Default network connectivity reflects the level of consciousness in non-communicative brain-damaged patients
Default network connectivity reflects the level of consciousness in non-communicative brain-damaged patients
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DOI：
10.1093/brain/awp313
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发表时间：
2010-01-01
期刊：
影响因子：
14.5
通讯作者：
Boly, Melanie
中科院分区：
文献类型：
--
作者：
Vanhaudenhuyse, Audrey;Noirhomme, Quentin;Boly, Melanie
“默认网络”被定义为一组区域，包括后扣带/楔前叶、前扣带/中额叶皮层和颞顶叶连接，这些区域在休息时比在需要注意力的任务中表现出更多的活动。最近的研究表明，通过对健康志愿者的静息状态功能性磁共振成像连通性分析，可以在没有任何任务的情况下可靠地识别该网络。然而，这些自发的大脑活动波动的功能意义尚不清楚。本研究的目的是测试默认网络中静息状态连接模式的完整性是否会在不同的意识病理改变中有所不同。14名非交流性脑损伤患者和14名健康对照者参加了这项研究。使用概率独立组件分析和自动模板匹配组件选择方法来研究连接性。所有默认网络区域的连通性被发现与临床意识障碍的程度呈负相关，从健康对照组和闭锁综合征到最低意识，植物人然后昏迷的患者。此外，与无意识患者相比，最低意识患者的楔前叶连通性明显更强。闭锁综合征患者的默认网络连通性与对照组无显著差异。我们的研究结果表明，严重脑损伤患者的默认网络连通性下降，与他们的意识损伤程度成正比。为了评估所提出的方法的预后价值，未来需要在更大的患者群体中进行前瞻性研究。
The 'default network' is defined as a set of areas, encompassing posterior-cingulate/precuneus, anterior cingulate/mesiofrontal cortex and temporo-parietal junctions, that show more activity at rest than during attention-demanding tasks. Recent studies have shown that it is possible to reliably identify this network in the absence of any task, by resting state functional magnetic resonance imaging connectivity analyses in healthy volunteers. However, the functional significance of these spontaneous brain activity fluctuations remains unclear. The aim of this study was to test if the integrity of this resting-state connectivity pattern in the default network would differ in different pathological alterations of consciousness. Fourteen non-communicative brain-damaged patients and 14 healthy controls participated in the study. Connectivity was investigated using probabilistic independent component analysis, and an automated template-matching component selection approach. Connectivity in all default network areas was found to be negatively correlated with the degree of clinical consciousness impairment, ranging from healthy controls and locked-in syndrome to minimally conscious, vegetative then coma patients. Furthermore, precuneus connectivity was found to be significantly stronger in minimally conscious patients as compared with unconscious patients. Locked-in syndrome patient's default network connectivity was not significantly different from controls. Our results show that default network connectivity is decreased in severely brain-damaged patients, in proportion to their degree of consciousness impairment. Future prospective studies in a larger patient population are needed in order to evaluate the prognostic value of the presented methodology.