Default mode network overshadow executive control network in coma emergence and awakening prediction of patients with sTBI

Zheng, Ruizhe; Xu, Can-xin; Zhou, Lai-yang; Feng, Dong-fu

doi:10.1016/j.nicl.2023.103361

Cited by 4 publications

(1 citation statement)

References 28 publications

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“…Clinicians gradually realize that spontaneous brain activity in a resting state is distributed spatially and temporally in multiple brain regions of patients with sTBI (9,10). With the help of functional magnetic resonance imaging (fMRI), people can identify and describe the widespread disruption of brain network mechanisms, such as the changes in functional connectivity and abnormal brain activation in patients with sTBI (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Integrating fractional amplitude of low-frequency fluctuation and functional connectivity to investigate the mechanism and prognosis of severe traumatic brain injury

Li,

Guo

et al. 2023

Front. Neurol.

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ObjectiveFunctional magnetic resonance imaging (fMRI) has been used for evaluating residual brain function and predicting the prognosis of patients with severe traumatic brain injury (sTBI). This study aimed to integrate the fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity (FC) to investigate the mechanism and prognosis of patients with sTBI.MethodsSixty-five patients with sTBI were included and underwent fMRI scanning within 14 days after brain injury. The patient’s outcome was assessed using the Glasgow Outcome Scale—Extended (GOSE) at 6 months post-injury. Of the 63 patients who met fMRI data analysis standards, the prognosis of 18 patients was good (GOSE scores ≥ 5), and the prognosis of 45 patients was poor (GOSE scores ≤ 4). First, we apply fALFF to identify residual brain functional differences in patients who present different prognoses and conjoined it in regions of interest (ROI)-based FC analysis to investigate the residual brain function of sTBI at the acute phase of sTBI. Then, the area under the curve (AUC) was used to evaluate the predictive ability of the brain regions with the difference of fALFF and FC values.ResultsPatients who present good outcomes at 6 months post-injury have increased fALFF values in the Brodmann area (7, 18, 31, 13, 39 40, 42, 19, 23) and decreased FC values in the Brodmann area (28, 34, 35, 36, 20, 28, 34, 35, 36, 38, 1, 2, 3, 4, 6, 13, 40, 41, 43, 44, 20, 28 35, 36, 38) at the acute phase of sTBI. The parameters of these alterations can be used for predicting the long-term outcomes of patients with sTBI, of which the fALFF increase in the temporal lobe, occipital lobe, precuneus, and middle temporal gyrus showed the highest predictive ability (AUC = 0.883).ConclusionWe provide a compensatory mechanism that several regions of the brain can be spontaneously activated at the acute phase of sTBI in those who present with a good prognosis in the 6-month follow-up, that is, a destructive mode that increases its fALFF in the local regions and weakens its FC to the whole brain. These findings provide a theoretical basis for developing early intervention targets for sTBI patients.

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Section: Introductionmentioning

confidence: 99%

Integrating fractional amplitude of low-frequency fluctuation and functional connectivity to investigate the mechanism and prognosis of severe traumatic brain injury

Li,

Guo

et al. 2023

Front. Neurol.

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Neuroimaging biomarkers for the diagnosis and prognosis of patients with disorders of consciousness

Wang,

Lai,

Han

et al. 2024

Brain Research

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Clinical application of neuromodulation therapy in patients with disorder of consciousness: A pooled analysis of 544 participants

Zheng,

Qi,

Thibaut

et al. 2023

NRE

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BACKGROUND: The number of patients with disorders of consciousness (DoC) has increased dramatically with the advancement of intensive care and emergency medicine, which brings tremendous economic burdens and even ethical issues to families and society. OBJECTIVE: To evaluate the effectiveness of neuromodulation therapy for patients with DoC. METHODS: First, we conducted a literature review of individual patient data (IPD) on PubMed, EMBASE, and Cochrane-controlled trials following PRISMA guidelines. Then, we collected neuromodulation cases from our institution. Finally, we conducted a pooled analysis using the participants from the medical literature (n = 522) and our local institutions (n = 22). RESULTS: In this pooled analysis of 544 patients with DoC with a mean age of 46.33 years, our results revealed that patients have improved CRS-R scores [1.0 points (95% CI, 0.57–1.42)] after neuromodulation. Among them, patients have better effectiveness in traumatic than non-traumatic etiology (P < 0.05). The effectiveness of consciousness improvement could be affected by the age, baseline consciousness state, and duration of stimulation. Compared with non-invasive intervention, an invasive intervention can bring more behavioral improvement (P < 0.0001) to MCS rather than UWS/VS patients. Importantly, neuromodulation is a valuable therapy even years after the onset of DoC. CONCLUSION: This pooled analysis spotlights that the application of neuromodulation can improve the behavioral performance of patients with DoC. A preliminary trend is that age, etiology, baseline consciousness state, and stimulation duration could impact its effectiveness.

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Default mode network overshadow executive control network in coma emergence and awakening prediction of patients with sTBI

Cited by 4 publications

References 28 publications

Integrating fractional amplitude of low-frequency fluctuation and functional connectivity to investigate the mechanism and prognosis of severe traumatic brain injury

Integrating fractional amplitude of low-frequency fluctuation and functional connectivity to investigate the mechanism and prognosis of severe traumatic brain injury

Neuroimaging biomarkers for the diagnosis and prognosis of patients with disorders of consciousness

Clinical application of neuromodulation therapy in patients with disorder of consciousness: A pooled analysis of 544 participants

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