Brain function in the vegetative state

vegetative state; consciousness; functional neuroimaging; positron emission tomography; brain metabolism, cerebral blood flow; functional connectivity; brain plasticity

Abstract :

[en] Positron emission tomography (PET) techniques represent a useful tool to better understand the residual brain function in vegetative state patients. It has been shown that overall cerebral metabolic rates for glucose are massively reduced in this condition. However, the recovery of consciousness from vegetative state is not always associated with substantial changes in global metabolism. This finding led us to hypothesize that some vegetative patients are unconscious not just because of a global loss of neuronal function, but rather due to an altered activity in some critical brain regions and to the abolished functional connections between them. We used voxel-based Statistical Parametric Mapping (SPM) approaches to characterize the functional neuroanatomy of the vegetative state. The most dysfunctional brain regions were bilateral frontal and parieto-temporal associative cortices. Despite the metabolic impairment, external stimulation still induced a significant neuronal activation (i.e., change in blood flow) in vegetative patients as shown by both auditory click stimuli and noxious somatosensory stimuli. However this activation was limited to primary cortices and dissociated from higher-order associative cortices, thought to be necessary for conscious perception. Finally, we demonstrated that vegetative patients have impaired functional connections between distant cortical areas and between the thalami and the cortex and, more importantly, that recovery of consciousness is paralleled by a restoration of this cortico-thalamo-cortical interaction.

Disciplines :

Neurology

Author, co-author :

Laureys, Steven ; Université de Liège - ULiège > Centre de recherches du cyclotron

Antoine, S.

Boly, Mélanie ; Université de Liège - ULiège > Neurologie

Elincx, S.

Faymonville, Marie-Elisabeth ; Université de Liège - ULiège > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine)

Berré, Jacques

Sadzot, Bernard ; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques

Ferring, Martine

De Tiège, Xavier

van Bogaert, Patrick

More authors (15 more)

Language :

English

Title :

Brain function in the vegetative state

Publication date :

December 2002

Journal title :

Acta Neurologica Belgica

ISSN :

0300-9009

eISSN :

2240-2993

Publisher :

Acta Medica Belgica, Brussels, Belgium

Volume :

102

Issue :

Pages :

177-185

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 12 November 2008

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223 (45 by ULiège)

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14 (10 by ULiège)

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Scopus citations^®
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