Silvia Marino, Lilla Bonanno, Rosella Ciurleo, Annalisa Baglieri, Rosa Morabito, Silvia Guerrera, Carmela Rifici, Antonio Giorgio, Placido Bramanti, Nicola De Stefano
{"title":"植物人与最低意识状态下意识的功能评价。","authors":"Silvia Marino, Lilla Bonanno, Rosella Ciurleo, Annalisa Baglieri, Rosa Morabito, Silvia Guerrera, Carmela Rifici, Antonio Giorgio, Placido Bramanti, Nicola De Stefano","doi":"10.2174/1874440001711010017","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to assess differences in brain activation in a large sample of Vegetative State (VS) and Minimally Conscious State (MCS) patients, using functional magnetic resonance imaging (fMRI).</p><p><strong>Methods: </strong>We studied 50 patients four to seven months after brain injury. By using international clinical criteria and validated behavioural scales such as the Glasgow Coma Scale and the Clinical Unawareness Assessment Scale, the patients were grouped into <i>VS</i> (n=23) and MCS (n=27). All patients underwent to fMRI examination. After 6 months, the patients were reassessed using Glasgow Outcome Scale and Revised Coma Recovery Scale.</p><p><strong>Results: </strong>fMRI showed significant (p<0.01, cluster-corrected) brain activation in the primary auditory cortex bilaterally during the acoustic stimuli in patients with both VS and MCS. However, ten patients clinically classified as VS, showed a pattern of brain activation very similar to that of MCS patients. Six months later, these ten VS patients had significant clinical improvement, evolving into MCS, whereas the other VS patients and patients with MCS remained clinically stable.</p><p><strong>Conclusion: </strong>Brain activity could help in discerning whether the status of wakefulness in <i>VS</i> is also accompanied by partial awareness, as occurs in MCS. This may have very important prognostic implications.</p>","PeriodicalId":37431,"journal":{"name":"Open Neuroimaging Journal","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2017-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427708/pdf/","citationCount":"16","resultStr":"{\"title\":\"Functional Evaluation of Awareness in Vegetative and Minimally Conscious State.\",\"authors\":\"Silvia Marino, Lilla Bonanno, Rosella Ciurleo, Annalisa Baglieri, Rosa Morabito, Silvia Guerrera, Carmela Rifici, Antonio Giorgio, Placido Bramanti, Nicola De Stefano\",\"doi\":\"10.2174/1874440001711010017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The aim of this study was to assess differences in brain activation in a large sample of Vegetative State (VS) and Minimally Conscious State (MCS) patients, using functional magnetic resonance imaging (fMRI).</p><p><strong>Methods: </strong>We studied 50 patients four to seven months after brain injury. By using international clinical criteria and validated behavioural scales such as the Glasgow Coma Scale and the Clinical Unawareness Assessment Scale, the patients were grouped into <i>VS</i> (n=23) and MCS (n=27). All patients underwent to fMRI examination. After 6 months, the patients were reassessed using Glasgow Outcome Scale and Revised Coma Recovery Scale.</p><p><strong>Results: </strong>fMRI showed significant (p<0.01, cluster-corrected) brain activation in the primary auditory cortex bilaterally during the acoustic stimuli in patients with both VS and MCS. However, ten patients clinically classified as VS, showed a pattern of brain activation very similar to that of MCS patients. Six months later, these ten VS patients had significant clinical improvement, evolving into MCS, whereas the other VS patients and patients with MCS remained clinically stable.</p><p><strong>Conclusion: </strong>Brain activity could help in discerning whether the status of wakefulness in <i>VS</i> is also accompanied by partial awareness, as occurs in MCS. This may have very important prognostic implications.</p>\",\"PeriodicalId\":37431,\"journal\":{\"name\":\"Open Neuroimaging Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2017-04-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427708/pdf/\",\"citationCount\":\"16\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Neuroimaging Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2174/1874440001711010017\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2017/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Neuroimaging Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/1874440001711010017","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2017/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Functional Evaluation of Awareness in Vegetative and Minimally Conscious State.
Objective: The aim of this study was to assess differences in brain activation in a large sample of Vegetative State (VS) and Minimally Conscious State (MCS) patients, using functional magnetic resonance imaging (fMRI).
Methods: We studied 50 patients four to seven months after brain injury. By using international clinical criteria and validated behavioural scales such as the Glasgow Coma Scale and the Clinical Unawareness Assessment Scale, the patients were grouped into VS (n=23) and MCS (n=27). All patients underwent to fMRI examination. After 6 months, the patients were reassessed using Glasgow Outcome Scale and Revised Coma Recovery Scale.
Results: fMRI showed significant (p<0.01, cluster-corrected) brain activation in the primary auditory cortex bilaterally during the acoustic stimuli in patients with both VS and MCS. However, ten patients clinically classified as VS, showed a pattern of brain activation very similar to that of MCS patients. Six months later, these ten VS patients had significant clinical improvement, evolving into MCS, whereas the other VS patients and patients with MCS remained clinically stable.
Conclusion: Brain activity could help in discerning whether the status of wakefulness in VS is also accompanied by partial awareness, as occurs in MCS. This may have very important prognostic implications.
期刊介绍:
The Open Neuroimaging Journal is an Open Access online journal, which publishes research articles, reviews/mini-reviews, and letters in all important areas of brain function, structure and organization including neuroimaging, neuroradiology, analysis methods, functional MRI acquisition and physics, brain mapping, macroscopic level of brain organization, computational modeling and analysis, structure-function and brain-behavior relationships, anatomy and physiology, psychiatric diseases and disorders of the nervous system, use of imaging to the understanding of brain pathology and brain abnormalities, cognition and aging, social neuroscience, sensorimotor processing, communication and learning.