Nociception; Pain; Cut-off score; Nociception Coma Scale-Revised; Disorders of Consciousness
Résumé :
[en] The Nociception Coma Scale-Revised (NCS-R) was developed to help assess pain in patients with disorders of consciousness (DOC). Several studies have shown its sensitivity in assessing response to acute noxious stimuli. However, they failed to determine a reliable cut-off score that could be used to infer pain processing in these patients.
This retrospective cross-sectional study aimed to determine a NCS-R cut-off score supporting preserved neural basis for pain experience, based on brain metabolism preservation as measured by fluorodeoxyglucose positron emission tomography (FDG-PET).
We included patients in unresponsive wakefulness syndrome (UWS) confirmed by the FDG-PET and examined the NCS-R total scores. As the highest score was 4, we defined the cut-off to be 5 and compared the brain metabolism of these patients to matched patients with DOC and a NCS-R cut-off score ≥ 5 (i.e., potential pain), as well as healthy subjects.
We found a higher global cerebral metabolism in healthy subjects compared to both patient groups and also in patients with potential pain compared with FDG-PET confirmed UWS. We observed a preserved metabolism in the left insula in patients with potential pain compared with FDG-PET confirmed UWS.
Centre/Unité de recherche :
Coma Science Group GIGA Consciousness (Coma Science Group, Centre du Cerveau)
Disciplines :
Neurosciences & comportement
Auteur, co-auteur :
Bonin, Estelle ; Université de Liège - ULiège > GIGA-Consciousness-Coma Science Group ; CHU de Liège - Centre du Cerveau²
Lejeune, Nicolas ; Université de Liège - ULiège > Form. doct. sc. méd. (paysage)
Thibaut, Aurore ; Université de Liège - ULiège > Consciousness-Coma Science Group
Cassol, Helena ; Université de Liège - ULiège > Consciousness-Coma Science Group
Wannez, Sarah ; Université de Liège - ULiège > GIGA Consciousness > Coma Science Group
Martial, Charlotte ; Université de Liège - ULiège > Consciousness-Coma Science Group
Schnakers, Caroline; Research institute Casa Colina hospital and centers for healthcare
LAUREYS, Steven ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Centre intégré pluridisc. étude cerveau-cognition-conscience
Chatelle, Camille ; Université de Liège - ULiège > Consciousness-Coma Science Group
Langue du document :
Anglais
Titre :
Nociception Coma Scale Revised allows to identify patients with preserved neural basis for pain experience
Boly, M, Balteau, E, Schnakers, C, Degueldre, C, Moonen, G, Luxen, A, Phillips, C, Peigneux, P, Maquet, P, Laureys, S, Baseline brain activity fluctuations predict somatosensory perception in humans. Proc Nat Acad Sci 104 (2007), 12187–12192.
Boly, M, Faymonville, M-E, Schnakers, C, Peigneux, P, Lambermont, B, Phillips, C, Lancellotti, P, Luxen, A, Lamy, M, Moonen, G, Maquet, P, Laureys, S, Perception of pain in the minimally conscious state with PET activation: An observational study. Lancet Neurol 7 (2008), 1013–1020.
Brooks, JCW, Nurmikko, TJ, Bimson, WE, Singh, KD, Roberts, N, fMRI of thermal pain: Effects of stimulus laterality and attention. NeuroImage 15 (2002), 293–301.
Chatelle, C, De Val, M-D, Catano, A, Chaskis, C, Seeldrayers, P, Laureys, S, Biston, P, Schnakers, C, Is the nociception coma scale-revised a useful clinical tool for managing pain in patients with disorders of consciousness?. Clin J Pain 32 (2016), 321–326.
Chatelle, C, Hauger, SL, Martial, C, Becker, F, Eifert, B, Boering, D, Giacino, JT, Laureys, S, Løvstad, M, Maurer-Karattup, P, Assessment of nociception and pain in participants in an unresponsive or minimally conscious state after acquired brain injury: The relation between the coma recovery scale–revised and the nociception coma scale–revised. Arch Phys Med Rehabil 99 (2018), 1755–1762.
Chatelle, C, Majerus, S, Whyte, J, Laureys, S, Schnakers, C, A sensitive scale to assess nociceptive pain in patients with disorders of consciousness. J Neurol Neurosurg Psychiatry 83 (2012), 1233–1237.
Chatelle, C, Thibaut, A, Bruno, M-A, Boly, M, Bernard, C, Hustinx, R, Schnakers, C, Laureys, S, Nociception coma scale–revised scores correlate with metabolism in the anterior cingulate cortex. Neurorehabil Neural Repair 28 (2014), 149–152.
Chatelle, C, Thibaut, A, Whyte, J, De Val, MD, Laureys, S, Schnakers, C, Pain issues in disorders of consciousness. Brain Injury 28 (2014), 1202–1208.
Coghill, RC, Sang, CN, Maisog, JMa, Iadarola, MJ, Pain intensity processing within the human brain: A bilateral, distributed mechanism. J Neurophysiol 82 (1999), 1934–1943.
Gélinas, C, Boitor, M, Puntillo, KA, Arbour, C, Topolovec-Vranic, J, Cusimano, MD, Choinière, M, Streiner, DL, Behaviors indicative of pain in brain-injured adult patients with different levels of consciousness in the intensive care unit. J Pain Symptom Manage 57 (2019), 761–773.
Gélinas, C, Puntillo, KA, Levin, P, Azoulay, E, The behavior pain assessment tool for critically ill adults: A validation study in 28 countries. Pain 158 (2017), 811–821.
Giacino, JT, Kalmar, K, Whyte, J, The JFK coma recovery scale-revised: Measurement characteristics and diagnostic utility. Arch Phys Med Rehabilit 85 (2004), 2020–2029.
Gosseries, O, Zasler, ND, Laureys, S, Recent advances in disorders of consciousness: Focus on the diagnosis. Brain Injury 28 (2014), 1141–1150.
Guenther, T, Schönknecht, P, Becker, G, Olbrich, S, Sander, C, Hesse, S, Meyer, PM, Luthardt, J, Hegerl, U, Sabri, O, Impact of EEG-vigilance on brain glucose uptake measured with [18F]FDG and PET in patients with depressive episode or mild cognitive impairment. NeuroImage 56 (2011), 93–101.
Ingvar, M, Pain and functional imaging. Howseman, A, Zeki, S, (eds.) Philosophical Transactions of the Royal Society of London Series B: Biological Sciences, 354, 1999, 1347–1358.
Kassubek, J, Juengling, FD, Els, T, Spreer, J, Herpers, M, Krause, T, Moser, E, Lücking, CH, Activation of a residual cortical network during painful stimulation in long-term postanoxic vegetative state: A 15O–H2O PET study. J Neurol Sci 212 (2003), 85–91.
Laureys, S, Faymonville, ME, Peigneux, P, Damas, P, Lambermont, B, Del Fiore, G, Degueldre, C, Aerts, J, Luxen, A, Franck, G, Lamy, M, Moonen, G, Maquet, P, Cortical processing of noxious somatosensory stimuli in the persistent vegetative state. NeuroImage 17 (2002), 732–741.
Markl, A, Yu, T, Vogel, D, Müller, F, Kotchoubey, B, Lang, S, Brain processing of pain in patients with unresponsive wakefulness syndrome. Brain Behav 3 (2013), 95–103.
Monti, MM, Vanhaudenhuyse, A, Coleman, MR, Boly, M, Pickard, JD, Tshibanda, L, Owen, AM, Laureys, S, Willful modulation of brain activity in disorders of consciousness. New Engl J Med 362 (2010), 579–589.
Ostrowsky, K, Representation of pain and somatic sensation in the human insula: A study of responses to direct electrical cortical stimulation. Cereb Cortex 12 (2002), 376–385.
Peyron, R, Frot, M, Schneider, F, Garcia-Larrea, L, Mertens, P, Barral, FG, Sindou, M, Laurent, B, Mauguière, F, Role of operculoinsularcortices in human pain processing: Converging evidence from PET, fMRI, dipole modeling, and intracerebral recordings of evoked potentials. NeuroImage 17 (2002), 1336–1346.
Phillips, CL, Bruno, M-A, Maquet, P, Boly, M, Noirhomme, Q, Schnakers, C, Vanhaudenhuyse, A, Bonjean, M, Hustinx, R, Moonen, G, Luxen, A, Laureys, S, “Relevance vector machine” consciousness classifier applied to cerebral metabolism of vegetative and locked-in patients. NeuroImage 56 (2011), 797–808.
Posner, JB, Saper, CB, Schiff, NN, Plum, F, Plum and Posner's - Diagnosis of Stupor and Coma. 4th ed, 2007, Oxford University Press.
Rainville, P, Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science 277 (1997), 968–971.
Schnakers, C, Chatelle, C, Vanhaudenhuyse, A, Majerus, S, Ledoux, D, Boly, M, Bruno, M-A, Boveroux, P, Demertzi, A, Moonen, G, Laureys, S, The nociception coma scale: A new tool to assess nociception in disorders of consciousness. Pain 148 (2010), 215–219.
Stender, J, Gosseries, O, Bruno, M-A, Charland-Verville, V, Vanhaudenhuyse, A, Demertzi, A, Chatelle, C, Thonnard, M, Thibaut, A, Heine, L, Soddu, A, Boly, M, Schnakers, C, Gjedde, A, Laureys, S, Diagnostic precision of PET imaging and functional MRI in disorders of consciousness: A clinical validation study. Lancet 384 (2014), 514–522.
Stender, J, Kupers, R, Rodell, A, Thibaut, A, Chatelle, C, Bruno, M-A, Gejl, M, Bernard, C, Hustinx, R, Laureys, S, Gjedde, A, Quantitative rates of brain glucose metabolism distinguish minimally conscious from vegetative state patients. J Cereb Blood Flow Metab 35 (2015), 58–65.
Stender, J, Mortensen, KN, Thibaut, A, Darkner, S, Laureys, S, Gjedde, A, Kupers, R, The minimal energetic requirement of sustained awareness after brain injury. Curr Biol 26 (2016), 1494–1499.
Symonds, LL, Gordon, NS, Bixby, JC, Mande, MM, Right-lateralized pain processing in the human cortex: An fMRI study. J Neurophysiol 95 (2006), 3823–3830.
Teasdale, G, Jennett, B, Assessment of coma and impaired consciousness: A practical scale. Lancet, 1974, 81–83.
The Multi-Society Task Force on PVS. Medical aspects of the persistent vegetative state. N Engl J Med, 1994, 1499–1508.
Thibaut, A, Bruno, M, Chatelle, C, Gosseries, O, Vanhaudenhuyse, A, Demertzi, A, Schnakers, C, Thonnard, M, Charland-Verville, V, Bernard, C, Bahri, M, Phillips, C, Boly, M, Hustinx, R, Laureys, S, Metabolic activity in external and internal awareness networks in severely brain-damaged patients. J Rehabilit Med 44 (2012), 487–494.
Thibaut, A, Chatelle, C, Wannez, S, Deltombe, T, Stender, J, Schnakers, C, Laureys, S, Gosseries, O, Spasticity in disorders of consciousness A behavioral study.pdf. Eur J Phys Rehabil Med 51 (2014), 389–397.
Vogt, BA, Derbyshire, S, Jones, AKP, Pain processing in four regions of human cingulate cortex localized with Co-registered PET and MR imaging. Eur J Neurosci 8 (1996), 1461–1473.
Wannez, S, Heine, L, Thonnard, M, Gosseries, O, Laureys, S, Coma Science Group collaborators. The repetition of behavioral assessments in diagnosis of disorders of consciousness: Repeated CRS-R assessments for diagnosis in DOC. Ann Neurol 81 (2017), 883–889.
Youell, PD, Wise, RG, Bentley, DE, Dickinson, MR, King, TA, Tracey, I, Jones, AKP, Lateralisation of nociceptive processing in the human brain: a functional magnetic resonance imaging study. NeuroImage 23 (2004), 1068–1077.
