Functional Brain Network Topology Discriminates between Patients with Minimally Conscious State and Unresponsive Wakefulness Syndrome

Abstract

Consciousness arises from the functional interaction of multiple brain structures and their ability to integrate different complex patterns of internal communication. Although several studies demonstrated that the fronto-parietal and functional default mode networks play a key role in conscious processes, it is still not clear which topological network measures (that quantifies different features of whole-brain functional network organization) are altered in patients with disorders of consciousness. Herein, we investigate the functional connectivity of unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS) patients from a topological network perspective, by using resting-state EEG recording. Network-based statistical analysis reveals a subnetwork of decreased functional connectivity in UWS compared to in the MCS patients, mainly involving the interhemispheric fronto-parietal connectivity patterns. Network topological analysis reveals increased values of local-community-paradigm correlation, as well as higher clustering coefficient and local efficiency in UWS patients compared to in MCS patients. At the nodal level, the UWS patients showed altered functional topology in several limbic and temporo-parieto-occipital regions. Taken together, our results highlight (i) the involvement of the interhemispheric fronto-parietal functional connectivity in the pathophysiology of consciousness disorders and (ii) an aberrant connectome organization both at the network topology level and at the nodal level in UWS patients compared to in the MCS patients.

Electrophysiological and Neuroimaging Studies – During Resting State and Sensory Stimulation in Disorders of Consciousness: A Review

“…In the literature, most of the studies related to the assessment of consciousness can be divided into two broad categories, namely, (a) sensory stimulation-based and (b) resting-state based analysis methods. As opposed to the sensory stimulation-based methods, resting-state analysis ( Martinez et al, 2015 ; Schorr et al, 2016 ; Naro et al, 2018 ; Stefan et al, 2018 ; van den Brink et al, 2018 ; Cacciola et al, 2019 ; Wang et al, 2019 ) does not require the subjects to perform any specific task and it can provide valuable information about the spontaneous neural activity relevant to the fundamental brain state ( Lv et al, 2018 ). On the other hand, sensory stimulation-based methods ( Kotchoubey et al, 2005 ; Boly et al, 2007 ; Cruse et al, 2011 ; Schorr et al, 2015 ; Guger et al, 2017 ; Luauté et al, 2018 ; Schneider et al, 2018 ; Xiao et al, 2018 ; Agoiz Badia et al, 2019 ; Cacciola et al, 2019 ; Formisano et al, 2019 ; Huang et al, 2019 ; Xu et al, 2019 ) employ various modalities of sensory stimuli such as auditory, visual, olfactory, tactile and mental-imagery ( Figure 1 ) and look for the expected cerebral response corresponding to the stimuli.…”

Vocal cord surgery and pharmacological treatment of a patient with HPV and recurrent respiratory papillomatosis

“…Treatment must be aimed at combating viral infection rather than its epiphenomenon . For these reasons, adjuvant therapy with cidofovir is essential, and a non-aggressive surgical technique is useful to prevent the formation of synechias, granulomas and permanent alterations of the voice 28–33…”

Virtual Reality Based Cognitive Rehabilitation in Minimally Conscious State: A Case Report with EEG Findings and Systematic Literature Review

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