimulation (in press)

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See detailLes expériences de mort imminente
Cassol, Helena ULiege; Martial, Charlotte ULiege; Laureys, Steven ULiege et al

in MethIS (in press)

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See detailMultifaceted Brain Networks Reconfiguration in Disorders of Consciousness Uncovered by Co-Activation Patterns
Di Perri, Carol ULiege; Amico, Enrico; Heine, Lizette ULiege et al

in Human Brain Mapping (2018)

Introduction: Given that recent research has shown that functional connectivity is not a static phenomenon, we aim to investigate the dynamic properties of the default mode network’s (DMN) connectivity in ... [more ▼]

Introduction: Given that recent research has shown that functional connectivity is not a static phenomenon, we aim to investigate the dynamic properties of the default mode network’s (DMN) connectivity in patients with disorders of consciousness. Methods: Resting-state fMRI volumes of a convenience sample of 17 patients in unresponsive wakefulness syndrome (UWS) and controls were reduced to a spatiotemporal point process by selecting critical time points in the posterior cingulate cortex (PCC). Spatial clustering was performed on the extracted PCC time frames to obtain 8 different co-activation patterns (CAPs). We investigated spatial connectivity patterns positively and negatively correlated with PCC using both CAPs and standard stationary method. We calculated CAPs occurrences and the total number of frames. Results: Compared to controls, patients showed (i) decreased within-network positive correlations and between-network negative correlations, (ii) emergence of “pathological” within-network negative correlations and between-network positive correlations (better defined with CAPs), and (iii) “pathological” increases in within-network positive correlations and between-network negative correlations (only detectable using CAPs). Patients showed decreased occurrence of DMN-like CAPs (1–2) compared to controls. No between-group differences were observed in the total number of frames Conclusion: CAPs reveal at a more fine-grained level the multifaceted spatial connectivity reconfiguration following the DMN disruption in UWS patients, which is more complex than previously thought and suggests alternative anatomical substrates for consciousness. BOLD fluctuations do not seem to differ between patients and controls, suggesting that BOLD response represents an intrinsic feature of the signal, and therefore that spatial configuration is more important for consciousness than BOLD activation itself. [less ▲]

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See detailÉtats de conscience altérée: Quel rôle pour les neuropsychologues ?
Stephan, Julie; Radiguer, François; Martial, Charlotte ULiege et al

in Neurologies (2017)

Avec les progrès des techniques de soins intensifs et de réanimation, de nombreuses personnes survivent à des lésions cérébrales graves et peuvent notamment présenter dans les suites un état de conscience ... [more ▼]

Avec les progrès des techniques de soins intensifs et de réanimation, de nombreuses personnes survivent à des lésions cérébrales graves et peuvent notamment présenter dans les suites un état de conscience altérée (ECA). Malgré la création depuis les années 2000 des unités spécialisées “états végétatifs chroniques/états pauci-relationnels”, leurs équipes sont encore peu pourvues de psychologues spécialisés en neuropsychologie (appelés neuropsychologues), pourtant présents dans de plus en plus d’autres services et avec un profil qui pourrait sembler pertinent dans l’accompagnement et la prise en charge des ECA. Où en sont les pratiques sur le terrain et quelles seraient les perspectives de développement à envisager ? Afin de répondre à ces questions, nous avons réalisé une revue de la littérature sur le sujet, pris l’avis d’un centre spécialisé dans les troubles de la conscience et mené une enquête sur les pratiques actuelles des services francophones accueillant cette population spécifique, en France, en Belgique, au Québec et en Suisse. Nos résultats mettent en avant que : • le sujet des ECA mériterait d’être davantage abordé en formation initiale des psychologues spécialisés en neuropsychologie ; • ces derniers sont encore peu présents dans les services concernés ; • et ce, malgré des compétences transversales et des connaissances croisées qui apportent manifestement une réelle plus-value dans le diagnostic et la prise en charge de ces patients et de leur entourage. Nous avons réalisé une synthèse de ces différents éléments et discutons des perspectives d’amélioration en vue de favoriser l’implication des neuropsychologues dans ses services, auprès des patients et de leurs familles. [less ▲]

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See detailLe cerveau en question
Martial, Charlotte ULiege

Conference (2017, October 19)

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See detailLes expériences de mort imminente: le point de vue des neurosciences
Martial, Charlotte ULiege

Conference (2017, September 27)

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See detailCorrigendum: Temporality of Features in Near-Death Experience Narratives
Martial, Charlotte ULiege; Cassol, Helena ULiege; Antonopoulos, Georgios ULiege et al

in Frontiers in Human Neuroscience (2017)

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See detailResting functional connectivity in minimally conscious state minus and plus
Aubinet, Charlène ULiege; Heine, Lizette ULiege; Martial, Charlotte ULiege et al

Poster (2017, June 27)

Patients in a minimally conscious state (MCS) have been subcategorized in MCS plus and MCS minus, that is, with or without command following capacity respectively. We aimed to characterize this residual ... [more ▼]

Patients in a minimally conscious state (MCS) have been subcategorized in MCS plus and MCS minus, that is, with or without command following capacity respectively. We aimed to characterize this residual capacity in both patient groups by means of resting state fMRI. We hypothesized a higher connectivity in MCS plus as compared with MCS minus in language-related networks, that is the left fronto-parietal network (FPN). Our sample includes 10 MCS plus and 9 MCS minus who match for age, gender, etiology and disease duration, as well as 35 healthy controls. We performed a seed-based resting state analysis using CONN toolbox2. We investigated the left FPN, and also the right FPN, the auditory network and the default mode network (DMN) in order to exclude the influence of perception of surrounding, auditory capacity, or internal thoughts. We employed a ROI-to-ROI analysis to investigate the inter-hemispheric connectivity and we investigated inter-group differences in grey and white matter volume by means of voxel-based morphometry (VBM). We observed a higher functional connectivity in controls than in patients, as well as in MCS plus as compared to MCS minus patients. Specifically, with DLPFC as seed, the left FPN was more connected in MCS plus patients to the left temporo-occipital fusiform cortex. No significant differences were found between both patient groups in the right FPN, the auditory network and the DMN, or using the ROI-to-ROI analyses and the VBM. Our results suggest that the clinical sub-categorization of MCS is sustained by functional connectivity differences in a language-related executive control network. MCS plus and MCS minus patients are not differentiated by networks involved in auditory processing, perception of surroundings and internal thoughts, nor by inter-hemispheric connectivity and morphology. [less ▲]

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See detailRôle des psychologues spécialisés en neuropsychologie auprès des patients en état de conscience altérée : état des lieux et perspectives
Wauquiez, Grégoire; Radiguer, François; Stephan, Julie et al

Poster (2017, June 02)

Avec les progrès des techniques de soins intensifs et de réanimation, de nombreuses personnes survivent à des lésions cérébrales graves et peuvent notamment présenter dans les suites un état de conscience ... [more ▼]

Avec les progrès des techniques de soins intensifs et de réanimation, de nombreuses personnes survivent à des lésions cérébrales graves et peuvent notamment présenter dans les suites un état de conscience altérée. La création depuis les années 2000 d’unités spécialisées dites “Etats Végétatifs Chroniques / Etats Pauci-Relationnels” témoigne du développement de l’offre de soin dédiée à ces problématiques complexes. De plus en plus d’études scientifiques sont également publiées chaque année sur le sujet de l’évaluation et de la prise en charge de ces patients (ref1). La question du diagnostic d'état d'éveil non répondant ou d'état de conscience minimale constitue entre autres un enjeu majeur pour proposer à ces patients une stimulation adaptée (ref2). Néanmoins, ce domaine d’intervention paraît aujourd'hui encore modérément investi par les psychologues spécialisés en neuropsychologie, professionnels qui semblent pourtant à même d’y contribuer de manière pertinente de par leurs connaissances et leurs compétences (ref3). Où en sont les pratiques sur le terrain et quelles seraient les perspectives de développement à envisager ? Pour tenter de répondre à ces questions, nous avons diffusé une enquête en ligne à destination des neuropsychologues francophones (Belgique, France, Québec et Suisse) en vue de recueillir des données sur la formation, les activités et les attentes de nos collègues. En parallèle, nous avons réalisé une brève revue de la littérature scientifique sur le sujet et sollicité l’avis d’experts concernant les pratiques et spécificités des neuropsychologues auprès de ces patients. Nos premiers résultats mettent en avant 1°) qu’un nombre non négligeable de psychologues spécialisés en neuropsychologie travaillent auprès de patients en état de conscience altérée, 2°) qu'ils ont des connaissances et une pratique spécifique leur permettant d'apporter un réel bénéfice dans le diagnostic et la prise en charge interdisciplinaire de ces patients, et 3°) que le sujet des états de conscience altérée mériterait une place plus importante dans la formation initiale et continue des neuropsychologues afin de contribuer au développement d’une pratique de haut niveau auprès de ces patients tout à fait particuliers. Ces résultats nous feront discuter des questions de la formation initiale, des variétés de pratiques et de la perspective d’une enquête élargie aux pays non francophones. [less ▲]

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See detailMultimodal imaging analysis in Charles Bonnet Syndrome: a case report
Martial, Charlotte ULiege; Di Perri, Carol ULiege; Larroque, Stephen Karl ULiege et al

Poster (2017, June)

Charles Bonnet syndrome (CBS) is a rare condition characterized by visual impairment associated with complex visual hallucinations in psychologically normal elderly people. Previous studies have suggested ... [more ▼]

Charles Bonnet syndrome (CBS) is a rare condition characterized by visual impairment associated with complex visual hallucinations in psychologically normal elderly people. Previous studies have suggested that visual hallucinations may be caused by brain damage in the visual system. However, in the case of CBS, specific brain regions in the occipital cortex have not been clearly determined and functional neuroimaging remains relatively unexplored. To our knowledge, functional connectivity by means of resting-state magnetic resonance imaging (MRI) has never been investigated in patients with CBS. We here aimed to investigate structural imaging, brain metabolism and functional connectivity in a patient with CBS. Resting-state functional and structural MRI were acquired in an 85-year-old patient with CBS and 12 age- and gender-matched normally sighted controls. Cognitive functioning was measured by behavioral assessment. A seed-based resting state fMRI was performed to investigate the default mode network (DMN), the executive control network and the visual networks connectivity. A voxel-based morphometry (VBM) analysis was employed to investigate the grey matter volume. Cortical and subcortical grey matter thickness were further investigated. Finally, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) was also acquired to observe regional glucose uptake by comparing standard uptake values (SUVs). Increased functional connectivity was found between the DMN and the temporo-occipital fusiform cortex, as well as between the secondary visual cortex and the left frontal cortex, in the CBS patient compared to controls. The patient also demonstrated increased functional connectivity between the primary visual cortex and the left supramarginal gyrus and between the associative visual cortex and the superior temporal gyrus/angular gyrus, as compared to controls. Decreased grey matter volume was observed in the lateral occipital cortex/angular gyrus in our patient as compared to controls. Diminished grey matter thickness values were observed in the lateral geniculate nucleus compared to healthy controls. FDG-PET results confirmed previous work and showed bilateral hypometabolism in the occipital cortex (mean SUV reduction of 5.36%, p<0.001). Our results suggest that structural alterations in visual system in CBS are associated with compensatory/adaptive changes in functional connectivity that involve regions known to support hallucinations of faces in CBS patients. We suggest that this functional connectivity reorganization following visual structural damage may contribute to visual hallucinations. These findings might shed light on the pathophysiology underlining this rare condition. [less ▲]

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See detailTemporality of Features in Near-Death Experience Narratives
Martial, Charlotte ULiege; Cassol, Helena ULiege; Antonopoulos, Georgios ULiege et al

in Frontiers in Human Neuroscience (2017)

Background: After an occurrence of a Near-Death Experience (NDE), Near- Death Experiencers (NDErs) usually report extremely rich and detailed narratives. Phenomenologically, a NDE can be described as a ... [more ▼]

Background: After an occurrence of a Near-Death Experience (NDE), Near- Death Experiencers (NDErs) usually report extremely rich and detailed narratives. Phenomenologically, a NDE can be described as a set of distinguishable features. Some authors have proposed regular patterns of NDEs, however, the actual temporality sequence of NDE core features remains a little explored area. Objectives: The aim of the present study was to investigate the frequency distribution of these features (globally and according to the position of features in narratives) as well as the most frequently reported temporality sequences of features. Methods: We collected 154 French freely expressed written NDE narratives (i.e., Greyson NDE scale total score 7/32). A text analysis was conducted on all narratives in order to infer temporal ordering and frequency distribution of NDE features. Results: Our analyses highlighted the following most frequently reported sequence of consecutive NDE features: Out-of-Body Experience, Experiencing a tunnel, Seeing a bright light, Feeling of peace. Yet, this sequence was encountered in a very limited number of NDErs. Conclusion: These findings may suggest that NDEs temporality sequences can vary across NDErs. Exploring associations and relationships among features encountered during NDEs may complete the rigorous definition and scientific comprehension of the phenomenon. [less ▲]

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See detailIs oral feeding compatible with an unresponsive wakefulness syndrome?
MELOTTE, Evelyne ULiege; MAUDOUX, Audrey ULiege; DELHALLE, Sabrina ULiege et al

Conference (2017, May)

INTRODUCTION AND AIMS Vegetative state/Unresponsive wakefulness syndrome (VS/UWS) is defined by the presence of eye-opening and the absence of awareness and voluntary movement (Laureys et al., 2010). VS ... [more ▼]

INTRODUCTION AND AIMS Vegetative state/Unresponsive wakefulness syndrome (VS/UWS) is defined by the presence of eye-opening and the absence of awareness and voluntary movement (Laureys et al., 2010). VS/UWS patients classically receive hydration and nutrition through an enteral feeding tube. We present the cases of two patients that were diagnosed as VS/UWS but were able to resume oral feeding. It is however unclear if the presence of oral feeding is compatible with the diagnosis of VS/UWS or if this observation should lead to a modification of the diagnosis. METHODS AND RESULTS We retrospectively reviewed the clinical information of 65 VS/UWS patients (aged 45±12; range 16-85 years) evaluated at the CHU hospital of Liege searching for mention of oral feeding. VS/UWS diagnosis was made after repeated behavioral assessments using the standardized Coma Recovery Scale–Revised (CRS-R, (Teasdale & Jennet, 1974)) in association with complementary evaluations using neuroimaging techniques. Of the 65 VS/UWS patients, two could resume oral feeding (3%). One could achieve full oral feeding (mixed texture and liquid) and the other had oral feeding (liquid and semi-liquid) in addition to gastrostomy feeding. Neuroimaging evaluations showed in both patients a massive decrease in the spontaneous brain activity and its functional connectivity (using functional magnetic resonance imaging), bilateral cerebral cortex hypometabolism (fronto- parietal associative areas, posterior parietal areas, cingulate cortices, precuneus) and preserved metabolism in the brainstem and cerebellum (using positron emission tomography). CONCLUSIONS Oral feeding is rare in VS/UWS patients (3% in our cohort). Based on neuroimaging results, this behaviour does not seem to be incompatible with the diagnosis of VS/UWS but the neuromecanistic root, which allows this behavior, still needs to be elucidate. This study also emphasizes the importance of systematic swallowing evaluation in patients with altered state of consciousness regardless of their level of consciousness. Moreover, tactile oro-facial stimulation, manual therapy, taste stimulation and therapeutic feeding can be another “gateway” to interact with these patients and improve their quality of life. [less ▲]

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See detailClinical sub-categorization of minimally conscious state according to resting functional connectivity
Aubinet, Charlène ULiege; Heine, Lizette ULiege; Martial, Charlotte ULiege et al

Conference (2017, March 31)

Introduction: Patients in a minimally conscious state (MCS) have been subcategorized in MCS plus and MCS minus, respectively with and without command following capacity. Here we aim to characterize ... [more ▼]

Introduction: Patients in a minimally conscious state (MCS) have been subcategorized in MCS plus and MCS minus, respectively with and without command following capacity. Here we aim to characterize differences in MCS plus as compared to MCS minus by means of functional connectivity (FC). Method: Resting state functional magnetic resonance imagery (fMRI) was acquired in 292 MCS patients and a seed-based analysis was conducted on a convenience sample of 19 MCS patients (10 MCS plus and 9 MCS minus) and 35 healthy controls. We investigated the left and right frontoparietal networks (FPN), the auditory network and the default mode network (DMN). We employed a ROI-to-ROI analysis to investigate the inter-hemispheric connectivity and we investigated inter-group differences in grey and white matter volume by means of voxel-based morphometry. Results: We found a higher FC in MCS plus as compared to MCS minus in the left FPN, specifically between the left dorso-lateral prefrontal cortex and the left temporo-occipital fusiform cortex (TOFC). The FC of auditory network, right FPN and DMN, inter-hemispheric connectivity and structure of grey and white matter did not show differences between patients groups. Discussion: Our results suggest that the clinical sub-categorization of MCS is sustained by FC differences in a language-related executive control network. MCS plus and MCS minus patients are not differentiated by networks involved in auditory processing, perception of surroundings and internal thoughts, nor by differences in inter-hemispheric connectivity and in morphology. [less ▲]

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See detailNear-death experiences: recent findings
Martial, Charlotte ULiege

Conference (2017, March)

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See detailCan science explain consciousness? Lessons from coma and related states
Martial, Charlotte ULiege

Conference (2017, March)

Understanding consciousness remains one of the greatest mysteries for science to solve. How do our brains work? How can we know if some patients in coma have any consciousness left and how could we ... [more ▼]

Understanding consciousness remains one of the greatest mysteries for science to solve. How do our brains work? How can we know if some patients in coma have any consciousness left and how could we communicate with them? What are near-death experiences? What is brain death? What happens in our brains during dreaming, hypnosis or meditation? At present, nobody understands how matter (our trillions of neural connections) becomes perception and thought. We will here briefly review some neurological facts on consciousness and impaired consciousness. Thanks to recent advances in (neuroimaging) technology, the mapping of conscious perception and cognition in health (e.g., conscious waking, sleep, dreaming, hypnosis, meditation, sleepwalking and anesthesia) and in disease (e.g., coma, near-death, “vegetative” state, seizures, hallucinations etc) is providing exiting new insights into the functional neuroanatomy of human consciousness. Our perception of the outside world (sensory awareness; what we see, hear, etc.) and our awareness of an inner world (self-awareness; the little "voice" inside that "speaks" to ourselves) seemingly depend on two separate networks we could recently identify. Philosophers might argue that the subjective aspect of the mind will never be sufficiently accounted for by the objective methods of reductionistic science. We here prefer a more pragmatic approach and remain naively optimistic that technological advances might ultimately lead to an understanding of the neural substrate of human consciousness. [less ▲]

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See detailApplication of Qualitative Thematic Analysis to Near-Death Experiences
Cassol, Helena ULiege; Pétré, Benoît ULiege; Degrange, Sophie ULiege et al

Poster (2017, February 01)

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See detailCharacterization of minimally conscious state minus and plus according to resting functional connectivity
Aubinet, Charlène ULiege; Heine, Lizette; Martial, Charlotte ULiege et al

Scientific conference (2017, February 01)

The minimally conscious state (MCS) has been sub-categorized in MCS plus and MCS minus, i.e. respectively with and without command following capacity. Here we aimed at characterizing differences in MCS ... [more ▼]

The minimally conscious state (MCS) has been sub-categorized in MCS plus and MCS minus, i.e. respectively with and without command following capacity. Here we aimed at characterizing differences in MCS plus as compared to MCS minus by means of functional connectivity (FC). Resting state functional magnetic resonance imagery (fMRI) was acquired in 292 MCS patients and a seed-based analysis was conducted on a convenience sample of 19 MCS patients (10 MCS plus and 9 MCS minus) and 35 healthy controls. We investigated the left and right frontoparietal networks (FPN), the auditory network and the default mode network (DMN). We employed a ROI-to-ROI analysis and a voxel-based morphometry in order to investigate the inter-hemispheric connectivity and the grey and white matter volume, respectively. A significantly higher FC was found in MCS plus as compared to MCS minus in the left FPN, specifically between the left dorso-lateral prefrontal cortex and the left temporo-occipital fusiform cortex (TOFC). The FC of auditory network, right FPN and DMN, inter-hemispheric connectivity and structure of grey and white matter did not show differences between patients groups. The clinical sub-categorization of MCS is therefore sustained by FC differences in a language-related executive control network. These patient groups are not differentiated by networks involved in auditory processing, perception of surroundings and internal thoughts, nor by differences in inter-hemispheric connectivity and in morphology. [less ▲]

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