Resting state networks in patients with acute disorders of consciousness after severe traumatic brain injury

• Published in: Clinical neurology and neurosurgery Vol. 242; p. 108353
• Main Authors: Ordóñez-Rubiano, Edgar G., Castañeda-Duarte, Marcelo A., Baeza-Antón, Laura, Romo-Quebradas, Jorge A., Perilla-Estrada, Juan P., Perilla-Cepeda, Tito A., Enciso-Olivera, Cesar O., Rudas, Jorge, Marín-Muñoz, Jorge H., Pulido, Cristian, Gómez, Francisco, Martínez, Darwin, Zorro, Oscar, Garzón, Emilio, Patiño-Gómez, Javier G.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.07.2024; Elsevier Limited
• Subjects: Adult; Aged; Algorithms; Anesthesia; Blood levels; Brain Injuries, Traumatic - complications; Brain Injuries, Traumatic - diagnostic imaging; Brain Injuries, Traumatic - physiopathology; Cerebellum; Coma; Consciousness; Consciousness Disorders - diagnostic imaging; Consciousness Disorders - etiology; Consciousness Disorders - physiopathology; Contusions; Data analysis; Executive function; Female; Functional magnetic resonance imaging; Hematoma; Humans; Magnetic Resonance Imaging; Male; Medical imaging; Middle Aged; Nerve Net - diagnostic imaging; Nerve Net - physiopathology; Neuroimaging; Neurology; Neurosurgery; Patients; Persistent Vegetative State - diagnostic imaging; Persistent Vegetative State - etiology; Persistent Vegetative State - physiopathology; Physiology; Rest - physiology; Resting state; Resting state networks; Sleep and wakefulness; Time series; Trauma; Traumatic brain injury; Young Adult; Functional magnetic resonance imaging; Resting state; Traumatic brain injury; Consciousness; Resting state networks
• ISSN: 0303-8467; 1872-6968; 1872-6968
• DOI: 10.1016/j.clineuro.2024.108353

This study aims to describe resting state networks (RSN) in patients with disorders of consciousness (DOC)s after acute severe traumatic brain injury (TBI). Adult patients with TBI with a GCS score <8 who remained in a coma, minimally conscious state (MCS), or unresponsive wakefulness syndrome (UWS), between 2017 and 2020 were included. Blood-oxygen-level dependent imaging was performed to compare their RSN with 10 healthy volunteers. Of a total of 293 patients evaluated, only 13 patients were included according to inclusion criteria: 7 in coma (54%), 2 in MCS (15%), and 4 (31%) had an UWS. RSN analysis showed that the default mode network (DMN) was present and symmetric in 6 patients (46%), absent in 1 (8%), and asymmetric in 6 (46%). The executive control network (ECN) was present in all patients but was asymmetric in 3 (23%). The right ECN was absent in 2 patients (15%) and the left ECN in 1 (7%). The medial visual network was present in 11 (85%) patients. Finally, the cerebellar network was symmetric in 8 patients (62%), asymmetric in 1 (8%), and absent in 4 (30%). A substantial impairment in activation of RSN is demonstrated in patients with DOC after severe TBI in comparison with healthy subjects. Three patterns of activation were found: normal/complete activation, 2) asymmetric activation or partially absent, and 3) absent activation. •Impaired consciousness following severe traumatic brain injury is a major cause of disability.•No tests or scales can accurately predict disorders of consciousness (DOC) prognosis.•rsfMRI reveals resting state networks linked to DOC severity.•Key brain networks might predict DOC outcomes.