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Improving Diagnosis and Prognosis in Acute Severe Brain Injury: A Multimodal Imaging Protocol

Multi-modal neuroimaging techniques have the potential to dramatically improve the diagnosis of the level consciousness and prognostication of neurological outcome for patients with severe brain injury in the intensive care unit (ICU). This protocol describes a study that will utilize functional Mag...

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Autores principales: Kazazian, Karnig, Norton, Loretta, Laforge, Geoffrey, Abdalmalak, Androu, Gofton, Teneille E., Debicki, Derek, Slessarev, Marat, Hollywood, Sarah, Lawrence, Keith St., Owen, Adrian M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8685572/
https://www.ncbi.nlm.nih.gov/pubmed/34938260
http://dx.doi.org/10.3389/fneur.2021.757219
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author Kazazian, Karnig
Norton, Loretta
Laforge, Geoffrey
Abdalmalak, Androu
Gofton, Teneille E.
Debicki, Derek
Slessarev, Marat
Hollywood, Sarah
Lawrence, Keith St.
Owen, Adrian M.
author_facet Kazazian, Karnig
Norton, Loretta
Laforge, Geoffrey
Abdalmalak, Androu
Gofton, Teneille E.
Debicki, Derek
Slessarev, Marat
Hollywood, Sarah
Lawrence, Keith St.
Owen, Adrian M.
author_sort Kazazian, Karnig
collection PubMed
description Multi-modal neuroimaging techniques have the potential to dramatically improve the diagnosis of the level consciousness and prognostication of neurological outcome for patients with severe brain injury in the intensive care unit (ICU). This protocol describes a study that will utilize functional Magnetic Resonance Imaging (fMRI), electroencephalography (EEG), and functional Near Infrared Spectroscopy (fNIRS) to measure and map the brain activity of acute critically ill patients. Our goal is to investigate whether these modalities can provide objective and quantifiable indicators of good neurological outcome and reliably detect conscious awareness. To this end, we will conduct a prospective longitudinal cohort study to validate the prognostic and diagnostic utility of neuroimaging techniques in the ICU. We will recruit 350 individuals from two ICUs over the course of 7 years. Participants will undergo fMRI, EEG, and fNIRS testing several times over the first 10 days of care to assess for residual cognitive function and evidence of covert awareness. Patients who regain behavioral awareness will be asked to complete web-based neurocognitive tests for 1 year, as well as return for follow up neuroimaging to determine which acute imaging features are most predictive of cognitive and functional recovery. Ultimately, multi-modal neuroimaging techniques may improve the clinical assessments of patients' level of consciousness, aid in the prediction of outcome, and facilitate efforts to find interventional methods that improve recovery and quality of life.
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spelling pubmed-86855722021-12-21 Improving Diagnosis and Prognosis in Acute Severe Brain Injury: A Multimodal Imaging Protocol Kazazian, Karnig Norton, Loretta Laforge, Geoffrey Abdalmalak, Androu Gofton, Teneille E. Debicki, Derek Slessarev, Marat Hollywood, Sarah Lawrence, Keith St. Owen, Adrian M. Front Neurol Neurology Multi-modal neuroimaging techniques have the potential to dramatically improve the diagnosis of the level consciousness and prognostication of neurological outcome for patients with severe brain injury in the intensive care unit (ICU). This protocol describes a study that will utilize functional Magnetic Resonance Imaging (fMRI), electroencephalography (EEG), and functional Near Infrared Spectroscopy (fNIRS) to measure and map the brain activity of acute critically ill patients. Our goal is to investigate whether these modalities can provide objective and quantifiable indicators of good neurological outcome and reliably detect conscious awareness. To this end, we will conduct a prospective longitudinal cohort study to validate the prognostic and diagnostic utility of neuroimaging techniques in the ICU. We will recruit 350 individuals from two ICUs over the course of 7 years. Participants will undergo fMRI, EEG, and fNIRS testing several times over the first 10 days of care to assess for residual cognitive function and evidence of covert awareness. Patients who regain behavioral awareness will be asked to complete web-based neurocognitive tests for 1 year, as well as return for follow up neuroimaging to determine which acute imaging features are most predictive of cognitive and functional recovery. Ultimately, multi-modal neuroimaging techniques may improve the clinical assessments of patients' level of consciousness, aid in the prediction of outcome, and facilitate efforts to find interventional methods that improve recovery and quality of life. Frontiers Media S.A. 2021-12-06 /pmc/articles/PMC8685572/ /pubmed/34938260 http://dx.doi.org/10.3389/fneur.2021.757219 Text en Copyright © 2021 Kazazian, Norton, Laforge, Abdalmalak, Gofton, Debicki, Slessarev, Hollywood, Lawrence and Owen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Kazazian, Karnig
Norton, Loretta
Laforge, Geoffrey
Abdalmalak, Androu
Gofton, Teneille E.
Debicki, Derek
Slessarev, Marat
Hollywood, Sarah
Lawrence, Keith St.
Owen, Adrian M.
Improving Diagnosis and Prognosis in Acute Severe Brain Injury: A Multimodal Imaging Protocol
title Improving Diagnosis and Prognosis in Acute Severe Brain Injury: A Multimodal Imaging Protocol
title_full Improving Diagnosis and Prognosis in Acute Severe Brain Injury: A Multimodal Imaging Protocol
title_fullStr Improving Diagnosis and Prognosis in Acute Severe Brain Injury: A Multimodal Imaging Protocol
title_full_unstemmed Improving Diagnosis and Prognosis in Acute Severe Brain Injury: A Multimodal Imaging Protocol
title_short Improving Diagnosis and Prognosis in Acute Severe Brain Injury: A Multimodal Imaging Protocol
title_sort improving diagnosis and prognosis in acute severe brain injury: a multimodal imaging protocol
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8685572/
https://www.ncbi.nlm.nih.gov/pubmed/34938260
http://dx.doi.org/10.3389/fneur.2021.757219
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