Feasibility of Non-Gaussian Diffusion Metrics in Chronic Disorders of Consciousness

Abstract

Diagnostic accuracy of different chronic disorders of consciousness (DOC) can be affected by the false negative errors in up to 40% cases. In the present study, we aimed to investigate the feasibility of a non-Gaussian diffusion approach in chronic DOC and to estimate a sensitivity of diffusion kurtosis imaging (DKI) metrics for the differentiation of vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious state (MCS) from a healthy brain state. We acquired diffusion MRI data from 18 patients in chronic DOC (11 VS/UWS, 7 MCS) and 14 healthy controls. A quantitative comparison of the diffusion metrics for grey (GM) and white (WM) matter between the controls and patient group showed a significant (p < 0.05) difference in supratentorial WM and GM for all evaluated diffusion metrics, as well as for brainstem, corpus callosum, and thalamus. An intra-subject VS/UWS and MCS group comparison showed only kurtosis metrics and fractional anisotropy differences using tract-based spatial statistics, owing mainly to macrostructural differences on most severely lesioned hemispheres. As a result, we demonstrated an ability of DKI metrics to localise and detect changes in both WM and GM and showed their capability in order to distinguish patients with a different level of consciousness.

Brainstem volume, diffusion, and metabolism are associated with chronic consciousness disorders after traumatic brain injury

“…Moreover, the brainstem‐hypothalamus, brainstem‐temporal lobe, and thalamus‐temporal lobe connectivity have also been reported to be involved in the recovery of impaired consciousness 1 . In another study, metrics for gray and white matter were revealed to be reduced in many regions including the brainstem in patients with DOC 22 . The possibility of differentiating between the VS and the MCS was demonstrated by evaluating the total score of the brainstem and/or thalamus degeneration from the DOC‐MRI‐based Distinguishing Scale criteria 2 .…”

“…1 In another study, metrics for gray and white matter were revealed to be reduced in many regions including the brainstem in patients with DOC. 22 The possibility of differentiating between the VS and the MCS was demonstrated by evaluating the total score of the brainstem and/or thalamus degeneration from the DOC-MRI-based Distinguishing Scale criteria. 2 The results of these studies suggest that the brainstem may function as one of the hubs in the brain that connect the network of consciousness.…”

Hypothesis of Cyclic Structures of Pre- and Consciousness as a Transition in Neuron-like Graphs to a Special Type of Symmetry

“…The brain's global properties are explored, for example, in [42]. It has become possible to record the activity of huge populations of neurons and individual cells [43]. Since new tomographs can record blood flows in the brain, it will be possible to determine the circulation of neuron messages indirectly using these methods.…”

Distinct spectral profiles of awake resting EEG in disorders of consciousness - the role of frequency and topography of oscillations

“…1 for details). This amount, although high (∼37%), presents no deviation from the common exclusion criteria in the area of research on patients with severe brain injuries (Cao et al 2019;Pistoia et al 2014;Kremneva et al 2019;Forgacs et al 2017). Finally, the analysis included a set of 86 measurements from 60 PDOC patients (N = 53, including 20 females, aged 36.88 ± 13.53, see Tab.…”