Voxel-based statistical analysis of thalamic glucose metabolism in traumatic brain injury: Relationship with consciousness and cognition

Lull, Nuria; Noé, Enrique; Lull, Juan José; García-Panach, Javier; Chirivella, Javier; Ferri, J.; López-Aznar, D; Sopeña, Pablo; Robles, Montserrat

doi:10.3109/02699052.2010.494592

Cited by 44 publications

(24 citation statements)

References 48 publications

(71 reference statements)

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“…29 Two SPECT and 4 PET studies evaluated patients with TBI separately (table e-2). 32,36,41,43,47,48 In one study of comatose patients with TBI, a global reduction in activity was noted with minimal variation across ROIs compared with HCs. 47 This reduction was noted to be highly significant in the brainstem, striatum, and thalamus in another coma TBI study.…”

Section: Systematic Review Population Characteristicsmentioning

confidence: 99%

“…These studies showed widespread reductions in activity in parietal, occipital, frontal, insular and cingulate cortices, and in the thalamus (findings of each study are listed in detail in table e-3). 26,29,31,32,35,36,38,41,42 In several studies, when compared with subjects in the MCS, patients in VS had proportionally greater reductions in activity in the precuneus and in the posterior cingulate cortex (PCC). 26,35,39 This reduction in activity in the precuneus was coupled with increased activity in brainstem arousal centers in one study.…”

Section: Systematic Review Population Characteristicsmentioning

confidence: 99%

“…In 2 instances, the same patient samples were reported in more than one article. 17,32,34,36 In these cases, only data from one study were used for quantitative synthesis; however, because different analytical methods were used, results of all 4 articles are presented in the systematic review. Thus, a total of 34 studies reporting on 687 patients (431 males [62.7%], mean age 47.7 years) and 637 HCs were included.…”

Section: Systematic Review Population Characteristicsmentioning

confidence: 99%

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Resting brain activity in disorders of consciousness

et al. 2015

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Objective: To quantitatively synthesize results from neuroimaging studies that evaluated patterns of resting functional activity in patients with disorders of consciousness (DOC).Methods: We performed a systematic review and coordinate-based meta-analysis of studies published up to May 2014. Studies were included if they compared resting-state functional neuroimaging data acquired in patients with DOC (coma, minimally conscious state, emergence from minimally conscious state, or vegetative state) with a group of healthy controls. Coordinate-based meta-analysis was performed in studies that included voxel-based comparisons at the whole-brain level and if analysis was accomplished with data-driven approaches.Results: A total of 36 studies (687 patients, 637 healthy controls) were included in the systematic review. Reported DOC were vegetative state (43.2%), coma (23.4%), minimally conscious state (22.8%), and emergence from minimally conscious state (1.6%); the most common etiologies of DOC were traumatic brain injury (37.7%) and anoxic brain injury (36.9%). Functional neuroimaging was accomplished using fMRI (16 studies), PET (15 studies), SPECT (4 studies), and both PET and SPECT in one study. Meta-analysis in 13 studies (272 patients, 259 healthy controls) revealed consistently reduced activity in patients with DOC in bilateral medial dorsal nucleus of the thalamus, left cingulate, posterior cingulate, precuneus, and middle frontal and medial temporal gyri. Conclusions:In patients with DOC evaluated in the resting state, functional neuroimaging indicates markedly reduced activity within midline cortical and subcortical sites, anatomical structures that have been linked to the default-mode network. Studies are needed to determine the relation between activation (and coherence) within these structures and the emergence of conscious awareness. Neurology ® 2015;84:1272-1280 GLOSSARY ALE 5 activation likelihood estimate; ALFF 5 amplitude of low-frequency fluctuations; BOLD 5 blood oxygen level-dependent; CRS-R 5 Coma Recovery Scale-Revised; DMN 5 default mode network; DOC 5 disorders of consciousness; EMCS 5 emergence from minimally conscious state; FDG 5 fluorodeoxyglucose; HC 5 healthy control; ICA 5 independent component analysis; MCS 5 minimally conscious state; MNI 5 Montreal Neurological Institute; PCC 5 posterior cingulate cortex; ReHo 5 regional homogeneity; ROI 5 region of interest; TBI 5 traumatic brain injury; VS 5 vegetative state.Coma is a cardinal sign of brain injury resulting from trauma, stroke, cardiac arrest, infection, or metabolic causes. While coma is a transient state from which the majority of subjects awaken, a subset of patients develop a more prolonged impairment in consciousness, such as the vegetative state (VS) or minimally conscious state (MCS). Despite considerable research, states such as coma, VS, and MCS-collectively termed disorders of consciousness (DOC)-remain poorly understood regarding their neural basis, clinical recognition, and long-term outcome.1,2 Neurophysiologic...

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Section: Systematic Review Population Characteristicsmentioning

confidence: 99%

Section: Systematic Review Population Characteristicsmentioning

confidence: 99%

Section: Systematic Review Population Characteristicsmentioning

confidence: 99%

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Resting brain activity in disorders of consciousness

et al. 2015

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“…The role of the thalamus in DOC has also been explored. Thalamic metabolism has been shown to be depressed in a way correlating with the level of consciousness, as detected with behavioural examinations [3,15,16]. Interestingly, restoration of thalamocortical connectivity has been associated with recovery of a patient in chronic VS/UWS [17].…”

Section: Introductionmentioning

confidence: 99%

Structural brain injury in patients with disorders of consciousness: A voxel-based morphometry study

et al. 2016

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Main objective: Disorders of consciousness (DOC; encompassing coma, vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious state minus/plus (MCS-/+)) are associated with structural brain injury. The extent of this damage remains poorly understood and merits a detailed examination using novel analysis techniques. Research design/methods and procedures: This study used voxel-based morphometry (VBM) on structural magnetic resonance imaging scans of 61 patients with DOC to examine grey and white matter injury associated with DOC, time spent in DOC, aetiology and diagnosis. Main outcomes and results: DOC and time spent in DOC were found to be associated with widespread structural brain injury, although the latter did not correlate strongly with injury in the right cerebral hemisphere. Traumatic, as compared to non-traumatic aetiology, was related to more injury in the brainstem, midbrain, thalamus, hypothalamus, basal forebrain, cerebellum, and posterior corpus callosum. Potential structural differences were found between VS/ UWS and MCS and between MCS-and MCS+, but need further examination. Conclusions: The findings indicate that both traumatic and non-traumatic DOC are associated with widespread structural brain injury, although differences exist that could lead to aetiologyspecific treatment strategies. Furthermore, the high degree of atrophy occurring after initial brain injury prompts the development and use of neuroprotective techniques to potentially increase patients' chances of recovery. KeywordsVegetative state/unresponsive wakefulness syndrome, minimally conscious state, structural brain injury, voxel-based morphometry History

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“…18 F-fluorodeoxyglucose-positron emission tomography (FDG-PET) i maging studies have shown that the recovery of global m etabolic activity might not be required for regaining consciousness in DOCs patients. These studies have identified a fronto-parietal network encompassing midline (i.e., anterior cingulate/mesiofrontal and posterior cingulate/precuneus) and lateral (i.e., prefrontal and posterior parietal) associative cortices that is consistently hypometabolic in u nresponsive patients and regains metabolic activity when the patient recovers signs of awareness [6,46,47]. Moreover, data obtained in sleep (for a review e.g., see [48]) and general anaesthesia (for a review e.g., see [49]) also corroborates these findings.…”

Section: Measuring Consciousnessmentioning

confidence: 99%

Coma and related disorders

Charland‐Verville

Habbal

Laureys

et al. 2013

Swiss Arch Neurol Psychiatr

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SummaryDisorders of consciousness represent a major challenge in clinical practice. The last decade of neuroscience research brought new insights about brain function and neural correlates of these pathological states of consciousness. Although behavioural evaluation still remains the gold standard, conscious behaviours are too often missed, leading to unwanted grey zones between conscious and unconscious patients. In order to increase the chances of detecting the signs of consciousness, scientists now focus on the development and validation of neuroimaging and electrophysiological paradigms in noncommunicative patients. Recent insights in this field also raise new questions of medical ethics. Indeed, for conscious patients, legal questions will occur about treatment plans, rehabilitation and communication strategies while for the unconscious patients, end-of-life decisions will take place after the p atients' condition is stated as "permanent" or "irreversible". Coma and related disordersFor a long time, the primary seat of consciousness was believed to be localised only in the cerebral cortex [1]. It was only very recently that scientists were confronted with a great discovery. In 1949 neuroscientists found, through a nimal intracranial electrophysiological experiments, that the activation of the brain stem reticular formation was a ssociated with the level of arousal [2]. However, like other revolutionary discoveries, the idea was then abandoned some years later following many controversies. Fortunately, due to our recent advancements in consciousness research, these subcortical correlates of consciousness were brought back. In fact, we do not argue anymore that a preserved r eticular formation system is essential for normal vigilance, while the intralaminar nuclei of the thalami are implicated in higher order brain processes since the thalamus is the first centre for the integration and filtering of sensory inputs [3,4]. These subcortical structures are working closely together

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Voxel-based statistical analysis of thalamic glucose metabolism in traumatic brain injury: Relationship with consciousness and cognition

Cited by 44 publications

References 48 publications

Resting brain activity in disorders of consciousness

Resting brain activity in disorders of consciousness

Structural brain injury in patients with disorders of consciousness: A voxel-based morphometry study

Coma and related disorders

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