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  • Poster presentation
  • Open Access

fMRI default mode connectivity in vegetative state and locked-in syndrome patients

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Critical Care201014 (Suppl 1) :P352

https://doi.org/10.1186/cc8584

  • Published:

Keywords

  • Independent Component Analysis
  • Default Mode Network
  • Vegetative State
  • Rest State Connectivity
  • Rest State Data

Introduction

The aim of this study is to assess fMRI resting-state cerebral connectivity in vegetative state and locked-in syndrome patients by means of a user-independent method. Resting baseline (or default mode) activity is thought to be related to awareness of the internal world (that is, mind wandering, and so forth) and encompasses posterior cingulate/precuneal, anterior cingulate/mesiofrontal and posterior lateral parietal cortices.

Methods

We here present a novel clinical application for a user-independent default mode network analysis. Resting state data were acquired for seven vegetative state patients (age range 16 to 87 years), one locked-in syndrome patient (aged 24 years) and seven healthy subjects (25 to 65 years). Patients' diagnosis was based on Coma Recovery Scale assessment prior and following scanning. Data were pre-processed and analyzed using independent component analysis as implemented in Brain Voyager. Connectivity studies employed 13 target regions of interest defined on an average default mode map calculated from an independent dataset of 20 controls (21 to 60 years). Resting state connectivity was assessed by calculating the number of functional connections within the default mode map for each subject. Next, Student t tests compared patients with controls at the group level (P < 0.05).

Results

Compared with controls, vegetative patients showed a lower total number of edges (that is, connections; 24 ± 4, range 19 to 31 and 13 ± 3, range 8 to 15, P < 0.001) and less functional connections with the precuneus (6 ± 1 and 2 ± 2; P < 0.001). The default mode network shows a reduced connectivity in vegetative patients as compared with controls mainly between the precuneus and medial prefrontal cortex ventral. Finally, for the locked-in syndrome patient the connectivity graph counted 21 total number of effective connections and five effective connections with the precuneus, which was not significantly different from healthy controls.

Conclusions

The connectivity study showed no overlap between the number of effective connections or edges in vegetative state patients and in controls. Connectivity graph analysis identified anterior-posterior midline disconnections in the vegetative state, in line with previous studies emphasizing the critical role of the precuneus/PCC and mesiofrontal cortices in the emergence of conscious awareness.

Authors’ Affiliations

(1)
Coma Science Group,, Liege, Belgium
(2)
Neurology Department, CHU Sart Tilman Hospital, University of Liège, Belgium
(3)
Pubblica Clinica e Preventiva, Second University of Naples, Italy
(4)
Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
(5)
Department of Psychiatry, University of Wisconsin, Madison, WI, USA

Copyright

© BioMed Central Ltd. 2010

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