Reduction in inter-hemispheric connectivity in disorders of consciousness.
Reduction in inter-hemispheric connectivity in disorders of consciousness.
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DOI：
10.1371/journal.pone.0037238
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Malach R
中科院分区：
文献类型：
--
作者：
Ovadia-Caro S;Nir Y;Soddu A;Ramot M;Hesselmann G;Vanhaudenhuyse A;Dinstein I;Tshibanda JF;Boly M;Harel M;Laureys S;Malach R
脑损伤引起的意识障碍（DOC）的临床诊断带来了很大的挑战，因为患者通常行为反应迟钝。利用功能性磁共振成像（fMRI）检测静息状态下超慢（<0.1Hz）自发脑活动波动，为DOC的客观诊断提供了一种新的方法。先前的研究表明，“默认网络”内的功能连接性降低，这是已知在从事任务期间被停用的区域的子集，与意识障碍的程度相关。然而，目前尚不清楚是否连接的故障仅限于“默认网络”，以及在多大程度上可以观察到功能连接的变化，在单一的主题水平。在这里，我们分析了三个同伦感兴趣的区域，这可以可靠地确定基于不同的解剖标志，并作为“外部”（外部导向，任务积极）网络（前和后中央回，顶内沟）的一部分，休息状态半球间的连接。静息状态的fMRI数据采集一组11名健康受试者和8 DOC患者。在组水平上，我们的研究结果表明，与意识完整的受试者相比，意识受损的受试者半球间功能连接减少。个体连通性得分与意识程度显著相关。此外，单例统计表明，5/8例患者与健康样本存在显著偏差。重要的是，在连接指数与健康样本相当的三名患者中，有一名被诊断为闭锁。综上所述，我们的研究结果进一步突出了静息状态连接分析的临床潜力，并可能指导连接措施补充现有DOC诊断的方式。
Clinical diagnosis of disorders of consciousness (DOC) caused by brain injury poses great challenges since patients are often behaviorally unresponsive. A promising new approach towards objective DOC diagnosis may be offered by the analysis of ultra-slow (<0.1 Hz) spontaneous brain activity fluctuations measured with functional magnetic resonance imaging (fMRI) during the resting-state. Previous work has shown reduced functional connectivity within the “default network”, a subset of regions known to be deactivated during engaging tasks, which correlated with the degree of consciousness impairment. However, it remains unclear whether the breakdown of connectivity is restricted to the “default network”, and to what degree changes in functional connectivity can be observed at the single subject level. Here, we analyzed resting-state inter-hemispheric connectivity in three homotopic regions of interest, which could reliably be identified based on distinct anatomical landmarks, and were part of the “Extrinsic” (externally oriented, task positive) network (pre- and postcentral gyrus, and intraparietal sulcus). Resting-state fMRI data were acquired for a group of 11 healthy subjects and 8 DOC patients. At the group level, our results indicate decreased inter-hemispheric functional connectivity in subjects with impaired awareness as compared to subjects with intact awareness. Individual connectivity scores significantly correlated with the degree of consciousness. Furthermore, a single-case statistic indicated a significant deviation from the healthy sample in 5/8 patients. Importantly, of the three patients whose connectivity indices were comparable to the healthy sample, one was diagnosed as locked-in. Taken together, our results further highlight the clinical potential of resting-state connectivity analysis and might guide the way towards a connectivity measure complementing existing DOC diagnosis.
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DOI：
10.1073/pnas.0504136102
发表时间：
2005-07-05
影响因子：
11.1
作者：
Fox, MD;Snyder, AZ;Raichle, ME
通讯作者：
Raichle, ME
DOI：
10.1098/rstb.2005.1634
发表时间：
2005-05-29
影响因子：
6.3
作者：
Beckmann, CF;DeLuca, M;Smith, SM
通讯作者：
Smith, SM
影响因子：
6.6
作者：
Bluhm, Robyn L.;Miller, Jodi;Williamson, Peter
通讯作者：
Williamson, Peter
影响因子：
5.3
作者：
Dinstein, Ilan;Gardner, Justin L.;Heeger, David J.
通讯作者：
Heeger, David J.
DOI：
10.1073/pnas.0601417103
发表时间：
2006-09-12
影响因子：
11.1
作者：
Damoiseaux, J. S.;Rombouts, S. A. R. B.;Beckmann, C. F.
通讯作者：
Beckmann, C. F.