Measures of Metabolism and Complexity in the Brain of Patients with Disorders of Consciousness

Overview

Journal Neuroimage Clin

Publisher Elsevier

Specialties Neurology
Radiology

Date 2017 Feb 28

PMID 28239544

Citations 63

Authors

Olivier Bodart

Olivia Gosseries

Sarah Wannez

Aurore Thibaut

Jitka Annen

Melanie Boly

Mario Rosanova

Adenauer G Casali

Silvia Casarotto

Giulio Tononi

Marcello Massimini

Steven Laureys

Affiliations

Soon will be listed here.

Abstract

Background: Making an accurate diagnosis in patients with disorders of consciousness remains challenging. F-fluorodeoxyglucose (FDG)-PET has been validated as a diagnostic tool in this population, and allows identifying unresponsive patients with a capacity for consciousness. In parallel, the perturbational complexity index (PCI), a new measure based on the analysis of the electroencephalographic response to transcranial magnetic stimulation, has also been suggested as a tool to distinguish between unconscious and conscious states. The aim of the study was to cross-validate FDG-PET and PCI, and to identify signs of consciousness in otherwise unresponsive patients.

Methods: We jointly applied the Coma Recovery Scale-Revised, FDG-PET and PCI to assess 24 patients with non-acute disorders of consciousness or locked-in syndrome (13 male; 19-54 years old; 12 traumatic; 9 unresponsive wakefulness syndrome, 11 minimally conscious state; 2 emergence from the minimally conscious state, and 2 locked-in syndrome).

Results: FDG-PET and PCI provided congruent results in 22 patients, regardless of their behavioural diagnosis. Notably, FDG-PET and PCI revealed preserved metabolic rates and high complexity levels in four patients who were behaviourally unresponsive.

Conclusion: We propose that jointly measuring the metabolic activity and the electrophysiological complexity of cortical circuits is a useful complement to the diagnosis and stratification of patients with disorders of consciousness.

Citing Articles

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