論文

査読有り
2016年5月

Multimodal Study of Default-Mode Network Integrity in Disorders of Consciousness

ANNALS OF NEUROLOGY
  • Cristina Rosazza
  • ,
  • Adrian Andronache
  • ,
  • Davide Sattin
  • ,
  • Maria Grazia Bruzzone
  • ,
  • Giorgio Marotta
  • ,
  • Anna Nigri
  • ,
  • Stefania Ferraro
  • ,
  • Davide Rossi Sebastiano
  • ,
  • Luca Porcu
  • ,
  • Anna Bersano
  • ,
  • Riccardo Benti
  • ,
  • Matilde Leonardi
  • ,
  • Ludovico D'Incerti
  • ,
  • Ludovico Minati

79
5
開始ページ
841
終了ページ
853
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1002/ana.24634
出版者・発行元
WILEY-BLACKWELL

Objective: Understanding residual brain function in disorders of consciousness poses extraordinary challenges, and imaging examinations are needed to complement clinical assessment. The default-mode network (DMN) is known to be dysfunctional, although correlation with level of consciousness remains controversial. We investigated DMN activity with resting-state functional magnetic resonance imaging (rs-fMRI), alongside its structural and metabolic integrity, aiming to elucidate the corresponding associations with clinical assessment.
Methods: We enrolled 119 consecutive patients: 72 in a vegetative state/unresponsive wakefulness state (VS/UWS), 36 in a minimally conscious state (MCS), and 11 with severe disability. All underwent structural MRI and rs-fMRI, and a subset also underwent F-18-fluorodeoxyglucose positron emission tomography (FDG-PET). Data were analyzed with manual and automatic approaches, in relation to diagnosis and clinical score.
Results: Excluding the quartile with largest head movement, DMN activity was decreased in VS/UWS compared to MCS, and correlated with clinical score. Independent-component and seed-based analyses provided similar results, although the latter and their combination were most informative. Structural MRI and FDG-PET were less sensitive to head movement and had better diagnostic accuracy than rs-fMRI only when all cases were included. rs-fMRI indicated relatively preserved DMN activity in a small subset of VS/UWS patients, 2 of whom evolved to MCS. The integrity of the left hemisphere appears to be predictive of a better clinical status.
Interpretation: rs-fMRI of the DMN is sensitive to clinical severity. The effect is consistent across data analysis approaches, but heavily dependent on head movement. rs-fMRI could be informative in detecting residual DMN activity for those patients who remain relatively still during scanning and whose diagnosis is uncertain.

Web of Science ® 被引用回数 : 31

リンク情報
DOI
https://doi.org/10.1002/ana.24634
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000375752100013&DestApp=WOS_CPL
URL
http://www.scopus.com/inward/record.url?eid=2-s2.0-84962798435&partnerID=MN8TOARS
URL
http://orcid.org/0000-0002-2532-1674
ID情報
  • DOI : 10.1002/ana.24634
  • ISSN : 0364-5134
  • eISSN : 1531-8249
  • ORCIDのPut Code : 37534844
  • SCOPUS ID : 84962798435
  • Web of Science ID : WOS:000375752100013

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