Global structural integrity and effective connectivity in patients with disorders of consciousness

Transcranial magnetic stimulation; electroencephalography; unresponsive wakefulness syndrome; minimally conscious state; disorders of consciousness; connectivity

Abstract :

[en] Background Previous studies have separately reported impaired functional, structural, and effective connectivity in patients with disorders of consciousness (DOC). The perturbational complexity index (PCI) is a transcranial magnetic stimulation (TMS) derived marker of effective connectivity. The global fractional anisotropy (FA) is a marker of structural integrity. Little is known about how these parameters are related to each other. Objective We aimed at testing the relationship between structural integrity and effective connectivity. Methods We assessed 23 patients with severe brain injury more than 4 weeks post-onset, leading to DOC or locked-in syndrome, and 14 healthy subjects. We calculated PCI using repeated single pulse TMS coupled with high-density electroencephalography, and used it as a surrogate of effective connectivity. Structural integrity was measured using the global FA, derived from diffusion weighted imaging. We used linear regression modelling to test our hypothesis, and computed the correlation between PCI and FA in different groups. Results Global FA could predict 74% of PCI variance in the whole sample and 56% in the patients' group. No other predictors (age, gender, time since onset, behavioural score) improved the models. FA and PCI were correlated in the whole population (r = 0.86, p < 0.0001), the patients, and the healthy subjects subgroups. Conclusion We here demonstrated that effective connectivity correlates with structural integrity in brain-injured patients. Increased structural damage level decreases effective connectivity, which could prevent the emergence of consciousness.

Research Center/Unit :

GIGA-COMA - GIGA Consciousness-Coma Science Group - ULiège

Disciplines :

Neurology

Author, co-author :

BODART, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > Service de neurologie

Amico, Enrico

Gomez, Francisco

Casali, Adenauer

Wannez, Sarah ; Université de Liège - ULiège > Centre de recherches du cyclotron

Heine, Lizette ; Université de Liège - ULiège > Centre de recherches du cyclotron

Thibaut, Aurore ; Université de Liège - ULiège > GIGA : Coma Group

Annen, Jitka ; Université de Liège - ULiège > Centre de recherches du cyclotron

Boly, Mélanie

Casarotto, Silvia

More authors (4 more)

^✱ These authors have contributed equally to this work.

Language :

English

Title :

Global structural integrity and effective connectivity in patients with disorders of consciousness

Publication date :

March 2018

Journal title :

Brain Stimulation

ISSN :

1935-861X

eISSN :

1876-4754

Publisher :

Elsevier, New York, United States - New York

Peer reviewed :

Peer Reviewed verified by ORBi

Funders :

F.R.S.-FNRS - Fonds de la Recherche Scientifique

Available on ORBi :

since 22 November 2017

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