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Multimodal neuroimaging approach to variability of functional connectivity in disorders of consciousness: A PET/MRI pilot study
Frontiers in Neurology
  • Carlo Cavaliere, IRCCS Fondazione SDN
  • Sivayini Kandeepan
  • Marco Aiello, IRCCS Fondazione SDN
  • Demetrius Ribeiro De Paula, The University of Western Ontario
  • Rocco Marchitelli, IRCCS Fondazione SDN
  • Salvatore Fiorenza, Istituti Clinici Scientifici Maugeri Spa – SB
  • Mario Orsini, IRCCS Fondazione SDN
  • Luigi Trojano, Università degli Studi della Campania Luigi Vanvitelli
  • Orsola Masotta, Istituti Clinici Scientifici Maugeri Spa – SB
  • Keith St Lawrence, The University of Western Ontario
  • Vincenzo Loreto, Istituti Clinici Scientifici Maugeri Spa – SB
  • Blaine Alexander Chronik, The University of Western Ontario
  • Emanuele Nicolai, IRCCS Fondazione SDN
  • Andrea Soddu, The University of Western Ontario
  • Anna Estraneo, Istituti Clinici Scientifici Maugeri Spa – SB
Document Type
Article
Publication Date
10-18-2018
URL with Digital Object Identifier
10.3389/fneur.2018.00861
Abstract

Behavioral assessments could not suffice to provide accurate diagnostic information in individuals with disorders of consciousness (DoC). Multimodal neuroimaging markers have been developed to support clinical assessments of these patients. Here we present findings obtained by hybrid fludeoxyglucose (FDG-)PET/MR imaging in three severely brain-injured patients, one in an unresponsive wakefulness syndrome (UWS), one in a minimally conscious state (MCS), and one patient emerged from MCS (EMCS). Repeated behavioral assessment by means of Coma Recovery Scale-Revised and neurophysiological evaluation were performed in the two weeks before and after neuroimaging acquisition, to ascertain that clinical diagnosis was stable. The three patients underwent one imaging session, during which two resting-state fMRI (rs-fMRI) blocks were run with a temporal gap of about 30 min. rs-fMRI data were analyzed with a graph theory approach applied to nine independent networks. We also analyzed the benefits of concatenating the two acquisitions for each patient or to select for each network the graph strength map with a higher ratio of fitness. Finally, as for clinical assessment, we considered the best functional connectivity pattern for each network and correlated graph strength maps to FDG uptake. Functional connectivity analysis showed several differences between the two rs-fMRI acquisitions, affecting in a different way each network and with a different variability for the three patients, as assessed by ratio of fitness. Moreover, combined PET/fMRI analysis demonstrated a higher functional/metabolic correlation for patients in EMCS and MCS compared to UWS. In conclusion, we observed for the first time, through a test-retest approach, a variability in the appearance and temporal/spatial patterns of resting-state networks in severely brain-injured patients, proposing a new method to select the most informative connectivity pattern.

Citation Information
Carlo Cavaliere, Sivayini Kandeepan, Marco Aiello, Demetrius Ribeiro De Paula, et al.. "Multimodal neuroimaging approach to variability of functional connectivity in disorders of consciousness: A PET/MRI pilot study" Frontiers in Neurology Vol. 9 Iss. OCT (2018)
Available at: http://works.bepress.com/keith-stlawrence/33/