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Cerebral response to subject’s own name showed high prognostic value in traumatic vegetative state
BACKGROUND: Previous studies have shown the prognostic value of stimulation elicited blood-oxygen-level-dependent (BOLD) signal in traumatic patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS). However, to the best of our knowledge, no studies have focused on the relevance of eti...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406334/ https://www.ncbi.nlm.nih.gov/pubmed/25880206 http://dx.doi.org/10.1186/s12916-015-0330-7 |
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author | Wang, Fuyan Di, Haibo Hu, Xiaohua Jing, Shan Thibaut, Aurore Di Perri, Carol Huang, Wangshan Nie, Yunzhi Schnakers, Caroline Laureys, Steven |
author_facet | Wang, Fuyan Di, Haibo Hu, Xiaohua Jing, Shan Thibaut, Aurore Di Perri, Carol Huang, Wangshan Nie, Yunzhi Schnakers, Caroline Laureys, Steven |
author_sort | Wang, Fuyan |
collection | PubMed |
description | BACKGROUND: Previous studies have shown the prognostic value of stimulation elicited blood-oxygen-level-dependent (BOLD) signal in traumatic patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS). However, to the best of our knowledge, no studies have focused on the relevance of etiology and level of consciousness in patients with disorders of consciousness (DOC) when explaining the relationship between BOLD signal and both outcome and signal variability. We herein propose a study in a large sample of traumatic and non-traumatic DOC patients in order to ascertain the relevance of etiology and level of consciousness in the variability and prognostic value of a stimulation-elicited BOLD signal. METHODS: 66 patients were included, and the response of each subject to his/her own name said by a familiar voice (SON-FV) was recorded using fMRI; 13 patients were scanned twice in the same day, respecting the exact same conditions in both cases. A behavioral follow-up program was carried out at 3, 6, and 12 months after scanning. RESULTS: Of the 39 VS/UWS patients, 12 (75%) out of 16 patients with higher level activation patterns recovered to minimally conscious state (MCS) or emergence from MCS (EMCS) and 17 (74%) out of 23 patients with lower level activation patterns or no activation had a negative outcome. Taking etiology into account for VS/UWS patients, a higher positive predictive value was assigned to traumatic patients, i.e., up to 92% (12/13) patients with higher level activation pattern achieved good recovery whereas 11 out of 13 (85%) non-traumatic patients with lower level activation or without activation had a negative clinical outcome. The reported data from visual analysis of fMRI activation patterns were corroborated using ROC curve analysis, which supported the correlation between auditory cortex activation volume and VS/UWS patients’ recovery. The average brain activity overlap in primary and secondary auditory cortices in patients scanned twice was 52%. CONCLUSIONS: The activation type and volume in auditory cortex elicited by SON-FV significantly correlated with VS/UWS patients’ prognosis, particularly in patients with traumatic etiology, however, this could not be established in MCS patients. Repeated use of this simple fMRI task might help obtain more reliable prognostic information. |
format | Online Article Text |
id | pubmed-4406334 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-44063342015-04-23 Cerebral response to subject’s own name showed high prognostic value in traumatic vegetative state Wang, Fuyan Di, Haibo Hu, Xiaohua Jing, Shan Thibaut, Aurore Di Perri, Carol Huang, Wangshan Nie, Yunzhi Schnakers, Caroline Laureys, Steven BMC Med Research Article BACKGROUND: Previous studies have shown the prognostic value of stimulation elicited blood-oxygen-level-dependent (BOLD) signal in traumatic patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS). However, to the best of our knowledge, no studies have focused on the relevance of etiology and level of consciousness in patients with disorders of consciousness (DOC) when explaining the relationship between BOLD signal and both outcome and signal variability. We herein propose a study in a large sample of traumatic and non-traumatic DOC patients in order to ascertain the relevance of etiology and level of consciousness in the variability and prognostic value of a stimulation-elicited BOLD signal. METHODS: 66 patients were included, and the response of each subject to his/her own name said by a familiar voice (SON-FV) was recorded using fMRI; 13 patients were scanned twice in the same day, respecting the exact same conditions in both cases. A behavioral follow-up program was carried out at 3, 6, and 12 months after scanning. RESULTS: Of the 39 VS/UWS patients, 12 (75%) out of 16 patients with higher level activation patterns recovered to minimally conscious state (MCS) or emergence from MCS (EMCS) and 17 (74%) out of 23 patients with lower level activation patterns or no activation had a negative outcome. Taking etiology into account for VS/UWS patients, a higher positive predictive value was assigned to traumatic patients, i.e., up to 92% (12/13) patients with higher level activation pattern achieved good recovery whereas 11 out of 13 (85%) non-traumatic patients with lower level activation or without activation had a negative clinical outcome. The reported data from visual analysis of fMRI activation patterns were corroborated using ROC curve analysis, which supported the correlation between auditory cortex activation volume and VS/UWS patients’ recovery. The average brain activity overlap in primary and secondary auditory cortices in patients scanned twice was 52%. CONCLUSIONS: The activation type and volume in auditory cortex elicited by SON-FV significantly correlated with VS/UWS patients’ prognosis, particularly in patients with traumatic etiology, however, this could not be established in MCS patients. Repeated use of this simple fMRI task might help obtain more reliable prognostic information. BioMed Central 2015-04-15 /pmc/articles/PMC4406334/ /pubmed/25880206 http://dx.doi.org/10.1186/s12916-015-0330-7 Text en © Wang et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Wang, Fuyan Di, Haibo Hu, Xiaohua Jing, Shan Thibaut, Aurore Di Perri, Carol Huang, Wangshan Nie, Yunzhi Schnakers, Caroline Laureys, Steven Cerebral response to subject’s own name showed high prognostic value in traumatic vegetative state |
title | Cerebral response to subject’s own name showed high prognostic value in traumatic vegetative state |
title_full | Cerebral response to subject’s own name showed high prognostic value in traumatic vegetative state |
title_fullStr | Cerebral response to subject’s own name showed high prognostic value in traumatic vegetative state |
title_full_unstemmed | Cerebral response to subject’s own name showed high prognostic value in traumatic vegetative state |
title_short | Cerebral response to subject’s own name showed high prognostic value in traumatic vegetative state |
title_sort | cerebral response to subject’s own name showed high prognostic value in traumatic vegetative state |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406334/ https://www.ncbi.nlm.nih.gov/pubmed/25880206 http://dx.doi.org/10.1186/s12916-015-0330-7 |
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