Coma; Disorders of consciousness; EEG; Minimally conscious state; Neuroimaging; Unresponsive wakefulness syndrome; Vegetative state; Whole brain models; Medicine (all); General Medicine
Abstract :
[en] Patients with disorders of consciousness (DoC) represent a group of severely brain-injured patients with varying capacities for consciousness in terms of both wakefulness and awareness. The current state-of-the-art for assessing these patients is through standardised behavioural examinations, but inaccuracies are commonplace. Neuroimaging and electrophysiological techniques have revealed vast insights into the relationships between neural alterations, andcognitive and behavioural features of consciousness in patients with DoC. This has led to the establishment of neuroimaging paradigms for the clinical assessment of DoC patients. Here, we review selected neuroimaging findings on the DoC population, outlining key findings of the dysfunction underlying DoC and presenting the current clinical utility of neuroimaging tools. We discuss that whilst individual brain areas play instrumental roles in generating and supporting consciousness, activation of these areas alone is not sufficient for conscious experience. Instead, for consciousness to arise, we need preserved thalamo-cortical circuits, in addition to sufficient connectivity between distinctly differentiated brain networks, underlined by connectivity both within, and between such brain networks. Finally, we present recent advances and future perspectives in computational methodologies applied to DoC, supporting the notion that progress in the science of DoC will be driven by a symbiosis of these data-driven analyses, and theory-driven research. Both perspectives will work in tandem to provide mechanistic insights contextualised within theoretical frameworks which ultimately inform the practice of clinical neurology.
Disciplines :
Neurosciences & behavior
Author, co-author :
Alnagger, Naji ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group
Cardone, Paolo ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group
Martial, Charlotte ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group
Laureys, Steven ; Centre Hospitalier Universitaire de Liège - CHU > > Centre du Cerveau²
Annen, Jitka ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group
Gosseries, Olivia ; Université de Liège - ULiège > GIGA > GIGA Consciousness - Coma Science Group
Language :
English
Title :
The current and future contribution of neuroimaging to the understanding of disorders of consciousness.
The study was supported by the University and University Hospital of Liege, the Belgian National Funds for Scientific Research (FRS-FNRS), the European Union's Horizon 2020 Framework Programme for Research and Innovation under the Specific Grant Agreement No. 945539 (Human Brain Project SGA3), the FNRS MIS project (F.4521.23), the FNRS PDR project (T.0134.21), the fund Generet, the King Baudouin Foundation, the Télévie Foundation, the European Space Agency (ESA) and the Belgian Federal Science Policy Office (BELSPO) in the framework of the PRODEX Programme, the Public Utility Foundation ‘Université Européenne du Travail’, “Fondazione Europea di Ricerca Biomedica”, the BIAL Foundation, AstraZeneca Foundation, the Mind Science Foundation, the European Commission, the Fondation Leon Fredericq, the Mind Care International foundation, the DOCMA project (EU-H2020-MSCA–RISE–778234), the National Natural Science Foundation of China (Joint Research Project 81471100) and the European Foundation of Biomedical Research FERB Onlus. We would also like to thank Rajanikant Panda and Sepehr Mortaheb for providing the EEG and MRI analyses. We like to extend our thanks to the MRI and PET dept of the University Hospital of Liege. We are also thankful to the patients and their families for agreeing to take part in the studies reviewed here.
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