[en] Background and aims: Unresponsive patients at the
bedside may present covert consciousness. This
retrospective cross-sectional study aimed to determine brain
regions needed to demonstrate behavioural signs of
consciousness.
Methods: We looked at the 18fluorodesoxyglucose Positron
Emission Tomography (FDG-PET-scan) of 96 patients with
disorders of consciousness (see table 1). All patients were
assessed 5 times with the Coma Recovery Scale-Revised.
The diagnosis of MCS* was based on the FDG-PET relative
preservation of global brain metabolism as assessed by 3
experts. We compared brain metabolism of patients in
MCS* to UWS and MCS and performed seed-based
connectivity analyses. MRI and EEG data were also
analysed. Prognosis was collected using the Glasgow
Outcome Scale Extended.
Results: Out of the 35 behavioural UWS, 22 presented a
partial preservation of brain metabolism (i.e., patients in
MCS*), specifically in the fronto-parietal networks (Fig 1
– left). Patients in MCS* had more hypometabolism in the
right posterior regions (Fig 1 – right). We found a higher
correlation between the right superior temporal gyrus (seed)
and motor cortices, somato-sensory associative areas,
prefrontal area, and the thalami in MCS compared to
MCS*(Fig 2), as well as a higher connectivity (EEG) in the
theta band in the left hemisphere. Finally, MCS* patients
had a 50% chance to recover signs of consciousness (MCS)
at follow-up, while no patient in UWS improved.
Conclusion: Many patients clinically unresponsive may
present covert consciousness. The integrity of the
connectivity between the superior temporal gyrus and
sensori-motor regions, prefrontal cortex and thalami is
crucial to clinically demonstrate signs of consciousness.
Research Center/Unit :
CHU de Liège-Centre du Cerveau² - ULiège
Disciplines :
Neurology
Author, co-author :
Thibaut, Aurore ; Université de Liège - ULiège > Consciousness-Coma Science Group
Panda, Rajanikant ; Université de Liège - ULiège > Consciousness-Coma Science Group
Gosseries, Olivia ; Université de Liège - ULiège > Consciousness-Coma Science Group
Martial, Charlotte ; Université de Liège - ULiège > Consciousness-Coma Science Group
Aubinet, Charlène ; Université de Liège - ULiège > Consciousness-Coma Science Group
Cassol, Helena ; Université de Liège - ULiège > Département d'aérospatiale et mécanique > Ingénierie des véhicules terrestres
Laureys, Steven ; Université de Liège - ULiège > Consciousness-Coma Science Group
Language :
English
Title :
Neural correlates of (non-)behavioural signs of consciousness – what can we learn from resting state neuroimaging?
Publication date :
May 2020
Event name :
Congress of the European Academy of Neurology
Event organizer :
European Academy of Neurology
Event date :
du 23 au 26 mai 2020
Audience :
International
Peer reviewed :
Peer reviewed
References of the abstract :
A. Thibaut, R. Panda, O. Gosseries, C. Martial, C. Aubinet, H. Cassol, G. Martens, M. Carrière, A. Wolff, A. Barra, LRD. Sanz, C. Chatelle, S. Laureys. Neural correlates of (non-)behavioural signs of consciousness – what can we learn from resting state neuroimaging? Abstracts of the 6th Congress of the European Academy of Neurology, Virtual 2020, ePresentation Sessions, EPR2187. European Journal of Neurology, 27:S1, 103-522. doi: 10.1111/ene.14307
Funders :
F.R.S.-FNRS - Fonds de la Recherche Scientifique [BE]