Article (Scientific journals)
Global structural integrity and effective connectivity in patients with disorders of consciousness
BODART, Olivier; Amico, Enrico; Gomez, Francisco et al.
2018In Brain Stimulation
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Keywords :
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 :
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
Rosanova, Mario
Massimini, Marcello
Laureys, Steven   ;  Université de Liège - ULiège > GIGA : Coma Group
Gosseries, Olivia   ;  Université de Liège - ULiège > Centre de recherches du cyclotron
More authors (4 more) Less
 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 [BE]
Available on ORBi :
since 22 November 2017

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