Abnormal characteristics in disorders of consciousness: A resting-state functional magnetic resonance imaging study.

Aims: To explore the functional brain imaging characteristics of patients with disorders of consciousness (DoC).

Methods: This prospective cohort study consecutively enrolled 27 patients in minimally conscious state (MCS), 23 in vegetative state (VS), and 25 age-matched healthy controls (HC). Resting-state functional magnetic resonance imaging (rs-fMRI) was employed to evaluate the amplitude of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), degree centrality (DC), and functional connectivity (FC). Sliding windows approach was conducted to construct dynamic FC (dFC) matrices. Moreover, receiver operating characteristic analysis and Pearson correlation were used to distinguish these altered characteristics in DoC.

Results: Both MCS and VS exhibited lower ALFF, ReHo, and DC values, along with reduced FC in multiple brain regions compared with HC. Furthermore, the values in certain regions of VS were lower than those in MCS. The primary differences in brain function between patients with varying levels of consciousness were evident in the cortico-striatopallidal-thalamo-cortical mesocircuit. Significant differences in the temporal properties of dFC (including frequency, mean dwell time, number of transitions, and transition probability) were also noted among the three groups. Moreover, these multimodal alterations demonstrated high classificatory accuracy (AUC > 0.8) and were correlated with the Coma Recovery Scale-Revised (CRS-R).

Conclusion: Patients with DoC displayed abnormal patterns in local and global dynamic and static brain functions. These alterations in rs-fMRI were closely related to the level of consciousness.