Cerebral response to subject's own name showed high prognostic value in traumatic vegetative state

Functional MRI; Own name; Prognosis; Traumatic brain injury; Vegetative state/unresponsive wakefulness syndrome; Article; BOLD signal; Acoustic Stimulation; Adolescent; Adult; Aged; Child; Child, Preschool; Consciousness; Female; Humans; Infant; Magnetic Resonance Imaging; Male; Middle Aged; Persistent Vegetative State; Young Adult

Abstract :

[en] Background: Previous studies have shown the prognostic value of stimulation elicited blood-oxygen-level-dependent (BOLD) signal in traumatic patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS). However, to the best of our knowledge, no studies have focused on the relevance of etiology and level of consciousness in patients with disorders of consciousness (DOC) when explaining the relationship between BOLD signal and both outcome and signal variability. We herein propose a study in a large sample of traumatic and non-traumatic DOC patients in order to ascertain the relevance of etiology and level of consciousness in the variability and prognostic value of a stimulation-elicited BOLD signal. Methods: 66 patients were included, and the response of each subject to his/her own name said by a familiar voice (SON-FV) was recorded using fMRI; 13 patients were scanned twice in the same day, respecting the exact same conditions in both cases. A behavioral follow-up program was carried out at 3, 6, and 12 months after scanning. Results: Of the 39 VS/UWS patients, 12 (75%) out of 16 patients with higher level activation patterns recovered to minimally conscious state (MCS) or emergence from MCS (EMCS) and 17 (74%) out of 23 patients with lower level activation patterns or no activation had a negative outcome. Taking etiology into account for VS/UWS patients, a higher positive predictive value was assigned to traumatic patients, i.e., up to 92% (12/13) patients with higher level activation pattern achieved good recovery whereas 11 out of 13 (85%) non-traumatic patients with lower level activation or without activation had a negative clinical outcome. The reported data from visual analysis of fMRI activation patterns were corroborated using ROC curve analysis, which supported the correlation between auditory cortex activation volume and VS/UWS patients' recovery. The average brain activity overlap in primary and secondary auditory cortices in patients scanned twice was 52%. Conclusions: The activation type and volume in auditory cortex elicited by SON-FV significantly correlated with VS/UWS patients' prognosis, particularly in patients with traumatic etiology, however, this could not be established in MCS patients. Repeated use of this simple fMRI task might help obtain more reliable prognostic information. © 2015 Wang et al.; licensee BioMed Central.

Disciplines :

Neurosciences & behavior

Author, co-author :

Wang, Fuyan; International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China, Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China

Di, Haibo; International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China, Coma Science Group, GIGA-Research, University and University Hospital of Liège, Liège, Belgium

Hu, Xiaohua; International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China, Department of Rehabilitation, Hangzhou Wujing Hospital, Hangzhou, China

Jing, S.; Department of Rehabilitation, Hangzhou Wujing Hospital, Hangzhou, China

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

Di Perri, Carol ; Université de Liège - ULiège > GIGA : Coma Group

Huang, Wangshan; International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China

Nie, Yunzhi; International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China

Schnakers, Caroline; Coma Science Group, GIGA-Research, University and University Hospital of Liège, Liège, Belgium, Department of Neurosurgery, University of California, Los Angeles, CA, United States

Laureys, Steven ; Université de Liège - ULiège > GIGA : Coma Group

Language :

English

Title :

Cerebral response to subject's own name showed high prognostic value in traumatic vegetative state

Publication date :

2015

Journal title :

BMC Medicine

eISSN :

1741-7015

Publisher :

BioMed Central Ltd.

Volume :

Issue :

Peer reviewed :

Peer Reviewed verified by ORBi

Funders :

NSCF - National Natural Science Foundation of China [CN]

Available on ORBi :

since 29 April 2020

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