1
|
G PK, Panda R, Sharma K, Adarsh A, Annen J, Martial C, Faymonville ME, Laureys S, Sombrun C, Ganesan RA, Vanhaudenhuyse A, Gosseries O. Changes in high-order interaction measures of synergy and redundancy during non-ordinary states of consciousness induced by meditation, hypnosis, and auto-induced cognitive trance. Neuroimage 2024:120623. [PMID: 38670442 DOI: 10.1016/j.neuroimage.2024.120623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/08/2024] [Accepted: 04/21/2024] [Indexed: 04/28/2024] Open
Abstract
High-order interactions are required across brain regions to accomplish specific cognitive functions. These functional interdependencies are reflected by synergistic information that can be obtained by combining the information from all the sources considered and redundant information (i.e., common information provided by all the sources). However, electroencephalogram (EEG) functional connectivity is limited to pairwise interactions thereby precluding the estimation of high-order interactions. In this multicentric study, we used measures of synergistic and redundant information to study in parallel the high-order interactions between five EEG electrodes during three non-ordinary states of consciousness (NSCs): Rajyoga meditation (RM), hypnosis, and auto-induced cognitive trance (AICT). We analyzed EEG data from 22 long-term Rajyoga meditators, nine volunteers undergoing hypnosis, and 21 practitioners of AICT. We here report the within-group changes in synergy and redundancy for each NSC in comparison with the respective baseline. Since RM was practiced with open eyes, the baseline was also recorded with eyes open. During RM, synergy increased at the whole brain level in the delta and theta bands. Redundancy decreased in frontal, right central, and posterior electrodes in delta, and frontal, central, and posterior electrodes in beta1 and beta2 bands. Since the subjects kept their eyes closed during hypnosis and AICT, their baselines were also recorded with closed eyes. During hypnosis, synergy decreased in mid-frontal, temporal, and mid-centro-parietal electrodes in the delta band. The decrease was also observed in the beta2 band in the left frontal and right parietal electrodes. During AICT, synergy decreased in delta and theta bands in left-frontal, right-frontocentral, and posterior electrodes. The decrease was also observed at the whole brain level in the alpha band. However, redundancy changes during hypnosis and AICT were not significant. The subjective reports of absorption and dissociation during hypnosis and AICT, as well as the mystical experience questionnaires during AICT, showed no correlation with the estimated high-order measures. The proposed study is the first exploratory attempt to utilize the concepts of synergy and redundancy in NSCs. The differences in synergy and redundancy during different NSCs warrant further studies to relate the extracted measures with the phenomenology of the NSCs.
Collapse
Affiliation(s)
- Pradeep Kumar G
- MILE Lab, Department of Electrical Engineering, Indian Institute of Science, Bengaluru, India
| | - Rajanikant Panda
- Coma Science Group, GIGA-Consciousness, University of Liege, Liege, Belgium; Sensation & Perception Research Group, GIGA-Consciousness, University of Liege, Liege, Belgium; Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Kanishka Sharma
- MILE Lab, Department of Electrical Engineering, Indian Institute of Science, Bengaluru, India
| | - A Adarsh
- MILE Lab, Department of Electrical Engineering, Indian Institute of Science, Bengaluru, India
| | - Jitka Annen
- Coma Science Group, GIGA-Consciousness, University of Liege, Liege, Belgium; Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University of Liege, Liege, Belgium; Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Marie-Elisabeth Faymonville
- Sensation & Perception Research Group, GIGA-Consciousness, University of Liege, Liege, Belgium; Arsene Bruny Integrated Oncological Center, University Hospital of Liege, Liege, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liege, Liege, Belgium; Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | | | - Ramakrishnan Angarai Ganesan
- MILE Lab, Department of Electrical Engineering, Indian Institute of Science, Bengaluru, India; Centre for Neuroscience, Indian Institute of Science, Bengaluru, India
| | - Audrey Vanhaudenhuyse
- Sensation & Perception Research Group, GIGA-Consciousness, University of Liege, Liege, Belgium; Algology Interdisciplinary Center, University Hospital of Liege, Liege, Belgium
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liege, Liege, Belgium; Sensation & Perception Research Group, GIGA-Consciousness, University of Liege, Liege, Belgium; Centre du Cerveau, University Hospital of Liege, Liege, Belgium.
| |
Collapse
|
2
|
Schiller D, Yu ANC, Alia-Klein N, Becker S, Cromwell HC, Dolcos F, Eslinger PJ, Frewen P, Kemp AH, Pace-Schott EF, Raber J, Silton RL, Stefanova E, Williams JHG, Abe N, Aghajani M, Albrecht F, Alexander R, Anders S, Aragón OR, Arias JA, Arzy S, Aue T, Baez S, Balconi M, Ballarini T, Bannister S, Banta MC, Barrett KC, Belzung C, Bensafi M, Booij L, Bookwala J, Boulanger-Bertolus J, Boutros SW, Bräscher AK, Bruno A, Busatto G, Bylsma LM, Caldwell-Harris C, Chan RCK, Cherbuin N, Chiarella J, Cipresso P, Critchley H, Croote DE, Demaree HA, Denson TF, Depue B, Derntl B, Dickson JM, Dolcos S, Drach-Zahavy A, Dubljević O, Eerola T, Ellingsen DM, Fairfield B, Ferdenzi C, Friedman BH, Fu CHY, Gatt JM, de Gelder B, Gendolla GHE, Gilam G, Goldblatt H, Gooding AEK, Gosseries O, Hamm AO, Hanson JL, Hendler T, Herbert C, Hofmann SG, Ibanez A, Joffily M, Jovanovic T, Kahrilas IJ, Kangas M, Katsumi Y, Kensinger E, Kirby LAJ, Koncz R, Koster EHW, Kozlowska K, Krach S, Kret ME, Krippl M, Kusi-Mensah K, Ladouceur CD, Laureys S, Lawrence A, Li CSR, Liddell BJ, Lidhar NK, Lowry CA, Magee K, Marin MF, Mariotti V, Martin LJ, Marusak HA, Mayer AV, Merner AR, Minnier J, Moll J, Morrison RG, Moore M, Mouly AM, Mueller SC, Mühlberger A, Murphy NA, Muscatello MRA, Musser ED, Newton TL, Noll-Hussong M, Norrholm SD, Northoff G, Nusslock R, Okon-Singer H, Olino TM, Ortner C, Owolabi M, Padulo C, Palermo R, Palumbo R, Palumbo S, Papadelis C, Pegna AJ, Pellegrini S, Peltonen K, Penninx BWJH, Pietrini P, Pinna G, Lobo RP, Polnaszek KL, Polyakova M, Rabinak C, Helene Richter S, Richter T, Riva G, Rizzo A, Robinson JL, Rosa P, Sachdev PS, Sato W, Schroeter ML, Schweizer S, Shiban Y, Siddharthan A, Siedlecka E, Smith RC, Soreq H, Spangler DP, Stern ER, Styliadis C, Sullivan GB, Swain JE, Urben S, Van den Stock J, Vander Kooij MA, van Overveld M, Van Rheenen TE, VanElzakker MB, Ventura-Bort C, Verona E, Volk T, Wang Y, Weingast LT, Weymar M, Williams C, Willis ML, Yamashita P, Zahn R, Zupan B, Lowe L. The Human Affectome. Neurosci Biobehav Rev 2024; 158:105450. [PMID: 37925091 PMCID: PMC11003721 DOI: 10.1016/j.neubiorev.2023.105450] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023]
Abstract
Over the last decades, theoretical perspectives in the interdisciplinary field of the affective sciences have proliferated rather than converged due to differing assumptions about what human affective phenomena are and how they work. These metaphysical and mechanistic assumptions, shaped by academic context and values, have dictated affective constructs and operationalizations. However, an assumption about the purpose of affective phenomena can guide us to a common set of metaphysical and mechanistic assumptions. In this capstone paper, we home in on a nested teleological principle for human affective phenomena in order to synthesize metaphysical and mechanistic assumptions. Under this framework, human affective phenomena can collectively be considered algorithms that either adjust based on the human comfort zone (affective concerns) or monitor those adaptive processes (affective features). This teleologically-grounded framework offers a principled agenda and launchpad for both organizing existing perspectives and generating new ones. Ultimately, we hope the Human Affectome brings us a step closer to not only an integrated understanding of human affective phenomena, but an integrated field for affective research.
Collapse
Affiliation(s)
- Daniela Schiller
- Department of Psychiatry, the Nash Family Department of Neuroscience, and the Friedman Brain Institute, at the Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Alessandra N C Yu
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
| | - Nelly Alia-Klein
- Department of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Susanne Becker
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, J5, 68159 Mannheim, Germany; Integrative Spinal Research Group, Department of Chiropractic Medicine, University Hospital Balgrist, University of Zurich, Balgrist Campus, Lengghalde 5, 8008 Zurich, Switzerland
| | - Howard C Cromwell
- J.P. Scott Center for Neuroscience, Mind and Behavior, Department of Psychology, Bowling Green State University, Bowling Green, OH 43403, United States
| | - Florin Dolcos
- Beckman Institute for Advanced Science & Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States; Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Paul J Eslinger
- Departments of Neurology, Neural & Behavioral Science, Radiology, and Public Health Sciences, Penn State Hershey Medical Center and College of Medicine, Hershey, PA, United States
| | - Paul Frewen
- Departments of Psychiatry, Psychology and Neuroscience at the University of Western Ontario, London, Ontario, Canada
| | - Andrew H Kemp
- School of Psychology, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, United Kingdom
| | - Edward F Pace-Schott
- Harvard Medical School and Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Jacob Raber
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239, United States; Departments of Neurology, Radiation Medicine, Psychiatry, and Division of Neuroscience, ONPRC, Oregon Health & Science University, Portland, OR, United States
| | - Rebecca L Silton
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Elka Stefanova
- Faculty of Medicine, University of Belgrade, Serbia; Neurology Clinic, Clinical Center of Serbia, Serbia
| | - Justin H G Williams
- Griffith University, Gold Coast Campus, 1 Parklands Dr, Southport, QLD 4215, Australia
| | - Nobuhito Abe
- Institute for the Future of Human Society, Kyoto University, 46 Shimoadachi-cho, Yoshida Sakyo-ku, Kyoto, Japan
| | - Moji Aghajani
- Institute of Education & Child Studies, Section Forensic Family & Youth Care, Leiden University, the Netherlands; Department of Psychiatry, Amsterdam UMC, Location VUMC, GGZ InGeest Research & Innovation, Amsterdam Neuroscience, the Netherlands
| | - Franziska Albrecht
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Women's Health and Allied Health Professionals Theme, Medical unit Occupational Therapy & Physiotherapy, Stockholm, Sweden
| | - Rebecca Alexander
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia; Australian National University, Canberra, ACT, Australia
| | - Silke Anders
- Department of Neurology, University of Lübeck, Lübeck, Germany; Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
| | - Oriana R Aragón
- Yale University, 2 Hillhouse Ave, New Haven, CT, United States; Cincinnati University, Marketing Department, 2906 Woodside Drive, Cincinnati, OH 45221-0145, United States
| | - Juan A Arias
- School of Psychology, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, United Kingdom; Department of Statistics, Mathematical Analysis, and Operational Research, Universidade de Santiago de Compostela, Spain; The Galician Center for Mathematical Research and Technology (CITMAga), 15782 Santiago de Compostela, Spain
| | - Shahar Arzy
- Department of Medical Neurobiology, Hebrew University, Jerusalem, Israel
| | - Tatjana Aue
- Institute of Psychology, University of Bern, Fabrikstr. 8, 3012 Bern, Switzerland
| | | | - Michela Balconi
- International Research Center for Cognitive Applied Neuroscience, Catholic University of Milan, Milan, Italy
| | - Tommaso Ballarini
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Scott Bannister
- Durham University, Palace Green, DH1 RL3 Durham, United Kingdom
| | | | - Karen Caplovitz Barrett
- Department of Human Development & Family Studies, Colorado State University, Fort Collins, CO, United States; Department of Community & Behavioral Health, Colorado School of Public Health, Denver, CO, United States
| | | | - Moustafa Bensafi
- Research Center in Neurosciences of Lyon, CNRS UMR5292, INSERM U1028, Claude Bernard University Lyon 1, Lyon, Centre Hospitalier Le Vinatier, 95 bd Pinel, 69675 Bron Cedex, France
| | - Linda Booij
- Department of Psychology, Concordia University, Montreal, Canada; CHU Sainte-Justine, University of Montreal, Montreal, Canada
| | - Jamila Bookwala
- Department of Psychology, Lafayette College, Easton, PA, United States
| | - Julie Boulanger-Bertolus
- Department of Anesthesiology and Center for Consciousness Science, University of Michigan, Ann Arbor, MI, United States
| | - Sydney Weber Boutros
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239, United States
| | - Anne-Kathrin Bräscher
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, University of Mainz, Wallstr. 3, 55122 Mainz, Germany; Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States
| | - Antonio Bruno
- Department of Biomedical, Dental Sciences and Morpho-Functional Imaging - University of Messina, Italy
| | - Geraldo Busatto
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Lauren M Bylsma
- Departments of Psychiatry and Psychology; and the Center for Neural Basis of Cognition, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
| | | | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health, and Wellbeing, Australian National University, Canberra, ACT, Australia
| | - Julian Chiarella
- Department of Psychology, Concordia University, Montreal, Canada; CHU Sainte-Justine, University of Montreal, Montreal, Canada
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab., Istituto Auxologico Italiano (IRCCS), Milan, Italy; Department of Psychology, University of Turin, Turin, Italy
| | - Hugo Critchley
- Psychiatry, Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Sussex, United Kingdom
| | - Denise E Croote
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai and Friedman Brain Institute, New York, NY 10029, United States; Hospital Universitário Gaffrée e Guinle, Universidade do Rio de Janeiro, Brazil
| | - Heath A Demaree
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Thomas F Denson
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Brendan Depue
- Departments of Psychological and Brain Sciences and Anatomical Sciences and Neurobiology, University of Louisville, Louisville, KY, United States
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health, University of Tübingen, Tübingen, Germany
| | - Joanne M Dickson
- Edith Cowan University, Psychology Discipline, School of Arts and Humanities, 270 Joondalup Dr, Joondalup, WA 6027, Australia
| | - Sanda Dolcos
- Beckman Institute for Advanced Science & Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States; Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Anat Drach-Zahavy
- The Faculty of Health and Welfare Sciences, University of Haifa, Haifa, Israel
| | - Olga Dubljević
- Neurology Clinic, Clinical Center of Serbia, Serbia; Institute for Biological Research "Siniša Stanković", National Institute of Republic of Serbia, Belgrade, Serbia
| | - Tuomas Eerola
- Durham University, Palace Green, DH1 RL3 Durham, United Kingdom
| | - Dan-Mikael Ellingsen
- Department of Diagnostic Physics, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Beth Fairfield
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy; UniCamillus, International Medical University, Rome, Italy
| | - Camille Ferdenzi
- Research Center in Neurosciences of Lyon, CNRS UMR5292, INSERM U1028, Claude Bernard University Lyon 1, Lyon, Centre Hospitalier Le Vinatier, 95 bd Pinel, 69675 Bron Cedex, France
| | - Bruce H Friedman
- Department of Psychology, Virginia Tech, Blacksburg, VA, United States
| | - Cynthia H Y Fu
- School of Psychology, University of East London, United Kingdom; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Justine M Gatt
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia; School of Psychology, University of New South Wales, Randwick, Sydney, NSW, Australia
| | - Beatrice de Gelder
- Department of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Guido H E Gendolla
- Geneva Motivation Lab, University of Geneva, FPSE, Section of Psychology, CH-1211 Geneva 4, Switzerland
| | - Gadi Gilam
- The Institute of Biomedical and Oral Research, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Systems Neuroscience and Pain Laboratory, Stanford University School of Medicine, CA, United States
| | - Hadass Goldblatt
- Department of Nursing, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel
| | | | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness & Centre du Cerveau2, University and University Hospital of Liege, Liege, Belgium
| | - Alfons O Hamm
- Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Jamie L Hanson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15206, United States
| | - Talma Hendler
- Tel Aviv Center for Brain Function, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; School of Psychological Sciences, Tel-Aviv University, Tel Aviv, Israel
| | - Cornelia Herbert
- Department of Applied Emotion and Motivation Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Stefan G Hofmann
- Department of Clinical Psychology, Philipps University Marburg, Germany
| | - Agustin Ibanez
- Universidad de San Andres, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), United States and Trinity Collegue Dublin (TCD), Ireland
| | - Mateus Joffily
- Groupe d'Analyse et de Théorie Economique (GATE), 93 Chemin des Mouilles, 69130 Écully, France
| | - Tanja Jovanovic
- Department of Psychiatry and Behavaioral Neurosciences, Wayne State University, Detroit, MI, United States
| | - Ian J Kahrilas
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Maria Kangas
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Yuta Katsumi
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Elizabeth Kensinger
- Department of Psychology and Neuroscience, Boston College, Boston, MA, United States
| | - Lauren A J Kirby
- Department of Psychology and Counseling, University of Texas at Tyler, Tyler, TX, United States
| | - Rebecca Koncz
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia; Specialty of Psychiatry, The University of Sydney, Concord, New South Wales, Australia
| | - Ernst H W Koster
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | | | - Sören Krach
- Social Neuroscience Lab, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
| | - Mariska E Kret
- Leiden University, Cognitive Psychology, Pieter de la Court, Waassenaarseweg 52, Leiden 2333 AK, the Netherlands
| | - Martin Krippl
- Faculty of Natural Sciences, Department of Psychology, Otto von Guericke University Magdeburg, Universitätsplatz 2, Magdeburg, Germany
| | - Kwabena Kusi-Mensah
- Department of Psychiatry, Komfo Anokye Teaching Hospital, P. O. Box 1934, Kumasi, Ghana; Department of Psychiatry, University of Cambridge, Darwin College, Silver Street, CB3 9EU Cambridge, United Kingdom; Behavioural Sciences Department, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Cecile D Ladouceur
- Departments of Psychiatry and Psychology and the Center for Neural Basis of Cognition (CNBC), University of Pittsburgh, Pittsburgh, PA, United States
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness & Centre du Cerveau2, University and University Hospital of Liege, Liege, Belgium
| | - Alistair Lawrence
- Scotland's Rural College, King's Buildings, Edinburgh, Scotland; The Roslin Institute, University of Edinburgh, Easter Bush, Scotland
| | - Chiang-Shan R Li
- Connecticut Mental Health Centre, Yale University, New Haven, CT, United States
| | - Belinda J Liddell
- School of Psychology, University of New South Wales, Randwick, Sydney, NSW, Australia
| | - Navdeep K Lidhar
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Christopher A Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Kelsey Magee
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Marie-France Marin
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada; Research Center, Institut universitaire en santé mentale de Montréal, Montreal, Canada
| | - Veronica Mariotti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Loren J Martin
- Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
| | - Hilary A Marusak
- Department of Psychiatry and Behavaioral Neurosciences, Wayne State University, Detroit, MI, United States; Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, Detroit, MI, United States
| | - Annalina V Mayer
- Social Neuroscience Lab, Translational Psychiatry Unit, University of Lübeck, Lübeck, Germany
| | - Amanda R Merner
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Jessica Minnier
- School of Public Health, Oregon Health & Science University, Portland, OR, United States
| | - Jorge Moll
- Cognitive Neuroscience and Neuroinformatics Unit, D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Robert G Morrison
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Matthew Moore
- Beckman Institute for Advanced Science & Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States; Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States; War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Anne-Marie Mouly
- Lyon Neuroscience Research Center, CNRS-UMR 5292, INSERM U1028, Universite Lyon, Lyon, France
| | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Andreas Mühlberger
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Regensburg, Regensburg, Germany
| | - Nora A Murphy
- Department of Psychology, Loyola Marymount University, Los Angeles, CA, United States
| | | | - Erica D Musser
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, United States
| | - Tamara L Newton
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, United States
| | - Michael Noll-Hussong
- Psychosomatic Medicine and Psychotherapy, TU Muenchen, Langerstrasse 3, D-81675 Muenchen, Germany
| | - Seth Davin Norrholm
- Department of Psychiatry and Behavaioral Neurosciences, Wayne State University, Detroit, MI, United States
| | - Georg Northoff
- Mind, Brain Imaging and Neuroethics Research Unit, University of Ottawa Institute of Mental Health Research, Royal Ottawa Mental Health Centre, Canada
| | - Robin Nusslock
- Department of Psychology and Institute for Policy Research, Northwestern University, 2029 Sheridan Road, Evanston, IL, United States
| | - Hadas Okon-Singer
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Thomas M Olino
- Department of Psychology, Temple University, 1701N. 13th St, Philadelphia, PA, United States
| | - Catherine Ortner
- Thompson Rivers University, Department of Psychology, 805 TRU Way, Kamloops, BC, Canada
| | - Mayowa Owolabi
- Department of Medicine and Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan; University College Hospital, Ibadan, Oyo State, Nigeria; Blossom Specialist Medical Center Ibadan, Oyo State, Nigeria
| | - Caterina Padulo
- Department of Psychological, Health and Territorial Sciences, University of Chieti, Chieti, Italy
| | - Romina Palermo
- School of Psychological Science, University of Western Australia, Perth, WA, Australia
| | - Rocco Palumbo
- Department of Psychological, Health and Territorial Sciences, University of Chieti, Chieti, Italy
| | - Sara Palumbo
- Department of Surgical, Medical and Molecular Pathology and of Critical Care, University of Pisa, Pisa, Italy
| | - Christos Papadelis
- Jane and John Justin Neuroscience Center, Cook Children's Health Care System, Fort Worth, TX, United States; Department of Bioengineering, University of Texas at Arlington, Arlington, TX, United States
| | - Alan J Pegna
- School of Psychology, University of Queensland, Saint Lucia, Queensland, Australia
| | - Silvia Pellegrini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Kirsi Peltonen
- Research Centre for Child Psychiatry, University of Turku, Turku, Finland; INVEST Research Flagship, University of Turku, Turku, Finland
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Location VUMC, GGZ InGeest Research & Innovation, Amsterdam Neuroscience, the Netherlands
| | | | - Graziano Pinna
- The Psychiatric Institute, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Rosario Pintos Lobo
- Center for Children and Families, Department of Psychology, Florida International University, Miami, FL, United States
| | - Kelly L Polnaszek
- Department of Psychology, Loyola University Chicago, Chicago, IL, United States
| | - Maryna Polyakova
- Neurology Department, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Christine Rabinak
- Department of Pharmacy Practice, Wayne State University, Detroit, MI, United States
| | - S Helene Richter
- Department of Behavioural Biology, University of Münster, Badestraße 13, Münster, Germany
| | - Thalia Richter
- School of Psychological Sciences, University of Haifa, Haifa, Israel
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab., Istituto Auxologico Italiano (IRCCS), Milan, Italy; Humane Technology Lab., Università Cattolica del Sacro Cuore, Milan, Italy
| | - Amelia Rizzo
- Department of Biomedical, Dental Sciences and Morpho-Functional Imaging - University of Messina, Italy
| | | | - Pedro Rosa
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, Australia
| | - Wataru Sato
- Psychological Process Research Team, Guardian Robot Project, RIKEN, 2-2-2 Hikaridai, Seika-cho, Soraku-gun, Kyoto, Japan
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Susanne Schweizer
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom; School of Psychology, University of New South Wales, Sydney, Australia
| | - Youssef Shiban
- Department of Psychology (Clinical Psychology and Psychotherapy), University of Regensburg, Regensburg, Germany; Department of Psychology (Clinical Psychology and Psychotherapy Research), PFH - Private University of Applied Sciences, Gottingen, Germany
| | - Advaith Siddharthan
- Knowledge Media Institute, The Open University, Milton Keynes MK7 6AA, United Kingdom
| | - Ewa Siedlecka
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Robert C Smith
- Departments of Medicine and Psychiatry, Michigan State University, East Lansing, MI, United States
| | - Hermona Soreq
- Department of Biological Chemistry, Edmond and Lily Safra Center of Brain Science and The Institute of Life Sciences, Hebrew University, Jerusalem, Israel
| | - Derek P Spangler
- Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, United States
| | - Emily R Stern
- Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, United States; New York University School of Medicine, New York, NY, United States
| | - Charis Styliadis
- Neuroscience of Cognition and Affection group, Lab of Medical Physics and Digital Innovation, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - James E Swain
- Departments of Psychiatry & Behavioral Health, Psychology, Obstetrics, Gynecology & Reproductive Medicine, and Program in Public Health, Renaissance School of Medicine at Stony Brook University, New York, United States
| | - Sébastien Urben
- Division of Child and Adolescent Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Jan Van den Stock
- Neuropsychiatry, Department of Neurosciences, Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Michael A Vander Kooij
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, Universitatsmedizin der Johannes Guttenberg University Medical Center, Mainz, Germany
| | | | - Tamsyn E Van Rheenen
- University of Melbourne, Melbourne Neuropsychiatry Centre, Department of Psychiatry, 161 Barry Street, Carlton, VIC, Australia
| | - Michael B VanElzakker
- Division of Neurotherapeutics, Massachusetts General Hospital, Boston, MA, United States
| | - Carlos Ventura-Bort
- Department of Biological Psychology and Affective Science, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany
| | - Edelyn Verona
- Department of Psychology, University of South Florida, Tampa, FL, United States
| | - Tyler Volk
- Professor Emeritus of Biology and Environmental Studies, New York University, New York, NY, United States
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Leah T Weingast
- Department of Social Work and Human Services and the Department of Psychological Sciences, Center for Young Adult Addiction and Recovery, Kennesaw State University, Kennesaw, GA, United States
| | - Mathias Weymar
- Department of Biological Psychology and Affective Science, Faculty of Human Sciences, University of Potsdam, Potsdam, Germany; Faculty of Health Sciences Brandenburg, University of Potsdam, Germany
| | - Claire Williams
- School of Psychology, Faculty of Medicine, Health & Life Science, Swansea University, Swansea, United Kingdom; Elysium Neurological Services, Elysium Healthcare, The Avalon Centre, United Kingdom
| | - Megan L Willis
- School of Behavioural and Health Sciences, Australian Catholic University, Sydney, NSW, Australia
| | - Paula Yamashita
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO, United States
| | - Roland Zahn
- Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Barbra Zupan
- Central Queensland University, School of Health, Medical and Applied Sciences, Bruce Highway, Rockhampton, QLD, Australia
| | - Leroy Lowe
- Neuroqualia (NGO), Truro, Nova Scotia, Canada.
| |
Collapse
|
3
|
Cecconi B, Montupil J, Mortaheb S, Panda R, Sanders RD, Phillips C, Alnagger N, Remacle E, Defresne A, Boly M, Bahri MA, Lamalle L, Laureys S, Gosseries O, Bonhomme V, Annen J. Study protocol: Cerebral characterization of sensory gating in disconnected dreaming states during propofol anesthesia using fMRI. Front Neurosci 2024; 18:1306344. [PMID: 38419667 PMCID: PMC10900985 DOI: 10.3389/fnins.2024.1306344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Background Disconnected consciousness describes a state in which subjective experience (i.e., consciousness) becomes isolated from the external world. It appears frequently during sleep or sedation, when subjective experiences remain vivid but are unaffected by external stimuli. Traditional methods of differentiating connected and disconnected consciousness, such as relying on behavioral responsiveness or on post-anesthesia reports, have demonstrated limited accuracy: unresponsiveness has been shown to not necessarily equate to unconsciousness and amnesic effects of anesthesia and sleep can impair explicit recollection of events occurred during sleep/sedation. Due to these methodological challenges, our understanding of the neural mechanisms underlying sensory disconnection remains limited. Methods To overcome these methodological challenges, we employ a distinctive strategy by combining a serial awakening paradigm with auditory stimulation during mild propofol sedation. While under sedation, participants are systematically exposed to auditory stimuli and questioned about their subjective experience (to assess consciousness) and their awareness of the sounds (to evaluate connectedness/disconnectedness from the environment). The data collected through interviews are used to categorize participants into connected and disconnected consciousness states. This method circumvents the requirement for responsiveness in assessing consciousness and mitigates amnesic effects of anesthesia as participants are questioned while still under sedation. Functional MRI data are concurrently collected to investigate cerebral activity patterns during connected and disconnected states, to elucidate sensory disconnection neural gating mechanisms. We examine whether this gating mechanism resides at the thalamic level or results from disruptions in information propagation to higher cortices. Furthermore, we explore the potential role of slow-wave activity (SWA) in inducing disconnected consciousness by quantifying high-frequency BOLD oscillations, a known correlate of slow-wave activity. Discussion This study represents a notable advancement in the investigation of sensory disconnection. The serial awakening paradigm effectively mitigates amnesic effects by collecting reports immediately after regaining responsiveness, while still under sedation. Ultimately, this research holds the potential to understand how sensory gating is achieved at the neural level. These biomarkers might be relevant for the development of sensitive anesthesia monitoring to avoid intraoperative connected consciousness and for the assessment of patients suffering from pathologically reduced consciousness. Clinical trial registration European Union Drug Regulating Authorities Clinical Trials Database (EudraCT), identifier 2020-003524-17.
Collapse
Affiliation(s)
- Benedetta Cecconi
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Javier Montupil
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, GIGA Institute, University of Liège, Liège, Belgium
- University Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Régional de la Citadelle (CHR Citadelle), Liège, Belgium
| | - Sepehr Mortaheb
- Physiology of Cognition Research Lab, GIGA-Consciousness, GIGA Institute, University of Liège, Liege, Belgium
| | - Rajanikant Panda
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Robert D. Sanders
- Central Clinical School, Sydney Medical School & NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
- Department of Anaesthetics & Institute of Academic Surgery, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Christophe Phillips
- GIGA-CRC—In vivo Imaging—Neuroimaging, Data Acquisition and Processing, GIGA Institute, University of Liège, Liège, Belgium
| | - Naji Alnagger
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Emma Remacle
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liège, Belgium
| | - Aline Defresne
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, GIGA Institute, University of Liège, Liège, Belgium
- University Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Régional de la Citadelle (CHR Citadelle), Liège, Belgium
- Department of Anesthesia and Intensive Care Medicine, Liège University Hospital, Liège, Belgium
| | - Melanie Boly
- Department of Psychiatry, Wisconsin Institute for Sleep and Consciousness, University of Wisconsin, Madison, WI, United States
| | - Mohamed Ali Bahri
- GIGA-CRC—In vivo Imaging—Aging & Memory, GIGA Institute, University of Liège, Liège, Belgium
| | - Laurent Lamalle
- GIGA-CRC—In vivo Imaging—Aging & Memory, GIGA Institute, University of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- Cervo Brain Research Centre, University Institute in Mental Health of Quebec, Québec, QC, Canada
- Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Vincent Bonhomme
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, GIGA Institute, University of Liège, Liège, Belgium
- Department of Anesthesia and Intensive Care Medicine, Liège University Hospital, Liège, Belgium
| | - Jitka Annen
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- Department of Data Analysis, University of Ghent, Ghent, Belgium
| |
Collapse
|
4
|
Yan Y, Li M, Cai T, Wang X, Dong Y, Hu X, Laureys S, Gosseries O, Grégoire C, Di H. Mood assessments of family caregivers of patients with severe brain injury in China. Qual Life Res 2024; 33:481-490. [PMID: 37971668 DOI: 10.1007/s11136-023-03539-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Long-term care of severe brain injury patients places a significant mental burden on family caregivers, yet few studies have reported the situation in China. We aimed to describe the mood states of family caregivers of patients with severe brain injury and examine the influencing factors that affect caregivers' moods. METHODS Cross-sectional survey was used to assess the mood profiles of Chinese family caregivers between February 2019 and February 2020. Demographic data of caregivers and patients, the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder scale (GAD-7) were used to assess the level of depressive and anxiety symptoms. The quality of life score was also assessed by a visual analog scale, and the Coma Recovery Scale-Revised was used to assess the patient's consciousness. RESULT One hundred and one patients with severe brain injury (57 unresponsive wakefulness syndrome, UWS) between the age of 14 and 70 and their main family caregivers were enrolled in the study. Most caregivers displayed depressive (n = 62) and anxiety symptoms (n = 65), with 17 and 20 of these family caregivers reporting (moderately) severe depressive symptom and severe anxiety symptom, respectively. The caregiver's depressive symptom level significantly decreased as the patient's injury lasted longer (r = - 0.208, P = 0.037). Moreover, the age of the patient negatively related to the levels of depressive (r = - 0.310, P = 0.002) and anxiety symptoms (r = - 0.289, P = 0.003) in caregivers. There was a significant positive correlation between anxiety and depressive symptoms scores in family caregivers (r = 0.838, P < 0.001). The higher the level of anxiety (r = - 0.273, P = 0.006) and depressive symptoms (r = - 0.265, P = 0.007), the worse the quality of life. CONCLUSION Many family caregivers of patients with severe brain injury experience various levels of anxiety and depressive symptoms in China. Tailor-made psychological help seems imperative. Researchers and doctors can provide information about patient's conditions to assist family members in discussing rehabilitation options for patients in different states of consciousness will help to ease anxiety of family caregivers.
Collapse
Affiliation(s)
- Yifan Yan
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Meiqi Li
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Tiantian Cai
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xueying Wang
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Yan Dong
- Department of Rehabilitation, Hospital of Zhejiang People's Armed Police, Hangzhou, China.
| | - Xiaohua Hu
- Department of Rehabilitation, Hospital of Zhejiang People's Armed Police, Hangzhou, China
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- Joint International Research Unit on Consciousness, CERVO Brain Research Centre, Laval University, Québec, Canada
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Charlotte Grégoire
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
| | - Haibo Di
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.
- School of Basic Medicine, Hangzhou Normal University, Hangzhou, China.
| |
Collapse
|
5
|
Staquet C, Vanhaudenhuyse A, Kandeepan S, Sanders RD, Ribeiro de Paula D, Brichant JF, Laureys S, Bonhomme V, Soddu A. Changes in Intrinsic Connectivity Networks Topology Across Levels of Dexmedetomidine-Induced Alteration of Consciousness. Anesth Analg 2024:00000539-990000000-00713. [PMID: 38289856 DOI: 10.1213/ane.0000000000006799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
BACKGROUND Human consciousness is generally thought to emerge from the activity of intrinsic connectivity networks (resting-state networks [RSNs]) of the brain, which have topological characteristics including, among others, graph strength and efficiency. So far, most functional brain imaging studies in anesthetized subjects have compared wakefulness and unresponsiveness, a state considered as corresponding to unconsciousness. Sedation and general anesthesia not only produce unconsciousness but also phenomenological states of preserved mental content and perception of the environment (connected consciousness), and preserved mental content but no perception of the environment (disconnected consciousness). Unresponsiveness may be seen during unconsciousness, but also during disconnectedness. Deep dexmedetomidine sedation is frequently a state of disconnected consciousness. In this study, we were interested in characterizing the RSN topology changes across 4 different and steady-state levels of dexmedetomidine-induced alteration of consciousness, namely baseline (Awake, drug-free state), Mild sedation (drowsy, still responding), Deep sedation (unresponsive), and Recovery, with a focus on changes occurring between a connected consciousness state and an unresponsiveness state. METHODS A functional magnetic resonance imaging database acquired in 14 healthy volunteers receiving dexmedetomidine sedation was analyzed using a method combining independent component analysis and graph theory, specifically looking at changes in connectivity strength and efficiency occurring during the 4 above-mentioned dexmedetomidine-induced altered consciousness states. RESULTS Dexmedetomidine sedation preserves RSN architecture. Unresponsiveness during dexmedetomidine sedation is mainly characterized by a between-networks graph strength alteration and within-network efficiency alteration of lower-order sensory RSNs, while graph strength and efficiency in higher-order RSNs are relatively preserved. CONCLUSIONS The differential dexmedetomidine-induced RSN topological changes evidenced in this study may be the signature of inadequate processing of sensory information by lower-order RSNs, and of altered communication between lower-order and higher-order networks, while the latter remain functional. If replicated in an experimental paradigm distinguishing, in unresponsive subjects, disconnected consciousness from unconsciousness, such changes would sustain the hypothesis that disconnected consciousness arises from altered information handling by lower-order sensory networks and altered communication between lower-order and higher-order networks, while the preservation of higher-order networks functioning allows for an internally generated mental content (or dream).
Collapse
Affiliation(s)
- Cecile Staquet
- From the Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, Liege University, Liege, Belgium
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
- GIGA-In Vivo Imaging (CRC) Platform, GIGA-Research, Liege University, Liege, Belgium
- Interdisciplinary Center of Algology, Liege University Hospital, Liege, Belgium
| | - Audrey Vanhaudenhuyse
- Interdisciplinary Center of Algology, Liege University Hospital, Liege, Belgium
- Sensation & Perception Research Group, GIGA-Consciousness, Liege University, Liege, Belgium
| | - Sivayini Kandeepan
- Department of Physics and Astronomy, Western Institute for Neuroscience, University of Western Ontario, London, Ontario, Canada
- Department of Physics, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Robert D Sanders
- University of Sydney, Sydney, New South Wales, Australia
- Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Institute of Academic Surgery, Sydney, New South Wales, Australia
| | - Demetrius Ribeiro de Paula
- Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Jean François Brichant
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, Liege University, Liege, Belgium; and
- Centre du Cerveau, Liege University Hospital, Liege, Belgium
| | - Vincent Bonhomme
- From the Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, Liege University, Liege, Belgium
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
- Institute of Academic Surgery, Sydney, New South Wales, Australia
- Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Andrea Soddu
- Department of Physics and Astronomy, Western Institute for Neuroscience, University of Western Ontario, London, Ontario, Canada
| |
Collapse
|
6
|
Li Y, Chen Y, Martial C, Shen M, Cassol H, Yu J, Zhou X, Ni C, Li M, Hu N, Gosseries O, Laureys S, Di H. Chinese translation and validation of the Near-Death Experience Content scale. Front Psychiatry 2024; 14:1201416. [PMID: 38268557 PMCID: PMC10806053 DOI: 10.3389/fpsyt.2023.1201416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction In recent years, a growing number of near-death experience (NDE) testimonies have been collected worldwide due to an increasing interest in research on this phenomenon. China has many patients who survive life-threatening situations, leaving over much data on NDEs to be collected for research. In the historical context of Eastern civilization, many mentally controlled practices in China can also lead to "NDEs-like" (e.g., meditation). This study aimed (1) to translate and validate the recently developed Near-Death Experience Content (NDE-C) scale into Chinese and (2) to quantify and identify NDEs and NDEs-like in China with this new Chinese version of the NDE-C scale. Methods Here, we presented the work that had been performed to translate the NDE-C scale into Chinese and validated this version on 79 NDE testimonies. Results Brislin's back-translation model was performed to translate a Chinese version of the NDE-C scale and internal consistency (the Cronbach's α value for the total group = 0.846) as well as the confirmatory factor analysis was conducted. Discussion Currently, the Chinese version of the NDE-C scale is ready for use in research practice in the context of Eastern culture, to screen people who have experienced an NDEs(-like) and to quantify their subjective experience, promoting further NDEs-related research in China.
Collapse
Affiliation(s)
- Yan Li
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Yan Chen
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Mingquan Shen
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Héléna Cassol
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
| | - Jing Yu
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Xingyue Zhou
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Chengcheng Ni
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Meiqi Li
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Nantu Hu
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- Joint International Research Unit on Consciousness, CERVO Brain Research Centre, Laval University, Québec, QC, Canada
| | - Haibo Di
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| |
Collapse
|
7
|
Farisco M, Formisano R, Gosseries O, Kato Y, Koboyashi S, Laureys S, Lejeune N, Martial C, Matar A, Morrisey AM, Schnakers C, Yakufujiang M, Yamaki T, Veeramuthu V, Zandalasini M, Zasler N, Magliacano A, Estraneo A. International survey on the implementation of the European and American guidelines on disorders of consciousness. J Neurol 2024; 271:395-407. [PMID: 37740739 PMCID: PMC10770208 DOI: 10.1007/s00415-023-11956-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/25/2023]
Abstract
Diagnostic, prognostic, and therapeutic procedures for patients with prolonged disorders of consciousness (pDoCs) vary significantly across countries and clinical settings, likely due to organizational factors (e.g., research vs. non-academic hospitals), expertise and availability of resources (e.g., financial and human). Two international guidelines, one from the European Academy of Neurology (EAN) and one from the American Academy of Neurology (AAN) in collaboration with the American Congress of Rehabilitation Medicine (ACRM) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), were developed to facilitate consistent practice among professionals working with this challenging patient population. While the recommendations of both guidelines agree in principle, it remains an open issue how to implement them into clinical practice in the care pathway for patients with pDoCs. We conducted an online survey to explore health professional clinical practices related to the management of patients with pDoCs, and compare said practices with selected recommendations from both the guidelines. The survey revealed that while some recommendations are being followed, others are not and/or may require more honing/specificity to enhance their clinical utility. Particular attention should be given to the implementation of a multimodal assessment of residual consciousness, to the detection and treatment of pain, and to the impact of restrictions imposed by COVID-19 pandemics on the involvement of patients' families/representatives.
Collapse
Affiliation(s)
- Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden.
- Biogem, Biology and Molecular Genetics Research Institute, Ariano Irpino, AV, Italy.
| | | | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Yoko Kato
- Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Shigeki Koboyashi
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihamaku, Chibashi, Chiba, 261-0012, Japan
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- CERVO Brain Research Center, University of Laval, Québec, QC, Canada
| | - Nicolas Lejeune
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- CHN William Lennox, Ottignies-Louvain-La Neuve, Belgium
- Institute of NeuroScienceUCLouvain, Ottignies-Louvain-La Neuve, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Amal Matar
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Ann-Marie Morrisey
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Caroline Schnakers
- Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, CA, USA
| | - Maidinamu Yakufujiang
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihamaku, Chibashi, Chiba, 261-0012, Japan
| | - Tomohiro Yamaki
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihamaku, Chibashi, Chiba, 261-0012, Japan
| | | | - Matteo Zandalasini
- Unità Spinale, Neuroriabilitazione E Medicina Riabilitativa Intensiva, Dipartimento Di Medicina Riabilitativa, Azienda USL Di Piacenza, Piacenza, Italy
| | - Nathan Zasler
- Concussion Care Centre of Virginia, LTD, Henrico, VA, 23233, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | - Alfonso Magliacano
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Florence and Sant'Angelo dei Lombardi, AV, Italy
| | - Anna Estraneo
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Florence and Sant'Angelo dei Lombardi, AV, Italy
| |
Collapse
|
8
|
Regnier A, Mélotte E, Aubinet C, Alnagger N, Fischer D, Lagier A, Thibaut A, Laureys S, Kaux JF, Gosseries O. Swallowing dysfunctions in patients with disorders of consciousness: Evidence from neuroimaging data, assessment, and management. NeuroRehabilitation 2024; 54:91-107. [PMID: 38217621 DOI: 10.3233/nre-230135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2024]
Abstract
Following severe brain injuries, a subset of patients may remain in an altered state of consciousness; most of these patients require artificial feeding. Currently, a functional oral phase and the presence of exclusive oral feeding may constitute signs of consciousness. Additionally, the presence of pharyngo-laryngeal secretions, saliva aspiration, cough reflex and tracheostomy are related to the level of consciousness. However, the link between swallowing and consciousness is yet to be fully understood. The primary aim of this review is to establish a comprehensive overview of the relationship between an individual's conscious behaviour and swallowing (reflexive and voluntary). Previous studies of brain activation during volitional and non-volitional swallowing tasks in healthy subjects are also reviewed. We demonstrate that the areas activated by voluntary swallowing tasks (primary sensorimotor, cingulate, insula, premotor, supplementary motor, cerebellum, and operculum) are not specific to deglutitive function but are shared with other motor tasks and brain networks involved in consciousness. This review also outlines suitable assessment and treatment methods for dysphagic patients with disorders of consciousness. Finally, we propose that markers of swallowing could contribute to the development of novel diagnostic guidelines for patients with disorders of consciousness.
Collapse
Affiliation(s)
- Amandine Regnier
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- Department of Physical and Rehabilitation Medicine, University Hospital of Liège, Liège, Belgium
| | - Evelyne Mélotte
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
| | - Charlène Aubinet
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
| | - Naji Alnagger
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - David Fischer
- Department of Neurology, Division of Neurocritical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Aude Lagier
- Department of Otorhinolaryngology, University Hospital of Liège, Liège, Belgium
| | - Aurore Thibaut
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- Joint International Research Unit on Consciousness, CERVO Brain Research Centre, CIUSS, Laval University, Québec, QC, Canada
| | - Jean-François Kaux
- Department of Physical and Rehabilitation Medicine, University Hospital of Liège, Liège, Belgium
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| |
Collapse
|
9
|
Farisco M, Formisano R, Gosseries O, Kato Y, Koboyashi S, Laureys S, Lejeune N, Martial C, Matar A, Morrisey AM, Schnakers C, Yakufujiang M, Yamaki T, Veeramuthu V, Zandalasini M, Zasler N, Magliacano A, Estraneo A. Correction to: International survey on the implementation of the European and American guidelines on disorders of consciousness. J Neurol 2024; 271:408-409. [PMID: 37991607 PMCID: PMC10769971 DOI: 10.1007/s00415-023-12083-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
Affiliation(s)
- Michele Farisco
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden.
- Biogem, Biology and Molecular Genetics Research Institute, Ariano Irpino, AV, Italy.
| | | | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Yoko Kato
- Department of Neurosurgery, Fujita Health University Bantane Hospital, Nagoya, Aichi, Japan
| | - Shigeki Koboyashi
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihamaku, Chibashi, Chiba, 261-0012, Japan
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- CERVO Brain Research Center, University of Laval, Québec, QC, Canada
| | - Nicolas Lejeune
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- CHN William Lennox, Ottignies-Louvain-La Neuve, Belgium
- Institute of NeuroScienceUCLouvain, Ottignies-Louvain-La Neuve, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Amal Matar
- Centre for Research Ethics and Bioethics, Uppsala University, Uppsala, Sweden
| | - Ann-Marie Morrisey
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Caroline Schnakers
- Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, CA, USA
| | - Maidinamu Yakufujiang
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihamaku, Chibashi, Chiba, 261-0012, Japan
| | - Tomohiro Yamaki
- Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba, National Agency for Automotive Safety and Victims' Aid, 3-30-1 Isobe, Mihamaku, Chibashi, Chiba, 261-0012, Japan
| | | | - Matteo Zandalasini
- Unità Spinale, Neuroriabilitazione E Medicina Riabilitativa Intensiva, Dipartimento Di Medicina Riabilitativa, Azienda USL Di Piacenza, Piacenza, Italy
| | - Nathan Zasler
- Concussion Care Centre of Virginia, LTD, Henrico, VA, 23233, USA
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, 23298, USA
| | | | - Anna Estraneo
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Florence, Italy
| |
Collapse
|
10
|
Edlow BL, Boerwinkle VL, Annen J, Boly M, Gosseries O, Laureys S, Mukherjee P, Puybasset L, Stevens RD, Threlkeld ZD, Newcombe VFJ, Fernandez-Espejo D. Common Data Elements for Disorders of Consciousness: Recommendations from the Working Group on Neuroimaging. Neurocrit Care 2023; 39:611-617. [PMID: 37552410 DOI: 10.1007/s12028-023-01794-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Over the past 5 decades, advances in neuroimaging have yielded insights into the pathophysiologic mechanisms that cause disorders of consciousness (DoC) in patients with severe brain injuries. Structural, functional, metabolic, and perfusion imaging studies have revealed specific neuroanatomic regions, such as the brainstem tegmentum, thalamus, posterior cingulate cortex, medial prefrontal cortex, and occipital cortex, where lesions correlate with the current or future state of consciousness. Advanced imaging modalities, such as diffusion tensor imaging, resting-state functional magnetic resonance imaging (fMRI), and task-based fMRI, have been used to improve the accuracy of diagnosis and long-term prognosis, culminating in the endorsement of fMRI for the clinical evaluation of patients with DoC in the 2018 US (task-based fMRI) and 2020 European (task-based and resting-state fMRI) guidelines. As diverse neuroimaging techniques are increasingly used for patients with DoC in research and clinical settings, the need for a standardized approach to reporting results is clear. The success of future multicenter collaborations and international trials fundamentally depends on the implementation of a shared nomenclature and infrastructure. METHODS To address this need, the Neurocritical Care Society's Curing Coma Campaign convened an international panel of DoC neuroimaging experts to propose common data elements (CDEs) for data collection and reporting in this field. RESULTS We report the recommendations of this CDE development panel and disseminate CDEs to be used in neuroimaging studies of patients with DoC. CONCLUSIONS These CDEs will support progress in the field of DoC neuroimaging and facilitate international collaboration.
Collapse
Affiliation(s)
- Brian L Edlow
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.
| | - Varina L Boerwinkle
- Clinical Resting-State Functional Magnetic Resonance Imaging Laboratory and Service, Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Jitka Annen
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre de Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Melanie Boly
- Department of Neurology, University of Wisconsin, Madison, WI, USA
- Department of Psychiatry, Wisconsin Institute for Sleep and Consciousness, University of Wisconsin, Madison, WI, USA
| | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre de Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre de Cerveau2, University Hospital of Liège, Liège, Belgium
- CERVO Research Institute, Laval University, Quebec, Canada
| | - Pratik Mukherjee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Louis Puybasset
- Department of Anesthesiology and Intensive Care, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Robert D Stevens
- Departments of Anesthesiology and Critical Care Medicine, Neurology, Radiology, and Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Zachary D Threlkeld
- Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Davinia Fernandez-Espejo
- School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| |
Collapse
|
11
|
Edlow BL, Boerwinkle VL, Annen J, Boly M, Gosseries O, Laureys S, Mukherjee P, Puybasset L, Stevens RD, Threlkeld ZD, Newcombe VFJ, Fernandez-Espejo D. Correction: Common Data Elements for Disorders of Consciousness: Recommendations from the Working Group on Neuroimaging. Neurocrit Care 2023; 39:753. [PMID: 37794309 DOI: 10.1007/s12028-023-01842-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Affiliation(s)
- Brian L Edlow
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA.
| | - Varina L Boerwinkle
- Clinical Resting-State Functional Magnetic Resonance Imaging Laboratory and Service, Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Jitka Annen
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre de Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Melanie Boly
- Department of Neurology, University of Wisconsin, Madison, WI, USA
- Department of Psychiatry, Wisconsin Institute for Sleep and Consciousness, University of Wisconsin, Madison, WI, USA
| | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre de Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre de Cerveau2, University Hospital of Liège, Liège, Belgium
- CERVO Research Institute, Laval University, Quebec, Canada
| | - Pratik Mukherjee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Louis Puybasset
- Department of Anesthesiology and Intensive Care, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Robert D Stevens
- Departments of Anesthesiology and Critical Care Medicine, Neurology, Radiology, and Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Zachary D Threlkeld
- Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Davinia Fernandez-Espejo
- School of Psychology and Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| |
Collapse
|
12
|
Laureys S, Schiettecatte E, Neumann O. Ethical dilemmas in disorders of consciousness: Good communication makes good medicine. Dev Med Child Neurol 2023; 65:1656-1657. [PMID: 37759377 DOI: 10.1111/dmcn.15753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/09/2023] [Indexed: 09/29/2023]
Affiliation(s)
- Steven Laureys
- Coma Science Group, GIGA Consciousness Research Unit, University of Liège, Liège, Belgium
- CERVO Brain Research Centre, Laval University, Québec City, Canada
| | | | - Olga Neumann
- Kliniken Schmieder Neurological Rehabilitation, Allensbach, Germany
| |
Collapse
|
13
|
Szymkowicz E, Neumann O, Sanz LRD, Gosseries O, Thibaut A, Cavaliere C, Laureys S, Liepert J. Recovery of Acute Leukoencephalopathy Documented by Neuroimaging: A Case Report. Neurol Clin Pract 2023; 13:e200203. [PMID: 37795500 PMCID: PMC10547467 DOI: 10.1212/cpj.0000000000200203] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/25/2023] [Indexed: 10/06/2023]
Abstract
Objectives We describe an atypical delayed neurologic recovery from coma and unresponsive wakefulness syndrome (i.e., persistent vegetative state) in a patient with severe drug-induced toxic leukoencephalopathy (presumably due to synthetic cannabinoid intake). Methods The patient underwent standardized behavioral and multimodal neuroimaging assessments to monitor clinical evolution and brain function over a 5-month period after presumed intoxication. Results A progressive clinical recovery was observed, from an initial state of coma to emergence from a minimally conscious state after 2 months. Despite the stability of extensive white matter lesions documented by CT and structural MRI, fluorodeoxyglucose PET showed partial recovery of cortical metabolism after 5 months. Discussion This case report illustrates that the temporal dynamics of recovery from toxic acute leukoencephalopathy may be atypical and delayed. Multimodal monitoring with repeated behavioral and functional neuroimaging assessments tends to improve the prognosis reliability, while early prognosis based on structural damage may result in misleading statements.
Collapse
Affiliation(s)
- Emilie Szymkowicz
- Coma Science Group (ES, LRS, OG, AT, SL), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (ES, LRDS, OG, AT, SL), University Hospital of Liège, Belgium; Kliniken Schmieder (ON, JL), Allensbach, Germany; and IRCCS SYNLAB SDN (CC), Naples, Italy
| | - Olga Neumann
- Coma Science Group (ES, LRS, OG, AT, SL), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (ES, LRDS, OG, AT, SL), University Hospital of Liège, Belgium; Kliniken Schmieder (ON, JL), Allensbach, Germany; and IRCCS SYNLAB SDN (CC), Naples, Italy
| | - Leandro R D Sanz
- Coma Science Group (ES, LRS, OG, AT, SL), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (ES, LRDS, OG, AT, SL), University Hospital of Liège, Belgium; Kliniken Schmieder (ON, JL), Allensbach, Germany; and IRCCS SYNLAB SDN (CC), Naples, Italy
| | - Olivia Gosseries
- Coma Science Group (ES, LRS, OG, AT, SL), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (ES, LRDS, OG, AT, SL), University Hospital of Liège, Belgium; Kliniken Schmieder (ON, JL), Allensbach, Germany; and IRCCS SYNLAB SDN (CC), Naples, Italy
| | - Aurore Thibaut
- Coma Science Group (ES, LRS, OG, AT, SL), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (ES, LRDS, OG, AT, SL), University Hospital of Liège, Belgium; Kliniken Schmieder (ON, JL), Allensbach, Germany; and IRCCS SYNLAB SDN (CC), Naples, Italy
| | - Carlo Cavaliere
- Coma Science Group (ES, LRS, OG, AT, SL), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (ES, LRDS, OG, AT, SL), University Hospital of Liège, Belgium; Kliniken Schmieder (ON, JL), Allensbach, Germany; and IRCCS SYNLAB SDN (CC), Naples, Italy
| | - Steven Laureys
- Coma Science Group (ES, LRS, OG, AT, SL), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (ES, LRDS, OG, AT, SL), University Hospital of Liège, Belgium; Kliniken Schmieder (ON, JL), Allensbach, Germany; and IRCCS SYNLAB SDN (CC), Naples, Italy
| | - Joachim Liepert
- Coma Science Group (ES, LRS, OG, AT, SL), GIGA-Consciousness, University of Liège; Centre du Cerveau2 (ES, LRDS, OG, AT, SL), University Hospital of Liège, Belgium; Kliniken Schmieder (ON, JL), Allensbach, Germany; and IRCCS SYNLAB SDN (CC), Naples, Italy
| |
Collapse
|
14
|
Van de Velde J, Levecque K, Weijters B, Laureys S. Doing what matters in times of stress: No-nonsense meditation and occupational well-being in COVID-19. PLoS One 2023; 18:e0292406. [PMID: 37910465 PMCID: PMC10619828 DOI: 10.1371/journal.pone.0292406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/19/2023] [Indexed: 11/03/2023] Open
Abstract
While the COVID-19 pandemic challenged the general public's health and well-being, it exacerbated the pre-existing well-being issues in the educational sector in many countries. Mindfulness-based interventions are often applied to protect and promote occupational well-being. To investigate how the well-being benefits of these interventions arise, we selected one accessible technique that is used in most of them: focused attention meditation. In the middle of the COVID-19 pandemic, 199 teachers voluntarily practiced five to ten minutes of meditation together with their pupils, every morning for six months. We employed a three-wave longitudinal design to follow any changes in the meditating teachers' well-being and compared these changes to a waitlist control condition of 42 teachers. Three dimensions of well-being were measured at baseline, half-time, and post-intervention: emotional, cognitive, and physical well-being. Latent growth curve models revealed that the meditation technique not only improves well-being but also prevents the development of well-being problems. The practice of focused attention meditation resulted in improvements in emotional and physical well-being and prevented the development of cognitive well-being problems that were observed within the control condition. The effects were strongest for emotional and cognitive well-being and followed a linear trend. This paper shows that the well-being effects of mindfulness-based interventions are at least in part due to the focused attention meditation that is practiced in them. Occupational groups that experience emotional, cognitive, or physical well-being issues can benefit from a few minutes of focused attention meditation per day.
Collapse
Affiliation(s)
| | - Katia Levecque
- Department of Work, Organization, and Society, Ghent University, Ghent, Belgium
| | - Bert Weijters
- Department of Work, Organization, and Society, Ghent University, Ghent, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness Research Unit, University and University Hospital of Liège, Liège, Belgium
- CERVO Brain Research Center, Laval University, Québec, Canada
- Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang, China
| |
Collapse
|
15
|
Maschke C, O'Byrne J, Colombo MA, Boly M, Gosseries O, Laureys S, Rosanova M, Jerbi K, Blain-Moraes S. Criticality of resting-state EEG predicts perturbational complexity and level of consciousness during anesthesia. bioRxiv 2023:2023.10.26.564247. [PMID: 37994368 PMCID: PMC10664178 DOI: 10.1101/2023.10.26.564247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
Consciousness has been proposed to be supported by electrophysiological patterns poised at criticality, a dynamical regime which exhibits adaptive computational properties, maximally complex patterns and divergent sensitivity to perturbation. Here, we investigated dynamical properties of the resting-state electroencephalogram of healthy subjects undergoing general anesthesia with propofol, xenon or ketamine. We then studied the relation of these dynamic properties with the perturbational complexity index (PCI), which has shown remarkably high sensitivity in detecting consciousness independent of behavior. All participants were unresponsive under anesthesia, while consciousness was retained only during ketamine anesthesia (in the form of vivid dreams)., enabling an experimental dissociation between unresponsiveness and unconsciousness. We estimated (i) avalanche criticality, (ii) chaoticity, and (iii) criticality-related measures, and found that states of unconsciousness were characterized by a distancing from both the edge of activity propagation and the edge of chaos. We were then able to predict individual subjects' PCI (i.e., PCImax) with a mean absolute error below 7%. Our results establish a firm link between the PCI and criticality and provide further evidence for the role of criticality in the emergence of consciousness.
Collapse
Affiliation(s)
- Charlotte Maschke
- Montreal General Hospital, McGill University Health Centre, Montreal, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, Canada
- Cognitive & Computational Neuroscience Lab, Psychology Department, University of Montreal, Québec, Canada
| | - Jordan O'Byrne
- Cognitive & Computational Neuroscience Lab, Psychology Department, University of Montreal, Québec, Canada
- MILA (Québec Artificial Intelligence Institute), Montréal, Québec, Canada
| | | | - Melanie Boly
- Department of Neurology and Department of Psychiatry, University of Wisconsin, Madison, USA
| | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du cerveau, CHU of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- CERVO Brain Research Centre, Laval University, Canada
- Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Karim Jerbi
- Cognitive & Computational Neuroscience Lab, Psychology Department, University of Montreal, Québec, Canada
- MILA (Québec Artificial Intelligence Institute), Montréal, Québec, Canada
- Centre UNIQUE (Union Neurosciences & Intelligence Artificielle), Montréal, Québec, Canada
| | - Stefanie Blain-Moraes
- Montreal General Hospital, McGill University Health Centre, Montreal, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada
| |
Collapse
|
16
|
Sebastián-Romagosa M, Cho W, Ortner R, Sieghartsleitner S, Von Oertzen TJ, Kamada K, Laureys S, Allison BZ, Guger C. Brain-computer interface treatment for gait rehabilitation in stroke patients. Front Neurosci 2023; 17:1256077. [PMID: 37920297 PMCID: PMC10618349 DOI: 10.3389/fnins.2023.1256077] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/28/2023] [Indexed: 11/04/2023] Open
Abstract
The use of Brain-Computer Interfaces (BCI) as rehabilitation tools for chronically ill neurological patients has become more widespread. BCIs combined with other techniques allow the user to restore neurological function by inducing neuroplasticity through real-time detection of motor-imagery (MI) as patients perform therapy tasks. Twenty-five stroke patients with gait disability were recruited for this study. Participants performed 25 sessions with the MI-BCI and assessment visits to track functional changes during the therapy. The results of this study demonstrated a clinically significant increase in walking speed of 0.19 m/s, 95%CI [0.13-0.25], p < 0.001. Patients also reduced spasticity and improved their range of motion and muscle contraction. The BCI treatment was effective in promoting long-lasting functional improvements in the gait speed of chronic stroke survivors. Patients have more movements in the lower limb; therefore, they can walk better and safer. This functional improvement can be explained by improved neuroplasticity in the central nervous system.
Collapse
Affiliation(s)
| | - Woosang Cho
- g.tec Medical Engineering GmbH, Schiedlberg, Austria
| | - Rupert Ortner
- g.tec Medical Engineering Spain SL, Barcelona, Catalonia, Spain
| | | | | | - Kyousuke Kamada
- Department for Neurosurgery, Asahikawa Medical University, Asahikawa, Japan
- Hokashin Group Megumino Hospital, Sapporo, Japan
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness Research Unit, University and University Hospital of Liège, Liège, Belgium
- CERVO Brain Research Center, Laval University, Québec, QC, Canada
- Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Brendan Z. Allison
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, United States
| | - Christoph Guger
- g.tec Medical Engineering Spain SL, Barcelona, Catalonia, Spain
- g.tec Medical Engineering GmbH, Schiedlberg, Austria
| |
Collapse
|
17
|
Cardone P, Bodart O, Kirsch M, Sanfilippo J, Virgillito A, Martial C, Simon J, Wannez S, Sanders RD, Laureys S, Massimini M, Vandewalle G, Bonhomme V, Gosseries O. Depth of sedation with dexmedetomidine increases transcranial magnetic stimulation-evoked potential amplitude non-linearly. Br J Anaesth 2023; 131:715-725. [PMID: 37596183 DOI: 10.1016/j.bja.2023.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 05/09/2023] [Accepted: 05/30/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Cortical excitability is higher in unconsciousness than in wakefulness, but it is unclear how this relates to anaesthesia. We investigated cortical excitability in response to dexmedetomidine, the effects of which are not fully known. METHODS We recorded transcranial magnetic stimulation (TMS) and EEG in frontal and parietal cortex of 20 healthy subjects undergoing dexmedetomidine sedation in four conditions (baseline, light sedation, deep sedation, recovery). We used the first component (0-30 ms) of the TMS-evoked potential (TEP) to measure cortical excitability (amplitude), slope, and positive and negative peak latencies (collectively, TEP indices). We used generalised linear mixed models to test the effect of condition, brain region, and responsiveness on TEP indices. RESULTS Compared with baseline, amplitude in the frontal cortex increased by 6.52 μV (P<0.001) in light sedation, 4.55 μV (P=0.003) in deep sedation, and 5.03 μV (P<0.001) in recovery. Amplitude did not change in the parietal cortex. Compared with baseline, slope increased in all conditions (P<0.02) in the frontal but not parietal cortex. The frontal cortex showed 5.73 μV higher amplitude (P<0.001), 0.63 μV ms-1 higher slope (P<0.001), and 2.2 ms shorter negative peak latency (P=0.001) than parietal areas. Interactions between dexmedetomidine and region had effects over amplitude (P=0.004) and slope (P=0.009), with both being higher in light sedation, deep sedation, and recovery compared with baseline. CONCLUSIONS Transcranial magnetic stimulation-evoked potential amplitude changes non-linearly as a function of depth of sedation by dexmedetomidine, with a region-specific paradoxical increase. Future research should investigate other anaesthetics to elucidate the link between cortical excitability and depth of sedation.
Collapse
Affiliation(s)
- Paolo Cardone
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau, University of Liège, Liège, Belgium
| | - Olivier Bodart
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau, University of Liège, Liège, Belgium; Department of Neurology, University of Liège, Liège, Belgium
| | - Murielle Kirsch
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, University of Liège, Liège, Belgium; Department of Anaesthesia and Intensive Care Medicine, University of Liège, Liège, Belgium
| | - Julien Sanfilippo
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, University of Liège, Liège, Belgium
| | | | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau, University of Liège, Liège, Belgium
| | - Jessica Simon
- Psychology and Neuroscience of Cognition, University of Liège, Liège, Belgium
| | - Sarah Wannez
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
| | - Robert D Sanders
- Specialty of Anaesthetics, University of Sydney, Camperdown, Australia; Department of Anaesthetics & Institute of Academic Surgery, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau, University of Liège, Liège, Belgium; Joint International Research Unit on Consciousness, CERVO Brain Research Centre, CIUSS, University Laval, Québec City, QC, Canada
| | - Marcello Massimini
- Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy; IRCCS Fondazione Don Gnocchi, Milan, Italy
| | - Gilles Vandewalle
- Sleep and Chronobiology Lab, GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Vincent Bonhomme
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, University of Liège, Liège, Belgium; Department of Anaesthesia and Intensive Care Medicine, University of Liège, Liège, Belgium; University Department of Anaesthesia and Intensive Care Medicine, Centre Hospitalier Régional de la Citadelle (CHR Citadelle), Liège, Belgium.
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau, University of Liège, Liège, Belgium.
| |
Collapse
|
18
|
Thibaut A, Fregni F, Estraneo A, Fiorenza S, Noe E, Llorens R, Ferri J, Formisano R, Morone G, Bender A, Rosenfelder M, Lamberti G, Kodratyeva E, Kondratyev S, Legostaeva L, Suponeva N, Krewer C, Müller F, Dardenne N, Jedidi H, Laureys S, Gosseries O, Lejeune N, Martens G. Sham-controlled randomized multicentre trial of transcranial direct current stimulation for prolonged disorders of consciousness. Eur J Neurol 2023; 30:3016-3031. [PMID: 37515394 DOI: 10.1111/ene.15974] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 06/01/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND AND PURPOSE Transcranial direct current stimulation (tDCS) has been shown to improve signs of consciousness in a subset of patients with disorders of consciousness (DoC). However, no multicentre study confirmed its efficacy when applied during rehabilitation. In this randomized controlled double-blind study, the effects of tDCS whilst patients were in rehabilitation were tested at the group level and according to their diagnosis and aetiology to better target DoC patients who might repond to tDCS. METHODS Patients received 2 mA tDCS or sham applied over the left prefrontal cortex for 4 weeks. Behavioural assessments were performed weekly and up to 3 months' follow-up. Analyses were conducted at the group and subgroup levels based on the diagnosis (minimally conscious state [MCS] and unresponsive wakefulness syndrome) and the aetiology (traumatic or non-traumatic). Interim analyses were planned to continue or stop the trial. RESULTS The trial was stopped for futility when 62 patients from 10 centres were enrolled (44 ± 14 years, 37 ± 24.5 weeks post-injury, 18 women, 32 MCS, 39 non-traumatic). Whilst, at the group level, no treatment effect was found, the subgroup analyses at 3 months' follow-up revealed a significant improvement for patients in MCS and with traumatic aetiology. CONCLUSIONS Transcranial direct current stimulation during rehabilitation does not seem to enhance patients' recovery. However, diagnosis and aetiology appear to be important factors leading to a response to the treatment. These findings bring novel insights into possible cortical plasticity changes in DoC patients given these differential results according to the subgroups of patients.
Collapse
Affiliation(s)
- Aurore Thibaut
- Coma Science Group, GIGA-Consciousness, Centre du Cerveau2, University and University Hospital of Liège, Liège, Belgium
| | - Felipe Fregni
- Neuromodulation Lab, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Anna Estraneo
- Neurorehabilitation Department, Scientific Institute for Research and Health Care, Don Carlo Gnocchi Foundation, Sant'Angelo dei Lombardi, Florence, Italy
| | - Salvatore Fiorenza
- Neurorehabilitation Department, Scientific Institute for Research and Health Care, Don Carlo Gnocchi Foundation, Sant'Angelo dei Lombardi, Florence, Italy
| | - Enrique Noe
- IRENEA Instituto de Rehabilitación Neurológica, Fundación Hospitales Vithas, Valéncia, Spain
| | - Roberto Llorens
- IRENEA Instituto de Rehabilitación Neurológica, Fundación Hospitales Vithas, Valéncia, Spain
- Neurorehabilitation and Brain Research Group, Instituto Universitario de Investigación en Tecnología Centrada en el Ser Humano, Universitat Politècnica de València, Valencia, Spain
| | - Joan Ferri
- IRENEA Instituto de Rehabilitación Neurológica, Fundación Hospitales Vithas, Valéncia, Spain
| | - Rita Formisano
- Santa Lucia Foundation, Neurorehabilitation and Scientific Institute for Research, Rome, Italy
| | - Giovanni Morone
- Santa Lucia Foundation, Neurorehabilitation and Scientific Institute for Research, Rome, Italy
| | - Andreas Bender
- Therapiezentrum Burgau, Burgau, Germany
- Department of Neurology, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Martin Rosenfelder
- Therapiezentrum Burgau, Burgau, Germany
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Gianfranco Lamberti
- Neurorehabilitation Department AUSL Piacenza - University of Parma, Piacenza, Italy
| | | | | | | | | | - Carmen Krewer
- Department for Neurology, Research Group, Schoen Clinic Bad Aibling, Bad Aibling, Germany
- Chair of Human Movement Science, Department of Sports and Health Sciences, Technical University of Munich, Munich, Germany
| | - Friedemann Müller
- Department for Neurology, Research Group, Schoen Clinic Bad Aibling, Bad Aibling, Germany
| | - Nadia Dardenne
- University and Hospital Biostatistics Center (B-STAT), Faculty of Medicine, University of Liège, Liège, Belgium
| | | | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, Centre du Cerveau2, University and University Hospital of Liège, Liège, Belgium
- Joint International Research Unit on Consciousness, CERVO Brain Research Centre, CIUSS, University Laval, Quebec, Canada
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, Centre du Cerveau2, University and University Hospital of Liège, Liège, Belgium
| | - Nicolas Lejeune
- Coma Science Group, GIGA-Consciousness, Centre du Cerveau2, University and University Hospital of Liège, Liège, Belgium
- Centre Hospitalier Neurologique William Lennox, Ottignies-Louvain-la-Neuve, Belgium
| | - Géraldine Martens
- Coma Science Group, GIGA-Consciousness, Centre du Cerveau2, University and University Hospital of Liège, Liège, Belgium
| |
Collapse
|
19
|
Assadzadeh S, Annen J, Sanz L, Barra A, Bonin E, Thibaut A, Boly M, Laureys S, Gosseries O, Robinson PA. Method for quantifying arousal and consciousness in healthy states and severe brain injury via EEG-based measures of corticothalamic physiology. J Neurosci Methods 2023; 398:109958. [PMID: 37661056 DOI: 10.1016/j.jneumeth.2023.109958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/09/2023] [Accepted: 08/27/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Characterization of normal arousal states has been achieved by fitting predictions of corticothalamic neural field theory (NFT) to electroencephalographic (EEG) spectra to yield relevant physiological parameters. NEW METHOD A prior fitting method is extended to distinguish conscious and unconscious states in healthy and brain injured subjects by identifying additional parameters and clusters in parameter space. RESULTS Fits of NFT predictions to EEG spectra are used to estimate neurophysiological parameters in healthy and brain injured subjects. Spectra are used from healthy subjects in wake and sleep and from patients with unresponsive wakefulness syndrome, in a minimally conscious state (MCS), and emerged from MCS. Subjects cluster into three groups in parameter space: conscious healthy (wake and REM), sleep, and brain injured. These are distinguished by the difference X-Y between corticocortical (X) and corticothalamic (Y) feedbacks, and by mean neural response rates α and β to incoming spikes. X-Y tracks consciousness in healthy individuals, with smaller values in wake/REM than sleep, but cannot distinguish between brain injuries. Parameters α and β differentiate deep sleep from wake/REM and brain injury. COMPARISON WITH EXISTING METHODS Other methods typically rely on laborious clinical assessment, manual EEG scoring, or evaluation of measures like Φ from integrated information theory, for which no efficient method exists. In contrast, the present method can be automated on a personal computer. CONCLUSION The method provides a means to quantify consciousness and arousal in healthy and brain injured subjects, but does not distinguish subtypes of brain injury.
Collapse
Affiliation(s)
- S Assadzadeh
- School of Physics, The University of Sydney, NSW 2006, Australia; Center for Integrative Brain Function, The University of Sydney, NSW 2006, Australia
| | - J Annen
- Coma Science Group, GIGA-Consciousness, University of Liège, Belgium; Centre du Cerveau, University Hospital of Liège, Belgium
| | - L Sanz
- Coma Science Group, GIGA-Consciousness, University of Liège, Belgium; Centre du Cerveau, University Hospital of Liège, Belgium
| | - A Barra
- Coma Science Group, GIGA-Consciousness, University of Liège, Belgium; Centre du Cerveau, University Hospital of Liège, Belgium
| | - E Bonin
- Coma Science Group, GIGA-Consciousness, University of Liège, Belgium; Centre du Cerveau, University Hospital of Liège, Belgium
| | - A Thibaut
- Coma Science Group, GIGA-Consciousness, University of Liège, Belgium; Centre du Cerveau, University Hospital of Liège, Belgium
| | - M Boly
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA; Department of Neurology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - S Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Belgium; Centre du Cerveau, University Hospital of Liège, Belgium; Joint International Research Unit on Consciousness, CERVO Brain Research Centre, U Laval, Canada; International Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - O Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Belgium; Centre du Cerveau, University Hospital of Liège, Belgium
| | - P A Robinson
- School of Physics, The University of Sydney, NSW 2006, Australia; Center for Integrative Brain Function, The University of Sydney, NSW 2006, Australia.
| |
Collapse
|
20
|
Wang A, Sun L, Cheng L, Hu N, Chen Y, Sanz LRD, Thibaut A, Gosseries O, Laureys S, Martial C, Di H. Validation of the simplified evaluation of consciousness disorders (SECONDs) scale in Mandarin. Ann Phys Rehabil Med 2023; 66:101764. [PMID: 37276835 DOI: 10.1016/j.rehab.2023.101764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 03/13/2023] [Accepted: 03/20/2023] [Indexed: 06/07/2023]
Affiliation(s)
- Anqi Wang
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang 310036, China
| | - Lingxiu Sun
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang 310036, China
| | - Lijuan Cheng
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang 310036, China
| | - Nantu Hu
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang 310036, China.
| | - Yan Chen
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang 310036, China
| | - Leandro R D Sanz
- Coma Science Group, GIGA-Consciousness, GIGA Research Center, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Aurore Thibaut
- Coma Science Group, GIGA-Consciousness, GIGA Research Center, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, GIGA Research Center, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang 310036, China; Coma Science Group, GIGA-Consciousness, GIGA Research Center, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium; CERVO Research Center, Laval University, Quebec, Canada
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, GIGA Research Center, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Haibo Di
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang 310036, China.
| |
Collapse
|
21
|
Oswald V, Vanhaudenhuyse A, Annen J, Martial C, Bicego A, Rousseaux F, Sombrun C, Harel Y, Faymonville ME, Laureys S, Jerbi K, Gosseries O. Autonomic nervous system modulation during self-induced non-ordinary states of consciousness. Sci Rep 2023; 13:15811. [PMID: 37737222 PMCID: PMC10516905 DOI: 10.1038/s41598-023-42393-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023] Open
Abstract
Self-induced cognitive trance (SICT) is a voluntary non-ordinary state of consciousness characterized by a lucid yet narrowed awareness of the external surroundings. It involves a hyper-focused immersive experience of flow, expanded inner imagery, modified somatosensory processing, and an altered perception of self and time. SICT is gaining attention due to its potential clinical applications. Similar states of non-ordinary state of consciousness, such as meditation, hypnosis, and psychedelic experiences, have been reported to induce changes in the autonomic nervous system. However, the functioning of the autonomic nervous system during SICT remains poorly understood. In this study, we aimed to investigate the impact of SICT on the cardiac and respiratory signals of 25 participants proficient in SICT. To accomplish this, we measured various metrics of heart rate variability (HRV) and respiration rate variability (RRV) in three conditions: resting state, SICT, and a mental imagery task. Subsequently, we employed a machine learning framework utilizing a linear discriminant analysis classifier and a cross-validation scheme to identify the features that exhibited the best discrimination between these three conditions. The results revealed that during SICT, participants experienced an increased heart rate and a decreased level of high-frequency (HF) HRV compared to the control conditions. Additionally, specific increases in respiratory amplitude, phase ratio, and RRV were observed during SICT in comparison to the other conditions. These findings suggest that SICT is associated with a reduction in parasympathetic activity, indicative of a hyperarousal state of the autonomic nervous system during SICT.
Collapse
Affiliation(s)
- Victor Oswald
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital 1, B34, 4000, Liège, Belgium.
- Cognitive and Computational Neuroscience Lab, Psychology Département, University of Montréal, Montreal, Canada.
| | - Audrey Vanhaudenhuyse
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital 1, B34, 4000, Liège, Belgium.
- Interdisciplinary Algology Center, CHU, University Hospital of Liège, B35, Liège, Belgium.
| | - Jitka Annen
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
| | - Aminata Bicego
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital 1, B34, 4000, Liège, Belgium
| | - Floriane Rousseaux
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital 1, B34, 4000, Liège, Belgium
| | | | - Yann Harel
- Cognitive and Computational Neuroscience Lab, Psychology Département, University of Montréal, Montreal, Canada
| | - Marie-Elisabeth Faymonville
- Interdisciplinary Algology Center, CHU, University Hospital of Liège, B35, Liège, Belgium
- Arsène Burny Center, Hospital of Liège University, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, Hospital of Liège University, Avenue de l'Hôpital 1, B34, 4000, Liège, Belgium
- CERVO Research Institute, Laval University, Quebec, Canada
| | - Karim Jerbi
- Cognitive and Computational Neuroscience Lab, Psychology Département, University of Montréal, Montreal, Canada
| | - Olivia Gosseries
- Sensation and Perception Research Group, GIGA Consciousness, University of Liège, Avenue de l'Hôpital 1, B34, 4000, Liège, Belgium.
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium.
- Centre du Cerveau, Hospital of Liège University, Avenue de l'Hôpital 1, B34, 4000, Liège, Belgium.
| |
Collapse
|
22
|
Martial C, Cassol H, Slater M, Bourdin P, Mensen A, Oliva R, Laureys S, Núñez P. Electroencephalographic Signature of Out-of-Body Experiences Induced by Virtual Reality: A Novel Methodological Approach. J Cogn Neurosci 2023; 35:1410-1422. [PMID: 37255451 DOI: 10.1162/jocn_a_02011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Out-of-body experiences (OBEs) are subjective experiences of seeing one's own body and the environment from a location outside the physical body. They can arise spontaneously or in specific conditions, such as during the intake of dissociative drug. Given its unpredictable occurrence, one way to empirically study it is to induce subjective experiences resembling an OBE using technology such as virtual reality. We employed a complex multisensory method of virtual embodiment in a virtual reality scenario with seven healthy participants to induce virtual OBE-like experiences. Participants performed two conditions in a randomly determined order. For both conditions, the participant's viewpoint was lifted out of the virtual body toward the ceiling of the virtual room, and real body movements were (visuo-tactile ON condition) or were not (visuo-tactile OFF condition) translated into movements on the virtual body below-the latter aiming to maintain a feeling of connection with the virtual body. A continuous 128-electrode EEG was recorded. Participants reported subjective experiences of floating in the air and of feeling high up in the virtual room at a strong intensity, but a weak to moderate feeling of being "out of their body" in both conditions. The EEG analysis revealed that this subjective experience was associated with a power shift that manifested in an increase of delta and a decrease of alpha relative power. A reduction of theta complexity and an increase of beta-2 connectivity were also found. This supports the growing body of evidence revealing a prominent role of delta activity during particular conscious states.
Collapse
Affiliation(s)
| | | | - Mel Slater
- University of Barcelona, Spain
- Institute of Neurosciences of the University of Barcelona, Spain
| | - Pierre Bourdin
- University of Barcelona, Spain
- Open University of Catalonia, Spain
| | | | | | - Steven Laureys
- University of Liège, Belgium
- University Hospital of Liège, Belgium
- University Laval, Québec, Canada
| | | |
Collapse
|
23
|
Panda R, Vanhaudenhuyse A, Piarulli A, Annen J, Demertzi A, Alnagger N, Chennu S, Laureys S, Faymonville ME, Gosseries O. Altered Brain Connectivity and Network Topological Organization in a Non-ordinary State of Consciousness Induced by Hypnosis. J Cogn Neurosci 2023; 35:1394-1409. [PMID: 37315333 DOI: 10.1162/jocn_a_02019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Hypnosis has been shown to be of clinical utility; however, its underlying neural mechanisms remain unclear. This study aims to investigate altered brain dynamics during the non-ordinary state of consciousness induced by hypnosis. We studied high-density EEG in 9 healthy participants during eyes-closed wakefulness and during hypnosis, induced by a muscle relaxation and eyes fixation procedure. Using hypotheses based on internal and external awareness brain networks, we assessed region-wise brain connectivity between six ROIs (right and left frontal, right and left parietal, upper and lower midline regions) at the scalp level and compared across conditions. Data-driven, graph-theory analyses were also carried out to characterize brain network topology in terms of brain network segregation and integration. During hypnosis, we observed (1) increased delta connectivity between left and right frontal, as well as between right frontal and parietal regions; (2) decreased connectivity for alpha (between right frontal and parietal and between upper and lower midline regions) and beta-2 bands (between upper midline and right frontal, frontal and parietal, also between upper and lower midline regions); and (3) increased network segregation (short-range connections) in delta and alpha bands, and increased integration (long-range connections) in beta-2 band. This higher network integration and segregation was measured bilaterally in frontal and right parietal electrodes, which were identified as central hub regions during hypnosis. This modified connectivity and increased network integration-segregation properties suggest a modification of the internal and external awareness brain networks that may reflect efficient cognitive-processing and lower incidences of mind-wandering during hypnosis.
Collapse
Affiliation(s)
| | | | | | - Jitka Annen
- University of Liège, Belgium
- University Hospital of Liège, Belgium
| | | | - Naji Alnagger
- University of Liège, Belgium
- University Hospital of Liège, Belgium
| | | | - Steven Laureys
- University of Liège, Belgium
- University Hospital of Liège, Belgium
- Laval University, Québec, Canada
| | | | - Olivia Gosseries
- University of Liège, Belgium
- University Hospital of Liège, Belgium
| |
Collapse
|
24
|
He J, Zhang H, Dang Y, Zhuang Y, Ge Q, Yang Y, Xu L, Xia X, Laureys S, Yu S, Zhang W. Electrophysiological characteristics of CM-pf in diagnosis and outcome of patients with disorders of consciousness. Brain Stimul 2023; 16:1522-1532. [PMID: 37778457 DOI: 10.1016/j.brs.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 09/07/2023] [Accepted: 09/20/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Deep brain stimulation (DBS) in the centromedian-parafascicular complex (CM-pf) has been reported as a potential therapeutic option for disorders of consciousness (DoC). However, the lack of understanding of its electrophysiological characteristics limits the improvement of therapeutic effect. OBJECTIVE To investigate the CM-pf electrophysiological characteristics underlying disorders of consciousness (DoC) and its recovery. METHODS We collected the CM-pf electrophysiological signals from 23 DoC patients who underwent central thalamus DBS (CT-DBS) surgery. Five typical electrophysiological features were extracted, including neuronal firing properties, multiunit activity (MUA) properties, signal stability, spike-MUA synchronization strength (syncMUA), and the background noise level. Their correlations with the consciousness level, the outcome, and the primary clinical factors of DoC were analyzed. RESULTS 11 out of 23 patients (0/2 chronic coma, 5/13 unresponsive wakefulness syndrome/vegetative state (UWS/VS), 6/8 minimally conscious state minus (MCS-)) exhibited an improvement in the level of consciousness after CT-DBS. In CM-pf, significantly stronger gamma band syncMUA strength and alpha band normalized MUA power were found in MCS- patients. In addition, higher firing rates, stronger high-gamma band MUA power and alpha band normalized power, and more stable theta oscillation were correlated with better outcomes. Besides, we also identified electrophysiological properties that are correlated with clinical factors, including etiologies, age, and duration of DoC. CONCLUSION We provide comprehensive analyses of the electrophysiological characteristics of CM-pf in DoC patients. Our results support the 'mesocircuit' hypothesis, one proposed mechanism of DoC recovery, and reveal CM-pf electrophysiological features that are crucial for understanding the pathogenesis of DoC, predicting its recovery, and explaining the effect of clinical factors on DoC.
Collapse
Affiliation(s)
- Jianghong He
- Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Haoran Zhang
- Laboratory of Brain Atlas and Brain-inspired Intelligence, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China; School of Future Technology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yuanyuan Dang
- Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Yutong Zhuang
- Department of Neurosurgery, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Qianqian Ge
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Yi Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Long Xu
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
| | - Xiaoyu Xia
- Department of Neurosurgery, The Seventh Medical Center of PLA General Hospital, Beijing, 100700, China
| | - Steven Laureys
- CERVO Brain Research Centre, Laval University, Canada; Coma Science Group, GIGA Consciousness Research Unit, Liège University Hospital, Belgium; International Consciousness Science Institute, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Shan Yu
- Laboratory of Brain Atlas and Brain-inspired Intelligence, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China; School of Future Technology, University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Wangming Zhang
- Neurosurgery Center, The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, China.
| |
Collapse
|
25
|
Annen J, Frasso G, van der Lande GJM, Bonin EAC, Vitello MM, Panda R, Sala A, Cavaliere C, Raimondo F, Bahri MA, Schiff ND, Gosseries O, Thibaut A, Laureys S. Cerebral electrometabolic coupling in disordered and normal states of consciousness. Cell Rep 2023; 42:112854. [PMID: 37498745 DOI: 10.1016/j.celrep.2023.112854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 06/02/2023] [Accepted: 07/08/2023] [Indexed: 07/29/2023] Open
Abstract
We assess cerebral integrity with cortical and subcortical FDG-PET and cortical electroencephalography (EEG) within the mesocircuit model framework in patients with disorders of consciousness (DoCs). The mesocircuit hypothesis proposes that subcortical activation facilitates cortical function. We find that the metabolic balance of subcortical mesocircuit areas is informative for diagnosis and is associated with four EEG-based power spectral density patterns, cortical metabolism, and α power in healthy controls and patients with a DoC. Last, regional electrometabolic coupling at the cortical level can be identified in the θ and α ranges, showing positive and negative relations with glucose uptake, respectively. This relation is inverted in patients with a DoC, potentially related to altered orchestration of neural activity, and may underlie suboptimal excitability states in patients with a DoC. By understanding the neurobiological basis of the pathophysiology underlying DoCs, we foresee translational value for diagnosis and treatment of patients with a DoC.
Collapse
Affiliation(s)
- Jitka Annen
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium.
| | | | - Glenn J M van der Lande
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Estelle A C Bonin
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Marie M Vitello
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Rajanikant Panda
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Arianna Sala
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | | | - Federico Raimondo
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - Mohamed Ali Bahri
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | | | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Aurore Thibaut
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium; Joint International Research Unit on Consciousness, CERVO Brain Research Centre, University Laval, Quebec City, QC, Canada
| |
Collapse
|
26
|
Vitello MM, Rosenfelder MJ, Cardone P, Niimi M, Willacker L, Thibaut A, Lejeune N, Laureys S, Bender A, Gosseries O. A protocol for a multicenter randomized and personalized controlled trial using rTMS in patients with disorders of consciousness. Front Neurol 2023; 14:1216468. [PMID: 37545735 PMCID: PMC10401598 DOI: 10.3389/fneur.2023.1216468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
Background Improving the functional recovery of patients with DoC remains one of the greatest challenges of the field. Different theories exist about the role of the anterior (prefrontal areas) versus posterior (parietal areas) parts of the brain as hotspots for the recovery of consciousness. Repetitive transcranial magnetic stimulation (rTMS) is a powerful non-invasive brain stimulation technique for the treatment of DoC. However, a direct comparison of the effect of TMS treatment on the front versus the back of the brain has yet to be performed. In this study, we aim to assess the short- and long-term effects of frontal and parietal rTMS on DoC recovery and characterize responders phenotypically. Methods/design Ninety patients with subacute and prolonged DoC will be included in a two-part multicenter prospective study. In the first phase (randomized controlled trial, RCT), patients will undergo four rTMS sessions in a crossover design over 10 days, targeting (i) the left dorsolateral prefrontal cortex (DLPFC) and (ii) the left angular gyrus (AG), as well as (iii & iv) their sham alternatives. In the second phase (longitudinal personalized trial), patients will receive personalized stimulations for 20 working days targeting the brain area that showed the best results in the RCT and will be randomly assigned to either active or sham intervention. The effects of rTMS on neurobehavioral and neurophysiological functioning in patients with DoC will be evaluated using clinical biomarkers of responsiveness (i.e., the Coma Recovery Scale-Revised; CRS-R), and electrophysiological biomarkers (e.g., power spectra, functional and effective connectivity, perturbational complexity index before and after intervention). Functional long-term outcomes will be assessed at 3 and 6 months post-intervention. Adverse events will be recorded during the treatment phase. Discussion This study seeks to identify which brain region (front or back) is best to stimulate for the treatment of patients with DoC using rTMS, and to characterize the neural correlates of its action regarding recovery of consciousness and functional outcome. In addition, we will define the responders' profile based on patients' characteristics and functional impairments; and develop biomarkers of responsiveness using EEG analysis according to the clinical responsiveness to the treatment. Clinical Trial Registration https://clinicaltrials.gov/ct2/show/NCT04401319, Clinicaltrials.gov, n° NCT04401319.
Collapse
Affiliation(s)
- Marie M. Vitello
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Martin J. Rosenfelder
- Department of Neurology, Therapiezentrum Burgau, Burgau, Germany
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Paolo Cardone
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Masachika Niimi
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- Department of Rehabilitation Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Lina Willacker
- Department of Neurology, Ludwig-Maximilians University Hospital of Munich, University of Munich, Munich, Germany
| | - Aurore Thibaut
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Nicolas Lejeune
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- William Lennox Neurological Hospital, Ottignies-Louvain-la-Neuve, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- CERVO Research Center, Laval University, Québec, QC, Canada
| | - Andreas Bender
- Department of Neurology, Therapiezentrum Burgau, Burgau, Germany
- Department of Neurology, Ludwig-Maximilians University Hospital of Munich, University of Munich, Munich, Germany
| | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| |
Collapse
|
27
|
Sanz LR, Laureys S, Gosseries O. Towards modern post-coma care based on neuroscientific evidence. Int J Clin Health Psychol 2023; 23:100370. [PMID: 36817874 PMCID: PMC9932483 DOI: 10.1016/j.ijchp.2023.100370] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/12/2023] [Indexed: 02/05/2023] Open
Abstract
Background Understanding the mechanisms underlying human consciousness is pivotal to improve the prognostication and treatment of severely brain-injured patients. Consciousness remains an elusive concept and the identification of its neural correlates is an active subject of research, however recent neuroscientific advances have allowed scientists to better characterize disorders of consciousness. These breakthroughs question the historical nomenclature and our current management of post-comatose patients. Method This review examines the contribution of consciousness neurosciences to the current clinical management of severe brain injury. It investigates the major impact of consciousness disorders on healthcare systems, the scientific frameworks employed to identify their neural correlates and how evidence-based data from neuroimaging research have reshaped the landscape of post-coma care in recent years. Results Our increased ability to detect behavioral and neurophysiological signatures of consciousness has led to significant changes in taxonomy and clinical practice. We advocate for a multimodal framework for the management of severely brain-injured patients based on precision medicine and evidence-based decisions, integrating epidemiology, health economics and neuroethics. Conclusions Major progress in brain imaging and clinical assessment have opened the door to a new era of post-coma care based on standardized neuroscientific evidence. We highlight its implications in clinical applications and call for improved collaborations between researchers and clinicians to better translate findings to the bedside.
Collapse
Affiliation(s)
- Leandro R.D. Sanz
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- Joint International Research Unit on Consciousness, CERVO Brain Research Centre, CIUSS, Laval University, Québec, Canada
| | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| |
Collapse
|
28
|
Panda R, López-González A, Gilson M, Gosseries O, Thibaut A, Frasso G, Cecconi B, Escrichs A, Deco G, Laureys S, Zamora-López G, Annen J. Whole-brain analyses indicate the impairment of posterior integration and thalamo-frontotemporal broadcasting in disorders of consciousness. Hum Brain Mapp 2023. [PMID: 37254960 DOI: 10.1002/hbm.26386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 06/01/2023] Open
Abstract
The study of the brain's dynamical activity is opening a window to help the clinical assessment of patients with disorders of consciousness. For example, glucose uptake and the dysfunctional spread of naturalistic and synthetic stimuli has proven useful to characterize hampered consciousness. However, understanding of the mechanisms behind loss of consciousness following brain injury is still missing. Here, we study the propagation of endogenous and in-silico exogenous perturbations in patients with disorders of consciousness, based upon directed and causal interactions estimated from resting-state fMRI data, fitted to a linear model of activity propagation. We found that patients with disorders of consciousness suffer decreased capacity for neural propagation and responsiveness to events, and that this can be related to severe reduction of glucose metabolism as measured with [18 F]FDG-PET. In particular, we show that loss of consciousness is related to the malfunctioning of two neural circuits: the posterior cortical regions failing to convey information, in conjunction with reduced broadcasting of information from subcortical, temporal, parietal and frontal regions. These results shed light on the mechanisms behind disorders of consciousness, triangulating network function with basic measures of brain integrity and behavior.
Collapse
Affiliation(s)
- Rajanikant Panda
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- University Hospital of Liège, Liège, Belgium
| | - Ane López-González
- Center for Brain and Cognition, Department of Information and Communication Technologies, Pompeu Fabra University, Barcelona, Spain
| | - Matthieu Gilson
- Center for Brain and Cognition, Department of Information and Communication Technologies, Pompeu Fabra University, Barcelona, Spain
- Institut des Neurosciences des Systemes, INSERM-AMU, Marseille, France
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- University Hospital of Liège, Liège, Belgium
| | - Aurore Thibaut
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- University Hospital of Liège, Liège, Belgium
| | - Gianluca Frasso
- Wageningen Food Safety Research, Wageningen, The Netherlands
| | - Benedetta Cecconi
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- University Hospital of Liège, Liège, Belgium
| | - Anira Escrichs
- Center for Brain and Cognition, Department of Information and Communication Technologies, Pompeu Fabra University, Barcelona, Spain
| | - Gustavo Deco
- Center for Brain and Cognition, Department of Information and Communication Technologies, Pompeu Fabra University, Barcelona, Spain
- Institució Catalana de la Recerça i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- School of Psychological Sciences, Monash University, Victoria, Australia
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- University Hospital of Liège, Liège, Belgium
- CERVO Research Center, Laval University, Québec, Quebec, Canada
| | - Gorka Zamora-López
- Center for Brain and Cognition, Department of Information and Communication Technologies, Pompeu Fabra University, Barcelona, Spain
| | - Jitka Annen
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- University Hospital of Liège, Liège, Belgium
| |
Collapse
|
29
|
Martial C, Poirrier AL, Pottier L, Cassol H, Mortaheb S, Panda R, Lopez M, Perrin T, Boilevin A, Gosseries O, Laureys S. From nose to brain: The effect of lemon inhalation observed by whole brain voxel to voxel functional connectivity. Cortex 2023; 165:119-128. [PMID: 37285762 DOI: 10.1016/j.cortex.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/07/2023] [Accepted: 04/06/2023] [Indexed: 06/09/2023]
Abstract
Lemon fragrance is known for its stimulating properties, but its mechanisms of action are not well known yet. This study aimed to examine the effect of lemon essential oil inhalation on healthy participants' alertness level and their neural correlates using magnetic resonance imaging (MRI). Twenty-one healthy men underwent functional MRI scans in different conditions: a resting state condition, a condition where they were exposed to passive lemon smelling (alternating exposure to lemon and breathing fresh air), and a control condition without lemon fragrance diffusion -the order of the last two conditions being randomized. Alertness levels were assessed immediately after each condition using the Karolinska Sleepiness Scale. Voxel-wise whole-brain global functional connectivity and graph theory analyses were computed to investigate brain functional connectivity and network topology alterations. After lemon fragrance inhalation, we observed a higher level of alertness as compared to resting state -but not compared to control condition. During lemon fragrance inhalation, we found increased global functional connectivity in the thalamus, paralleled by decreased global connectivity in several cortical regions such as precuneus, postcentral and precentral gyrus, lateral occipital cortex and paracingulate gyrus. Graph theory analysis revealed increased network integration in cortical regions typically involved in olfaction and emotion processing such as olfactory bulb, hypothalamus and thalamus, while decreased network segregation in several regions of the posterior part of the brain during olfaction as compared to resting state. The present findings suggest that lemon essential oil inhalation could increase the level of alertness.
Collapse
Affiliation(s)
- Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University of Liège, Avenue de L'hôpital, 11, 4000, Liège, Belgium; Centre Du Cerveau(2), University Hospital of Liège, Avenue de L'hôpital, 11, 4000, Liège, Belgium.
| | - Anne-Lise Poirrier
- ENT Department, University Hospital of Liège, Avenue de L'hôpital, 11, 4000, Liège, Belgium
| | - Laurence Pottier
- ENT Department, University Hospital of Liège, Avenue de L'hôpital, 11, 4000, Liège, Belgium
| | - Héléna Cassol
- Coma Science Group, GIGA-Consciousness, University of Liège, Avenue de L'hôpital, 11, 4000, Liège, Belgium
| | - Sepehr Mortaheb
- Physiology of Cognition, GIGA-CRC in Vivo Imaging Research Unit, University of Liège, Allée Du 6 Août 8, 4000, Liège, Belgium
| | - Rajanikant Panda
- Coma Science Group, GIGA-Consciousness, University of Liège, Avenue de L'hôpital, 11, 4000, Liège, Belgium
| | - Mateo Lopez
- Valeo, Carlab Health & WellBeing, 100 Rue de Courcelles, 75017, Paris, France
| | - Thibault Perrin
- Valeo, Carlab Health & WellBeing, 100 Rue de Courcelles, 75017, Paris, France
| | - Antoine Boilevin
- Valeo, Carlab Health & WellBeing, 100 Rue de Courcelles, 75017, Paris, France; Université Bordeaux Montaigne, UFR Humanités, Département Design Bordeaux, Esplanade des Antilles Domaine Niversitaire, 33607, Pessac, France
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Avenue de L'hôpital, 11, 4000, Liège, Belgium; Centre Du Cerveau(2), University Hospital of Liège, Avenue de L'hôpital, 11, 4000, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Avenue de L'hôpital, 11, 4000, Liège, Belgium; Centre Du Cerveau(2), University Hospital of Liège, Avenue de L'hôpital, 11, 4000, Liège, Belgium; Joint International Research Unit on Consciousness, CERVO Brain Research Centre, CIUSS, University Laval, 2301 Av. D'Estimauville, QC, G1E 1T2, Québec, Canada
| |
Collapse
|
30
|
Perl YS, Pallavicini C, Piccinini J, Demertzi A, Bonhomme V, Martial C, Panda R, Alnagger N, Annen J, Gosseries O, Ibañez A, Laufs H, Sitt JD, Jirsa VK, Kringelbach ML, Laureys S, Deco G, Tagliazucchi E. Low-dimensional organization of global brain states of reduced consciousness. Cell Rep 2023; 42:112491. [PMID: 37171963 DOI: 10.1016/j.celrep.2023.112491] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/19/2023] [Accepted: 04/24/2023] [Indexed: 05/14/2023] Open
Abstract
Brain states are frequently represented using a unidimensional scale measuring the richness of subjective experience (level of consciousness). This description assumes a mapping between the high-dimensional space of whole-brain configurations and the trajectories of brain states associated with changes in consciousness, yet this mapping and its properties remain unclear. We combine whole-brain modeling, data augmentation, and deep learning for dimensionality reduction to determine a mapping representing states of consciousness in a low-dimensional space, where distances parallel similarities between states. An orderly trajectory from wakefulness to patients with brain injury is revealed in a latent space whose coordinates represent metrics related to functional modularity and structure-function coupling, increasing alongside loss of consciousness. Finally, we investigate the effects of model perturbations, providing geometrical interpretation for the stability and reversibility of states. We conclude that conscious awareness depends on functional patterns encoded as a low-dimensional trajectory within the vast space of brain configurations.
Collapse
Affiliation(s)
- Yonatan Sanz Perl
- Department of Physics, University of Buenos Aires, Intendente Guiraldes 2160 (Ciudad Universitaria), Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), CABA, Buenos Aires, Argentina; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; Center for Brain and Cognition, Computational Neuroscience Group, Universitat Pompeu Fabra, Barcelona, Spain; Paris Brain Institute (ICM), Paris, France.
| | - Carla Pallavicini
- Department of Physics, University of Buenos Aires, Intendente Guiraldes 2160 (Ciudad Universitaria), Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), CABA, Buenos Aires, Argentina; Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI), Buenos Aires, Argentina
| | - Juan Piccinini
- Department of Physics, University of Buenos Aires, Intendente Guiraldes 2160 (Ciudad Universitaria), Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), CABA, Buenos Aires, Argentina
| | - Athena Demertzi
- Physiology of Cognition Research Lab, GIGA CRC-In Vivo Imaging Center, GIGA Institute, University of Liège, Liège, Belgium
| | - Vincent Bonhomme
- Anesthesia and Intensive Care Laboratory, GIGA-Consciousness, GIGA Institute, University of Liège, Liège, Belgium; University Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Régional de la Citadelle (CHR Citadelle), Liège, Belgium; Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Universitaire de Liège (CHU Liège), Liège, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), Centre Hospitalier Universitaire de Liège (CHU Liège), Liège, Belgium
| | - Rajanikant Panda
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), Centre Hospitalier Universitaire de Liège (CHU Liège), Liège, Belgium
| | - Naji Alnagger
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), Centre Hospitalier Universitaire de Liège (CHU Liège), Liège, Belgium
| | - Jitka Annen
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), Centre Hospitalier Universitaire de Liège (CHU Liège), Liège, Belgium
| | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), Centre Hospitalier Universitaire de Liège (CHU Liège), Liège, Belgium
| | - Agustin Ibañez
- National Scientific and Technical Research Council (CONICET), CABA, Buenos Aires, Argentina; Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina; Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile; Global Brain Health Institute (GBHI), University of California-San Francisco (UCSF), San Francisco, CA, USA; Trinity College, Dublin, Ireland
| | - Helmut Laufs
- Department of Neurology and Brain Imaging Center, Goethe University, Frankfurt am Main, Germany; Department of Neurology, Christian Albrechts University, Kiel, Germany
| | - Jacobo D Sitt
- Paris Brain Institute (ICM), Paris, France; INSERM U 1127, Paris, France; CNRS UMR 7225, Paris, France
| | - Viktor K Jirsa
- Institut de Neurosciences des Systèmes, Aix Marseille Université, Marseille, France
| | - Morten L Kringelbach
- Department of Psychiatry, University of Oxford, Oxford, UK; Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, Århus, Denmark; Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; Centre for Eudaimonia and Human Flourishing, University of Oxford, Oxford, UK
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), Centre Hospitalier Universitaire de Liège (CHU Liège), Liège, Belgium
| | - Gustavo Deco
- Center for Brain and Cognition, Computational Neuroscience Group, Universitat Pompeu Fabra, Barcelona, Spain; Department of Information and Communication Technologies, Universitat Pompeu Fabra, Barcelona, Spain; Institució Catalana de la Recerca i Estudis Avancats (ICREA), Barcelona, Spain
| | - Enzo Tagliazucchi
- Department of Physics, University of Buenos Aires, Intendente Guiraldes 2160 (Ciudad Universitaria), Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), CABA, Buenos Aires, Argentina; Centre du Cerveau(2), Centre Hospitalier Universitaire de Liège (CHU Liège), Liège, Belgium.
| |
Collapse
|
31
|
Shou F, Wang J, Laureys S, Cheng L, Huang W, Di H. Study protocol: Developing telephone follow-up scale for patients with disorders of consciousness. Front Public Health 2023; 11:1071008. [PMID: 37064695 PMCID: PMC10097956 DOI: 10.3389/fpubh.2023.1071008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 03/06/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundThe significant lack of rehabilitation prognostic data is the main reason that affects the treatment decision-making and ethical issues of patients with disorders of consciousness (DoC). Currently, the clinic's consciousness assessment tools cannot satisfy DoC patients' follow-up needs.ObjectiveThe purpose of this study is to construct a sensitive, professional, and simple telephone follow-up scale for DoC patients to follow up on the prognosis, especially the recovery of consciousness, of prolonged DoC patients transferred to community hospitals or at home.MethodsThis study is to adopt expert consultation to construct and to verify the validity and feasibility of the scale on-site.ConclusionAt present, there is a strong demand for portable, accurate, and easily operated scales. It is helpful to improve the rehabilitation data of prolonged DoC patients and provide more basis for their treatment and rehabilitation.
Collapse
Affiliation(s)
- Fangfang Shou
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
- Faculty of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Jing Wang
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liege, Liege, Belgium
- Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Lijuan Cheng
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Wangshan Huang
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Haibo Di
- International Unresponsive Wakefulness Syndrome and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Haibo Di
| |
Collapse
|
32
|
Colombo MA, Comanducci A, Casarotto S, Derchi CC, Annen J, Viganò A, Mazza A, Trimarchi PD, Boly M, Fecchio M, Bodart O, Navarro J, Laureys S, Gosseries O, Massimini M, Sarasso S, Rosanova M. Beyond alpha power: EEG spatial and spectral gradients robustly stratify disorders of consciousness. Cereb Cortex 2023:7091601. [PMID: 36977648 DOI: 10.1093/cercor/bhad031] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 03/30/2023] Open
Abstract
Neurophysiological markers can overcome the limitations of behavioural assessments of Disorders of Consciousness (DoC). EEG alpha power emerged as a promising marker for DoC, although long-standing literature reported alpha power being sustained during anesthetic-induced unconsciousness, and reduced during dreaming and hallucinations. We hypothesized that EEG power suppression caused by severe anoxia could explain this conflict. Accordingly, we split DoC patients (n = 87) in postanoxic and non-postanoxic cohorts. Alpha power was suppressed only in severe postanoxia but failed to discriminate un/consciousness in other aetiologies. Furthermore, it did not generalize to an independent reference dataset (n = 65) of neurotypical, neurological, and anesthesia conditions. We then investigated EEG spatio-spectral gradients, reflecting anteriorization and slowing, as alternative markers. In non-postanoxic DoC, these features, combined in a bivariate model, reliably stratified patients and indexed consciousness, even in unresponsive patients identified as conscious by an independent neural marker (the Perturbational Complexity Index). Crucially, this model optimally generalized to the reference dataset. Overall, alpha power does not index consciousness; rather, its suppression entails diffuse cortical damage, in postanoxic patients. As an alternative, EEG spatio-spectral gradients, reflecting distinct pathophysiological mechanisms, jointly provide a robust, parsimonious, and generalizable marker of consciousness, whose clinical application may guide rehabilitation efforts.
Collapse
Affiliation(s)
| | - Angela Comanducci
- IRCCS, Fondazione Don Carlo Gnocchi Onlus, Milan 20148, Italy
- Department of Engineering, Università Campus Bio-Medico di Roma, Rome 00128, Italy
| | - Silvia Casarotto
- Department of Biomedical and Clinical Sciences, University of Milan, Milan 20157, Italy
- IRCCS, Fondazione Don Carlo Gnocchi Onlus, Milan 20148, Italy
| | | | - Jitka Annen
- Coma Science Group, GIGA-Consciousness, University of Liège and Centre du Cerveau2, University Hospital of Liège, Liège 4000, Belgium
| | | | - Alice Mazza
- IRCCS, Fondazione Don Carlo Gnocchi Onlus, Milan 20148, Italy
| | | | - Melanie Boly
- Department of Neurology and Department of Psychiatry, University of Wisconsin, Madison, WI 53705-2281, USA
| | - Matteo Fecchio
- Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Olivier Bodart
- Coma Science Group, GIGA-Consciousness, University of Liège and Centre du Cerveau2, University Hospital of Liège, Liège 4000, Belgium
| | - Jorge Navarro
- IRCCS, Fondazione Don Carlo Gnocchi Onlus, Milan 20148, Italy
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège and Centre du Cerveau2, University Hospital of Liège, Liège 4000, Belgium
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège and Centre du Cerveau2, University Hospital of Liège, Liège 4000, Belgium
| | - Marcello Massimini
- Department of Biomedical and Clinical Sciences, University of Milan, Milan 20157, Italy
- IRCCS, Fondazione Don Carlo Gnocchi Onlus, Milan 20148, Italy
| | - Simone Sarasso
- Department of Biomedical and Clinical Sciences, University of Milan, Milan 20157, Italy
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences, University of Milan, Milan 20157, Italy
| |
Collapse
|
33
|
Rousseau AF, Dams L, Massart Q, Choquer L, Cassol H, Laureys S, Misset B, Dardenne N, Gosseries O, Martial C. Incidence of near-death experiences in patients surviving a prolonged critical illness and their long-term impact: a prospective observational study. Crit Care 2023; 27:76. [PMID: 36849984 PMCID: PMC9969623 DOI: 10.1186/s13054-023-04348-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/06/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND So far, the few prospective studies on near-death experience (NDE) were carried out only in intensive care unit (ICU) patients with homogeneous aetiologies, such as cardiac arrest or trauma survivors. The aims of this 1-year prospective and monocentric study were to investigate the incidence of NDE in ICU survivors (all aetiologies) as well as factors that may affect its frequency, and to assess quality of life up to 1 year after enrolment. METHODS We enrolled adults with a prolonged ICU stay (> 7 days). During the first 7 days after discharge, all eligible patients were assessed in a face-to-face interview for NDE using the Greyson NDE scale, dissociative experiences using the Dissociative Experience Scale, and spirituality beliefs using the WHOQOL-SRPB. Medical parameters were prospectively collected. At 1-year after inclusion, patients were contacted by phone to measure quality of life using the EuroQol five-dimensional questionnaire. RESULTS Out of the 126 included patients, 19 patients (15%) reported having experienced a NDE as identified by the Greyson NDE scale (i.e. cut-off score ≥ 7/32). In univariate analyses, mechanical ventilation, sedation, analgesia, reason for admission, primary organ dysfunction, dissociative and spiritual propensities were associated with the emergence of NDE. In multivariate logistic regression analysis, only the dissociative and spiritual propensity strongly predicted the emergence of NDE. One year later (n = 61), the NDE was not significantly associated with quality of life. CONCLUSIONS The recall of NDE is not so rare in the ICU. In our cohort, cognitive and spiritual factors outweighed medical parameters as predictors of the emergence of NDE. Trial registration This trial was registered in Clinicaltrials.gov in February 2020 ( NCT04279171 ).
Collapse
Affiliation(s)
- Anne-Françoise Rousseau
- grid.4861.b0000 0001 0805 7253Department of Intensive Care and Burn Centre, University Hospital of Liège, University of Liège, Liège, Belgium
| | - Laurence Dams
- grid.4861.b0000 0001 0805 7253Department of Anaesthesiology, University Hospital of Liège, University of Liège, Liège, Belgium
| | - Quentin Massart
- grid.4861.b0000 0001 0805 7253Department of Anaesthesiology, University Hospital of Liège, University of Liège, Liège, Belgium
| | - Laila Choquer
- grid.4861.b0000 0001 0805 7253Department of Anaesthesiology, University Hospital of Liège, University of Liège, Liège, Belgium
| | - Héléna Cassol
- grid.4861.b0000 0001 0805 7253Coma Science Group, GIGA-Consciousness, University of Liège, Avenue de L’hôpital, 11, 4000 Liège, Belgium ,grid.411374.40000 0000 8607 6858Centre du Cerveau², University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- grid.4861.b0000 0001 0805 7253Coma Science Group, GIGA-Consciousness, University of Liège, Avenue de L’hôpital, 11, 4000 Liège, Belgium ,grid.411374.40000 0000 8607 6858Centre du Cerveau², University Hospital of Liège, Liège, Belgium ,grid.23856.3a0000 0004 1936 8390Joint International Research Unit On Consciousness, CERVO Brain Research Centre, CIUSS, University Laval, Québec, Canada
| | - Benoit Misset
- grid.4861.b0000 0001 0805 7253Department of Intensive Care and Burn Centre, University Hospital of Liège, University of Liège, Liège, Belgium
| | - Nadia Dardenne
- grid.4861.b0000 0001 0805 7253University and Hospital Biostatistics Centre (B-STAT), University of Liège, Liège, Belgium
| | - Olivia Gosseries
- grid.4861.b0000 0001 0805 7253Coma Science Group, GIGA-Consciousness, University of Liège, Avenue de L’hôpital, 11, 4000 Liège, Belgium ,grid.411374.40000 0000 8607 6858Centre du Cerveau², University Hospital of Liège, Liège, Belgium ,grid.4861.b0000 0001 0805 7253Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liege, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University of Liège, Avenue de L'hôpital, 11, 4000, Liège, Belgium. .,Centre du Cerveau², University Hospital of Liège, Liège, Belgium.
| |
Collapse
|
34
|
Alnagger N, Cardone P, Martial C, Laureys S, Annen J, Gosseries O. The current and future contribution of neuroimaging to the understanding of disorders of consciousness. Presse Med 2023; 52:104163. [PMID: 36796250 DOI: 10.1016/j.lpm.2022.104163] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 11/21/2022] [Accepted: 12/13/2022] [Indexed: 02/16/2023] Open
Abstract
Patients with disorders of consciousness (DoC) represent a group of severely brain-injured patients with varying capacities for consciousness in terms of both wakefulness and awareness. The current state-of-the-art for assessing these patients is through standardised behavioural examinations, but inaccuracies are commonplace. Neuroimaging and electrophysiological techniques have revealed vast insights into the relationships between neural alterations, andcognitive and behavioural features of consciousness in patients with DoC. This has led to the establishment of neuroimaging paradigms for the clinical assessment of DoC patients. Here, we review selected neuroimaging findings on the DoC population, outlining key findings of the dysfunction underlying DoC and presenting the current clinical utility of neuroimaging tools. We discuss that whilst individual brain areas play instrumental roles in generating and supporting consciousness, activation of these areas alone is not sufficient for conscious experience. Instead, for consciousness to arise, we need preserved thalamo-cortical circuits, in addition to sufficient connectivity between distinctly differentiated brain networks, underlined by connectivity both within, and between such brain networks. Finally, we present recent advances and future perspectives in computational methodologies applied to DoC, supporting the notion that progress in the science of DoC will be driven by a symbiosis of these data-driven analyses, and theory-driven research. Both perspectives will work in tandem to provide mechanistic insights contextualised within theoretical frameworks which ultimately inform the practice of clinical neurology.
Collapse
Affiliation(s)
- Naji Alnagger
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Paolo Cardone
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium; CERVO Research Center, Laval University, Quebec, Canada
| | - Jitka Annen
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium; Centre du Cerveau(2), University Hospital of Liège, Liège, Belgium.
| |
Collapse
|
35
|
Mélotte E, Maudoux A, Panda R, Kaux JF, Lagier A, Herr R, Belorgeot M, Laureys S, Gosseries O. Links Between Swallowing and Consciousness: A Narrative Review. Dysphagia 2023; 38:42-64. [PMID: 35773497 DOI: 10.1007/s00455-022-10452-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 12/06/2021] [Indexed: 01/27/2023]
Abstract
This literature review explores a wide range of themes addressing the links between swallowing and consciousness. Signs of consciousness are historically based on the principle of differentiating reflexive from volitional behaviors. We show that the sequencing of the components of swallowing falls on a continuum of voluntary to reflex behaviors and we describe several types of volitional and non-volitional swallowing tasks. The frequency, speed of initiation of the swallowing reflex, efficacy of the pharyngeal phase of swallowing and coordination between respiration and swallowing are influenced by the level of consciousness during non-pathological modifications of consciousness such as sleep and general anesthesia. In patients with severe brain injury, the level of consciousness is associated with several components related to swallowing, such as the possibility of extubation, risk of pneumonia, type of feeding or components directly related to swallowing such as oral or pharyngeal abnormalities. Based on our theoretical and empirical analysis, the efficacy of the oral phase and the ability to receive exclusive oral feeding seem to be the most robust signs of consciousness related to swallowing in patients with disorders of consciousness. Components of the pharyngeal phase (in terms of abilities of saliva management) and evoked cough may be influenced by consciousness, but further studies are necessary to determine if they constitute signs of consciousness as such or only cortically mediated behaviors. This review also highlights the critical lack of tools and techniques to assess and treat dysphagia in patients with disorders of consciousness.
Collapse
Affiliation(s)
- Evelyne Mélotte
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.
- Physical and Rehabilitation Medicine Department, University and University Hospital of Liège, Avenue de l'Hopital 1, 4000, Liège, Belgium.
- Centre du Cerveau², University Hospital of Liège, Liège, Belgium.
| | - Audrey Maudoux
- Sensation and Perception Research Group, GIGA, University and University Hospital of Liège, Liège, Belgium
- Otorhinolaryngology Head and Neck Surgery Department, Robert Debré University Hospital, APHP, Paris, France
| | - Rajanikant Panda
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
| | - Jean-François Kaux
- Physical and Rehabilitation Medicine Department, University and University Hospital of Liège, Avenue de l'Hopital 1, 4000, Liège, Belgium
| | - Aude Lagier
- Otorhinolaryngology Head and Neck Surgery Department, University Hospital of Liège, Liège, Belgium
| | - Roxanne Herr
- Department of Speech and Language Pathology, Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Marion Belorgeot
- Physical and Rehabilitation Medicine Department, University Hospital of Nîmes, Nîmes, France
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau², University Hospital of Liège, Liège, Belgium
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau², University Hospital of Liège, Liège, Belgium
| |
Collapse
|
36
|
Jillings S, Pechenkova E, Tomilovskaya E, Rukavishnikov I, Jeurissen B, Van Ombergen A, Nosikova I, Rumshiskaya A, Litvinova L, Annen J, De Laet C, Schoenmaekers C, Sijbers J, Petrovichev V, Sunaert S, Parizel PM, Sinitsyn V, Eulenburg PZ, Laureys S, Demertzi A, Wuyts FL. Prolonged microgravity induces reversible and persistent changes on human cerebral connectivity. Commun Biol 2023; 6:46. [PMID: 36639420 PMCID: PMC9839680 DOI: 10.1038/s42003-022-04382-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 12/15/2022] [Indexed: 01/15/2023] Open
Abstract
The prospect of continued manned space missions warrants an in-depth understanding of how prolonged microgravity affects the human brain. Functional magnetic resonance imaging (fMRI) can pinpoint changes reflecting adaptive neuroplasticity across time. We acquired resting-state fMRI data of cosmonauts before, shortly after, and eight months after spaceflight as a follow-up to assess global connectivity changes over time. Our results show persisting connectivity decreases in posterior cingulate cortex and thalamus and persisting increases in the right angular gyrus. Connectivity in the bilateral insular cortex decreased after spaceflight, which reversed at follow-up. No significant connectivity changes across eight months were found in a matched control group. Overall, we show that altered gravitational environments influence functional connectivity longitudinally in multimodal brain hubs, reflecting adaptations to unfamiliar and conflicting sensory input in microgravity. These results provide insights into brain functional modifications occurring during spaceflight, and their further development when back on Earth.
Collapse
Affiliation(s)
- Steven Jillings
- grid.5284.b0000 0001 0790 3681Lab for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium
| | - Ekaterina Pechenkova
- grid.410682.90000 0004 0578 2005Laboratory for Cognitive Research, HSE University, Moscow, Russia
| | - Elena Tomilovskaya
- grid.4886.20000 0001 2192 9124SSC RF—Institute for Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Ilya Rukavishnikov
- grid.4886.20000 0001 2192 9124SSC RF—Institute for Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Ben Jeurissen
- grid.5284.b0000 0001 0790 3681Lab for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium ,grid.5284.b0000 0001 0790 3681imec-Vision Lab, University of Antwerp, Antwerp, Belgium
| | - Angelique Van Ombergen
- grid.5284.b0000 0001 0790 3681Lab for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium ,grid.5284.b0000 0001 0790 3681Department of Translational Neuroscience—ENT, University of Antwerp, Antwerp, Belgium
| | - Inna Nosikova
- grid.4886.20000 0001 2192 9124SSC RF—Institute for Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | - Alena Rumshiskaya
- grid.415738.c0000 0000 9216 2496Radiology Department, National Medical Research Treatment and Rehabilitation Center of the Ministry of Health of Russia, Moscow, Russia
| | - Liudmila Litvinova
- grid.415738.c0000 0000 9216 2496Radiology Department, National Medical Research Treatment and Rehabilitation Center of the Ministry of Health of Russia, Moscow, Russia
| | - Jitka Annen
- grid.411374.40000 0000 8607 6858Coma Science Group, GIGA Consciousness, GIGA Institute, University and University Hospital of Liège, Liège, Belgium
| | - Chloë De Laet
- grid.5284.b0000 0001 0790 3681Lab for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium
| | - Catho Schoenmaekers
- grid.5284.b0000 0001 0790 3681Lab for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium
| | - Jan Sijbers
- grid.5284.b0000 0001 0790 3681imec-Vision Lab, University of Antwerp, Antwerp, Belgium
| | - Victor Petrovichev
- grid.415738.c0000 0000 9216 2496Radiology Department, National Medical Research Treatment and Rehabilitation Center of the Ministry of Health of Russia, Moscow, Russia
| | - Stefan Sunaert
- grid.5596.f0000 0001 0668 7884Department of Imaging & Pathology, Translational MRI, KU Leuven—University of Leuven, Leuven, Belgium
| | - Paul M. Parizel
- grid.416195.e0000 0004 0453 3875Department of Radiology, Royal Perth Hospital and University of Western Australia Medical School, Perth, WA Australia
| | - Valentin Sinitsyn
- grid.14476.300000 0001 2342 9668Faculty of Fundamental Medicine, Lomonosov Moscow State University, Moscow, Russia
| | - Peter zu Eulenburg
- grid.5252.00000 0004 1936 973XInstitute for Neuroradiology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Steven Laureys
- grid.411374.40000 0000 8607 6858Coma Science Group, GIGA Consciousness, GIGA Institute, University and University Hospital of Liège, Liège, Belgium ,grid.23856.3a0000 0004 1936 8390Joint International Research Unit on Consciousness, CERVO Brain Research Centre, Laval University, Quebec, QC Canada ,grid.410595.c0000 0001 2230 9154International Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Athena Demertzi
- grid.4861.b0000 0001 0805 7253Physiology of Cognition, GIGA-CRC In Vivo Imaging, University of Liège, Liège, Belgium ,grid.4861.b0000 0001 0805 7253Department of Psychology, Psychology and Neuroscience of Cognition Research Unit, University of Liège, Liège, Belgium
| | - Floris L. Wuyts
- grid.5284.b0000 0001 0790 3681Lab for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
37
|
Ippoliti C, Fadeur M, Malherbe C, De Flines J, Verbrugge AM, Gosseries O, Ledoux D, Misset B, Laureys S, Paquot N, Thibaut A. What is the nutritional status of patients with prolonged disorders of consciousness? A retrospective cross-sectional study. Brain Inj 2023; 37:54-62. [PMID: 36426606 DOI: 10.1080/02699052.2022.2145361] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nutritional status of patients with disorders of consciousness (DoC) is poorly studied. OBJECTIVES To evaluate the relationship between nutritional status (body mass index, daily calories intake) and clinical variables (level of consciousness, time since injury, diagnosis, etiology and spastic muscle overactivity; SMO,) in patients with prolonged DoCor emerging. Our main hypotheses are i) patients with lower level of consciousness (UWS) have worse nutritional status compared to patients in minimally conscious state (MCS) and ii) SMO could influence nutritional status. METHODS AND RESULTS Among the 80 patients included in the study (19 UWS, 47 MCS, 14 emerging MCS; 43 ± 15 yo; 3 ± 4 years post-injury, 35 traumatic etiology, 34 females), 9% were at risk to be undernourished, with no differences between UWS and MCS. Patients without SMO had a higher BMI compared to patients with severe SMO. Compared to the recommended daily calories intake, patients with the highest BMI received less calories and patients with the lowest BMI received more calories. We observed a negative correlation between SMO (in lower limbs) and BMI. CONCLUSION Our study shows that most patients are well nourished, independently from the level of consciousness. SMO may require additional calories in patients' daily needs; however, longitudinal studies are needed to explore the causal relationship between these variables.
Collapse
Affiliation(s)
- Camilla Ippoliti
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Marjorie Fadeur
- Service de Diabétologie, Nutrition et Maladies Métaboliques, University Hospital of Liège, Liège, Belgium
| | | | - Jenny De Flines
- Service de Diabétologie, Nutrition et Maladies Métaboliques, University Hospital of Liège, Liège, Belgium
| | | | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Didier Ledoux
- Centre du Cerveau2, University Hospital of Liège, Liège, Belgium.,Service de Diététique, University Hospital of Liège, Liège, Belgium
| | - Benoit Misset
- Intensive care unit, University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| | - Nicolas Paquot
- Service de Diabétologie, Nutrition et Maladies Métaboliques, University Hospital of Liège, Liège, Belgium
| | - Aurore Thibaut
- Coma Science Group, GIGA Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau2, University Hospital of Liège, Liège, Belgium
| |
Collapse
|
38
|
Bonin EAC, Lejeune N, Szymkowicz E, Bonhomme V, Martial C, Gosseries O, Laureys S, Thibaut A. Assessment and management of pain/nociception in patients with disorders of consciousness or locked-in syndrome: A narrative review. Front Syst Neurosci 2023; 17:1112206. [PMID: 37021037 PMCID: PMC10067681 DOI: 10.3389/fnsys.2023.1112206] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/06/2023] [Indexed: 04/07/2023] Open
Abstract
The assessment and management of pain and nociception is very challenging in patients unable to communicate functionally such as patients with disorders of consciousness (DoC) or in locked-in syndrome (LIS). In a clinical setting, the detection of signs of pain and nociception by the medical staff is therefore essential for the wellbeing and management of these patients. However, there is still a lot unknown and a lack of clear guidelines regarding the assessment, management and treatment of pain and nociception in these populations. The purpose of this narrative review is to examine the current knowledge regarding this issue by covering different topics such as: the neurophysiology of pain and nociception (in healthy subjects and patients), the source and impact of nociception and pain in DoC and LIS and, finally, the assessment and treatment of pain and nociception in these populations. In this review we will also give possible research directions that could help to improve the management of this specific population of severely brain damaged patients.
Collapse
Affiliation(s)
- Estelle A. C. Bonin
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre du Cerveau, Liège University Hospital, Liège, Belgium
| | - Nicolas Lejeune
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre Hospitalier Neurologique (CHN) William Lennox, Saint-Luc Hospital Group, Ottignies-Louvain-la-Neuve, Belgium
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Emilie Szymkowicz
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre du Cerveau, Liège University Hospital, Liège, Belgium
| | - Vincent Bonhomme
- Department of Anesthesia and Intensive Care Medicine, Liège University Hospital, Liège, Belgium
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre du Cerveau, Liège University Hospital, Liège, Belgium
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre du Cerveau, Liège University Hospital, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre du Cerveau, Liège University Hospital, Liège, Belgium
- Joint International Research Unit on Consciousness, CERVO Brain Research Centre, Centre Intégré Universitaire de Santé et Services Sociaux (CIUSS), University Laval, Québec City, QC, Canada
| | - Aurore Thibaut
- Coma Science Group, GIGA-Consciousness Thematic Unit, GIGA-Research, Liège, Belgium
- Centre du Cerveau, Liège University Hospital, Liège, Belgium
- *Correspondence: Aurore Thibaut,
| |
Collapse
|
39
|
Zheng R, Qi Z, Thibaut A, Wang Z, Xu Z, Di H, Wu X, Mao Y, Laureys S. Clinical application of neuromodulation therapy in patients with disorder of consciousness: A pooled analysis of 544 participants. NeuroRehabilitation 2023; 53:491-503. [PMID: 37927281 DOI: 10.3233/nre-230103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
BACKGROUND The number of patients with disorders of consciousness (DoC) has increased dramatically with the advancement of intensive care and emergency medicine, which brings tremendous economic burdens and even ethical issues to families and society. OBJECTIVE To evaluate the effectiveness of neuromodulation therapy for patients with DoC. METHODS First, we conducted a literature review of individual patient data (IPD) on PubMed, EMBASE, and Cochrane-controlled trials following PRISMA guidelines. Then, we collected neuromodulation cases from our institution. Finally, we conducted a pooled analysis using the participants from the medical literature (n = 522) and our local institutions (n = 22). RESULTS In this pooled analysis of 544 patients with DoC with a mean age of 46.33 years, our results revealed that patients have improved CRS-R scores [1.0 points (95% CI, 0.57-1.42)] after neuromodulation. Among them, patients have better effectiveness in traumatic than non-traumatic etiology (P < 0.05). The effectiveness of consciousness improvement could be affected by the age, baseline consciousness state, and duration of stimulation. Compared with non-invasive intervention, an invasive intervention can bring more behavioral improvement (P < 0.0001) to MCS rather than UWS/VS patients. Importantly, neuromodulation is a valuable therapy even years after the onset of DoC. CONCLUSION This pooled analysis spotlights that the application of neuromodulation can improve the behavioral performance of patients with DoC. A preliminary trend is that age, etiology, baseline consciousness state, and stimulation duration could impact its effectiveness.
Collapse
Affiliation(s)
- Ruizhe Zheng
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- School of Basic Medical Sciences, Institutes of Brain Science, State Key Laboratory of Medical Neurobiology and Ministry of Education's (MOE) Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Zengxin Qi
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- School of Basic Medical Sciences, Institutes of Brain Science, State Key Laboratory of Medical Neurobiology and Ministry of Education's (MOE) Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Aurore Thibaut
- GIGA Consciousness Research Unit, Coma Science Group, Liège University, Liège, Belgium
- GIGA Consciousness, Centre du Cerveau, Liège University Hospital, Liège, Belgium
| | - Zhe Wang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- School of Basic Medical Sciences, Institutes of Brain Science, State Key Laboratory of Medical Neurobiology and Ministry of Education's (MOE) Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Zeyu Xu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- School of Basic Medical Sciences, Institutes of Brain Science, State Key Laboratory of Medical Neurobiology and Ministry of Education's (MOE) Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Haibo Di
- International Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Xuehai Wu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- School of Basic Medical Sciences, Institutes of Brain Science, State Key Laboratory of Medical Neurobiology and Ministry of Education's (MOE) Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Ying Mao
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- School of Basic Medical Sciences, Institutes of Brain Science, State Key Laboratory of Medical Neurobiology and Ministry of Education's (MOE) Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Steven Laureys
- GIGA Consciousness Research Unit, Coma Science Group, Liège University, Liège, Belgium
- GIGA Consciousness, Centre du Cerveau, Liège University Hospital, Liège, Belgium
- International Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
- Joint International Research Unit on Consciousness, CERVO Brain Research Centre, Laval University, Quebec, QC, Canada
| |
Collapse
|
40
|
Rousseaux F, Panda R, Toussaint C, Bicego A, Niimi M, Faymonville ME, Nyssen AS, Laureys S, Gosseries O, Vanhaudenhuyse A. Virtual reality hypnosis in the management of pain: Self-reported and neurophysiological measures in healthy subjects. Eur J Pain 2023; 27:148-162. [PMID: 36196745 PMCID: PMC10091709 DOI: 10.1002/ejp.2045] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 09/10/2022] [Accepted: 10/02/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Virtual reality hypnosis (VRH) has emerged as a new and promising option for pain management. Nonetheless, neural dynamics of pain modulation during VRH have not been investigated yet. The aim of this study was to measure the effects of VRH on pain, combining neurophysiological and self-reported measurements. METHODS Eighteen healthy subjects underwent noxious electrical stimulations in both normal wakefulness and VRH conditions. Dissociation, absorption, time perception, anxiety, pain intensity and unpleasantness, heart rate variability and breathing were reported for each condition. EEG signals were analysed using event-related potentials (ERP) and time-frequency response (TFR) time-locked to stimuli. Neurophysiological features were correlated with self-reported data. RESULTS VRH condition was associated with lower pain and higher dissociation. VRH significantly decreased amplitudes of N100 and P200 ERP components, reduced EEG power between 1 and 5 Hz from 100 to 560 ms, and increased EEG power from 5 to 11 Hz from 340 to 800 ms. These findings were observed at frontal, central and posterior electrodes. Heart rate variability was significantly higher and breathing frequency reduced with VRH. Correlations were found between the self-reported level of pain and ERP components. CONCLUSION VRH modulates cerebral pain processes and body physiology, leading to reduced pain levels. These findings offer a first insight on the analgesic mechanisms of VRH and suggest that VRH is an effective approach to reduce experimental pain. SIGNIFICANCE VRH decreases experimental pain perception, increases subject level of dissociation and modulates cerebral pain processing mechanisms. Pain can be managed with analgesic medication but also through complementary interventions. Among these, hypnosis and virtual reality (VR) are known to reduce pain for patients and healthy individuals. In recent years, an innovative technique combining hypnosis and VR has been proposed to help patients in managing pain. However, to our knowledge, no study has focused on the underlying mechanisms of this VR/hypnosis combination. We showed that VR combined with hypnosis decreases experimental pain, increases dissociation and influences EEG modulation.
Collapse
Affiliation(s)
- Floriane Rousseaux
- Sensation & Perception Research Group, GIGA Consciousness, University of Liege, GIGA (B34), Quartier Hopital, Liege, Belgium.,Laboratory of Cognitive Ergonomics and Work Intervention, University of Liege, ULiege (B32), Quartier Agora, Liege, Belgium
| | - Rajanikant Panda
- Coma Science Group, GIGA Consciousness, University of Liege, GIGA (B34), Quartier Hopital, Liege, Belgium.,Centre du Cerveau, University Hospital of Liège, Liege, Belgium
| | | | - Aminata Bicego
- Sensation & Perception Research Group, GIGA Consciousness, University of Liege, GIGA (B34), Quartier Hopital, Liege, Belgium.,Laboratory of Cognitive Ergonomics and Work Intervention, University of Liege, ULiege (B32), Quartier Agora, Liege, Belgium
| | - Masachika Niimi
- Coma Science Group, GIGA Consciousness, University of Liege, GIGA (B34), Quartier Hopital, Liege, Belgium
| | - Marie-Elisabeth Faymonville
- Sensation & Perception Research Group, GIGA Consciousness, University of Liege, GIGA (B34), Quartier Hopital, Liege, Belgium.,Algology Interdisciplinary Center, University Hospital of Liege, CHU Sart Tilman, Domaine Universitaire du Sart Tilman, Liège, Belgium
| | - Anne-Sophie Nyssen
- Sensation & Perception Research Group, GIGA Consciousness, University of Liege, GIGA (B34), Quartier Hopital, Liege, Belgium.,Laboratory of Cognitive Ergonomics and Work Intervention, University of Liege, ULiege (B32), Quartier Agora, Liege, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, University of Liege, GIGA (B34), Quartier Hopital, Liege, Belgium.,Centre du Cerveau, University Hospital of Liège, Liege, Belgium
| | - Olivia Gosseries
- Sensation & Perception Research Group, GIGA Consciousness, University of Liege, GIGA (B34), Quartier Hopital, Liege, Belgium.,Coma Science Group, GIGA Consciousness, University of Liege, GIGA (B34), Quartier Hopital, Liege, Belgium.,Centre du Cerveau, University Hospital of Liège, Liege, Belgium
| | - Audrey Vanhaudenhuyse
- Sensation & Perception Research Group, GIGA Consciousness, University of Liege, GIGA (B34), Quartier Hopital, Liege, Belgium.,Algology Interdisciplinary Center, University Hospital of Liege, CHU Sart Tilman, Domaine Universitaire du Sart Tilman, Liège, Belgium
| |
Collapse
|
41
|
Radstake WE, Jillings S, Laureys S, Demertzi A, Sunaert S, Van Ombergen A, Wuyts FL. Neuroplasticity in F16 fighter jet pilots. Front Physiol 2023; 14:1082166. [PMID: 36875024 PMCID: PMC9974643 DOI: 10.3389/fphys.2023.1082166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/09/2023] [Indexed: 02/17/2023] Open
Abstract
Exposure to altered g-levels causes unusual sensorimotor demands that must be dealt with by the brain. This study aimed to investigate whether fighter pilots, who are exposed to frequent g-level transitions and high g-levels, show differential functional characteristics compared to matched controls, indicative of neuroplasticity. We acquired resting-state functional magnetic resonance imaging data to assess brain functional connectivity (FC) changes with increasing flight experience in pilots and to assess differences in FC between pilots and controls. We performed whole-brain exploratory and region-of-interest (ROI) analyses, with the right parietal operculum 2 (OP2) and the right angular gyrus (AG) as ROIs. Our results show positive correlations with flight experience in the left inferior and right middle frontal gyri, and in the right temporal pole. Negative correlations were observed in primary sensorimotor regions. We found decreased whole-brain functional connectivity of the left inferior frontal gyrus in fighter pilots compared to controls and this cluster showed decreased functional connectivity with the medial superior frontal gyrus. Functional connectivity increased between the right parietal operculum 2 and the left visual cortex, and between the right and left angular gyrus in pilots compared to controls. These findings suggest altered motor, vestibular, and multisensory processing in the brains of fighter pilots, possibly reflecting coping strategies to altered sensorimotor demands during flight. Altered functional connectivity in frontal areas may reflect adaptive cognitive strategies to cope with challenging conditions during flight. These findings provide novel insights into brain functional characteristics of fighter pilots, which may be of interest to humans traveling to space.
Collapse
Affiliation(s)
| | - Steven Jillings
- Laboratory for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA Consciousness, GIGA Institute, University and University Hospital of Liège, Liège, Belgium
| | - Athena Demertzi
- Physiology of Cognition Lab, GIGA-CRC In Vivo Imaging, University of Liège, Liège, Belgium.,Psychology & Neuroscience of Cognition, University of Liège, Liège, Belgium
| | - Stefan Sunaert
- Translational MRI, Department of Imaging and Pathology, KU Leuven and University Hospital of Leuven, Leuven, Belgium
| | - Angelique Van Ombergen
- Laboratory for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium.,Department of Translational Neurosciences-ENT, University of Antwerp, Antwerp, Belgium
| | - Floris L Wuyts
- Laboratory for Equilibrium Investigations and Aerospace, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
42
|
Bicego A, Cassol H, Simon J, Fritz P, Abagnale S, Vanhaudenhuyse A, Laureys S, Martial C. Personality traits and pattern of beliefs of near-death(-like) experiencers. Front Hum Neurosci 2023; 17:1124739. [PMID: 37187942 PMCID: PMC10175626 DOI: 10.3389/fnhum.2023.1124739] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/17/2023] [Indexed: 05/17/2023] Open
Abstract
Introduction Little is known about the potential personality and psychological predictors of near-death experiences (NDEs), and fewer yet those of near-death-like experiences (NDEs-like; similar phenomenology reported after a non-life-threatening context). This study investigated whether personality traits (Openness, Extraversion, Pleasantness, Conscientiousness, and Neuroticism), dissociative experiences, Fantasy proneness, disposition toward auditory hallucinations, absorption trait, and endorsement of paranormal and spiritual beliefs could be associated with the recall of NDEs(-like). Methods To this aim, we invited four groups of people to retrospectively fill in questionnaires assessing the following factors: NDE experiencers (n = 63), NDE(-like) experiencers (n = 31), controls with a life-threatening situation but no NDE(-like) (n = 43), and controls without a life-threatening situation or an NDE(-like) (n = 44). We carried out univariate analyses for each factor and then performed a multiple regression analysis and a discriminant analysis. Results The multivariate logistic regression analysis revealed that the endorsement of spiritual beliefs was associated with the recall of NDEs-like while Openness and Fantasy proneness were associated with the recall of NDEs. The discriminant analysis showed that these variables produce 35% of correct classification. Discussion Albeit retrospective, these results pave the way for future research on psychological predictors of NDEs(-like) by highlighting the influence of Spirituality, Openness, and Fantasy proneness on these phenomena.
Collapse
Affiliation(s)
- Aminata Bicego
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
| | - Héléna Cassol
- Neurological and Functional Rehabilitation Center, University Hospital of Liège, Fraiture, Belgium
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
| | - Jessica Simon
- Psychology and Neuroscience of Cognition Research Unit (PsyNCog), University of Liège, Liège, Belgium
| | - Pauline Fritz
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Simona Abagnale
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
| | - Audrey Vanhaudenhuyse
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Interdisciplinary Algology Centre, University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- CERVO Brain Research Center, University of Laval, Québec, QC, Canada
| | - Charlotte Martial
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- *Correspondence: Charlotte Martial
| |
Collapse
|
43
|
Brunoni AR, Ekhtiari H, Antal A, Auvichayapat P, Baeken C, Benseñor IM, Bikson M, Boggio P, Borroni B, Brighina F, Brunelin J, Carvalho S, Caumo W, Ciechanski P, Charvet L, Clark VP, Cohen Kadosh R, Cotelli M, Datta A, Deng ZD, De Raedt R, De Ridder D, Fitzgerald PB, Floel A, Frohlich F, George MS, Ghobadi-Azbari P, Goerigk S, Hamilton RH, Jaberzadeh SJ, Hoy K, Kidgell DJ, Zonoozi AK, Kirton A, Laureys S, Lavidor M, Lee K, Leite J, Lisanby SH, Loo C, Martin DM, Miniussi C, Mondino M, Monte-Silva K, Morales-Quezada L, Nitsche MA, Okano AH, Oliveira CS, Onarheim B, Pacheco-Barrios K, Padberg F, Nakamura-Palacios EM, Palm U, Paulus W, Plewnia C, Priori A, Rajji TK, Razza LB, Rehn EM, Ruffini G, Schellhorn K, Zare-Bidoky M, Simis M, Skorupinski P, Suen P, Thibaut A, Valiengo LCL, Vanderhasselt MA, Vanneste S, Venkatasubramanian G, Violante IR, Wexler A, Woods AJ, Fregni F. Digitalized transcranial electrical stimulation: A consensus statement. Clin Neurophysiol 2022; 143:154-165. [PMID: 36115809 PMCID: PMC10031774 DOI: 10.1016/j.clinph.2022.08.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/16/2022] [Accepted: 08/20/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Although relatively costly and non-scalable, non-invasive neuromodulation interventions are treatment alternatives for neuropsychiatric disorders. The recent developments of highly-deployable transcranial electric stimulation (tES) systems, combined with mobile-Health technologies, could be incorporated in digital trials to overcome methodological barriers and increase equity of access. The study aims are to discuss the implementation of tES digital trials by performing a systematic scoping review and strategic process mapping, evaluate methodological aspects of tES digital trial designs, and provide Delphi-based recommendations for implementing digital trials using tES. METHODS We convened 61 highly-productive specialists and contacted 8 tES companies to assess 71 issues related to tES digitalization readiness, and processes, barriers, advantages, and opportunities for implementing tES digital trials. Delphi-based recommendations (>60% agreement) were provided. RESULTS The main strengths/opportunities of tES were: (i) non-pharmacological nature (92% of agreement), safety of these techniques (80%), affordability (88%), and potential scalability (78%). As for weaknesses/threats, we listed insufficient supervision (76%) and unclear regulatory status (69%). Many issues related to methodological biases did not reach consensus. Device appraisal showed moderate digitalization readiness, with high safety and potential for trial implementation, but low connectivity. CONCLUSIONS Panelists recognized the potential of tES for scalability, generalizability, and leverage of digital trials processes; with no consensus about aspects regarding methodological biases. SIGNIFICANCE We further propose and discuss a conceptual framework for exploiting shared aspects between mobile-Health tES technologies with digital trials methodology to drive future efforts for digitizing tES trials.
Collapse
Affiliation(s)
- Andre R Brunoni
- Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo & Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil; Laboratory of Neurosciences (LIM-27), Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA
| | - Andrea Antal
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Paradee Auvichayapat
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chris Baeken
- Vrije Universiteit Brussel (VUB): Department of Psychiatry University Hospital (UZBrussel), Brussels, Belgium; Department of Head and Skin, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, the Netherlands
| | - Isabela M Benseñor
- Center for Clinical and Epidemiological Research, University of São Paulo, São Paulo, Brazil
| | - Marom Bikson
- The Department of Biomedical Engineering, The City College of New York, The City University of New York, NY, USA
| | - Paulo Boggio
- Social and Cognitive Neuroscience Laboratory, Center for Biological Science and Health, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Filippo Brighina
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Jerome Brunelin
- Centre Hospitalier le Vinatier, Bron, France; INSERM U1028, CNRS UMR 5292, PSYR2 Team, Centre de recherche en Neurosciences de Lyon (CRNL), Université Lyon 1, Lyon, France
| | - Sandra Carvalho
- Translational Neuropsychology Lab, Department of Education and Psychology and William James Center for Research (WJCR), University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Wolnei Caumo
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil; Pain and Palliative Care Service at HCPA, Brazil; Department of Surgery, School of Medicine, UFRGS, Brazil
| | - Patrick Ciechanski
- Faculty of Medicine and Dentistry, University of Alberta, 1-002 Katz Group Centre for Pharmacy and Health Research, Edmonton, Alberta, Canada
| | - Leigh Charvet
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Vincent P Clark
- Psychology Clinical Neuroscience Center, Department of Psychology, The University of New Mexico, Albuquerque, NM, USA
| | - Roi Cohen Kadosh
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Abhishek Datta
- Research and Development, Soterix Medical Inc., New York, USA
| | - Zhi-De Deng
- Noninvasive Neuromodulation Unit, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | - Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Paul B Fitzgerald
- Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash University Department of Psychiatry, Camberwell, Victoria, Australia
| | - Agnes Floel
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany; German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Mark S George
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Peyman Ghobadi-Azbari
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; Department of Biomedical Engineering, Shahed University, Tehran, Iran
| | - Stephan Goerigk
- Department of Psychiatry and Psychotherapy, LMU Hospital, Munich, Germany; Department of Psychological Methodology and Assessment, LMU, Munich, Germany; Hochschule Fresenius, University of Applied Sciences, Munich, Germany
| | - Roy H Hamilton
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Shapour J Jaberzadeh
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Kate Hoy
- Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash University Department of Psychiatry, Camberwell, Victoria, Australia
| | - Dawson J Kidgell
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
| | - Arash Khojasteh Zonoozi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Adam Kirton
- Department of Clinical Neurosciences and Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liege, Belgium
| | - Michal Lavidor
- Bar Ilan University, Department of Psychology, and the Gonda Brain Research Center, Israel
| | - Kiwon Lee
- Ybrain Corporation, Gyeonggi-do, Republic of Korea
| | - Jorge Leite
- INPP, Portucalense University, Porto, Portugal
| | - Sarah H Lisanby
- Noninvasive Neuromodulation Unit, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Colleen Loo
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia
| | - Donel M Martin
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia
| | - Carlo Miniussi
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy
| | - Marine Mondino
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy; Centre Hospitalier le Vinatier, Bron, France
| | - Katia Monte-Silva
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, UFPE, Recife, PE, Brazil; NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Brazil
| | - Leon Morales-Quezada
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Alexandre H Okano
- NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Brazil; Center for Mathematics, Computation, and Cognition, Universidade Federal do ABC, São Bernardo do Campo, Brazil; Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
| | - Claudia S Oliveira
- Master's and Doctoral Program in Health Sciences, Faculty of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil; Master's and Doctoral Program in Human Movement and Rehabilitation, Evangelical University of Goiás, Anápolis, Brazil
| | | | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Ester M Nakamura-Palacios
- Laboratory of Cognitive Sciences and Neuropsychopharmacology, Program of Post-Graduation in Physiological Sciences, Health Sciences Center, Federal University of Espirito Santo, Vitória, ES, Brazil
| | - Ulrich Palm
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany; Medical Park Chiemseeblick, Rasthausstr. 25, 83233 Bernau-Felden, Germany
| | - Walter Paulus
- Department of Neurology. Ludwig Maximilians University Munich, Klinikum Großhadern, Marchioninistr, München, Germany
| | - Christian Plewnia
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Neurophysiology and Interventional Neuropsychiatry, University of Tübingen, Tübingen, Germany
| | - Alberto Priori
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Tarek K Rajji
- Centre for Addiction and Mental Health, Toronto, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Toronto Dementia Research Alliance, Toronto, Canada
| | - Lais B Razza
- Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Mehran Zare-Bidoky
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; School of Medicine, Shahid-Sadoughi University of Medical Sciences, Yazd, Iran
| | - Marcel Simis
- Physical and Rehabilitation Medicine Institute, General Hospital, Medical School of the University of Sao Paulo, São Paulo, Brazil
| | | | - Paulo Suen
- Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Aurore Thibaut
- Coma Science Group, GIGA-Consciousness & Centre du Cerveau, University and University Hospital of Liège, Liège, Belgium
| | - Leandro C L Valiengo
- Laboratory of Neurosciences (LIM-27), Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marie-Anne Vanderhasselt
- Department of Head and Skin, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
| | - Sven Vanneste
- Lab for Clinical & Integrative Neuroscience, Trinity College of Neuroscience, Trinity College Dublin, Ireland
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Ines R Violante
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Anna Wexler
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; Department of Neuroscience, University of Florida, Gainesville, FL, USA
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
44
|
Mainali S, Aiyagari V, Alexander S, Bodien Y, Boerwinkle V, Boly M, Brown E, Brown J, Claassen J, Edlow BL, Fink EL, Fins JJ, Foreman B, Frontera J, Geocadin RG, Giacino J, Gilmore EJ, Gosseries O, Hammond F, Helbok R, Claude Hemphill J, Hirsch K, Kim K, Laureys S, Lewis A, Ling G, Livesay SL, McCredie V, McNett M, Menon D, Molteni E, Olson D, O'Phelan K, Park S, Polizzotto L, Javier Provencio J, Puybasset L, Venkatasubba Rao CP, Robertson C, Rohaut B, Rubin M, Sharshar T, Shutter L, Sampaio Silva G, Smith W, Stevens RD, Thibaut A, Vespa P, Wagner AK, Ziai WC, Zink E, Suarez JI. Correction to: Proceedings of the Second Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness. Neurocrit Care 2022; 37:608-609. [PMID: 35715614 PMCID: PMC9519697 DOI: 10.1007/s12028-022-01536-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Shraddha Mainali
- Department of Neurology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
| | - Venkatesh Aiyagari
- Neurological Surgery and Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sheila Alexander
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yelena Bodien
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Varina Boerwinkle
- Division of Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Melanie Boly
- Departments of Neurology and Psychiatry, Wisconsin Institute for Sleep and Consciousness, University of Wisconsin, Madison, WI, USA
| | - Emery Brown
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jeremy Brown
- Office of Emergency Care Research, Division of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Jan Claassen
- Department of Neurology, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Brian L Edlow
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Ericka L Fink
- Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Joseph J Fins
- Division of Medical Ethics, Weill Cornell Medical College, New York, NY, USA
- Yale Law School, New Haven, CT, USA
| | - Brandon Foreman
- Division of Neurocritical Care, Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Jennifer Frontera
- Department of Neurology, New York University School of Medicine, New York, NY, USA
| | - Romergryko G Geocadin
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joseph Giacino
- Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Emily J Gilmore
- Comprehensive Epilepsy Center, Department of Neurology, Yale University, New Haven, CT, USA
| | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liege, Liege, Belgium
- Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Flora Hammond
- Indiana University Department of Physical Medicine and Rehabilitation, University of Indiana School of Medicine, Indianapolis, IN, USA
| | - Raimund Helbok
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - J Claude Hemphill
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Karen Hirsch
- Division of Neurocritical Care, Department of Neurology, Stanford University, Stanford, CA, USA
| | - Keri Kim
- College of Pharmacy, University of Illinois, Chicago, IL, USA
| | - Steven Laureys
- Coma Science Group, Cyclotron Research Center, University of Liege, Liege, Belgium
- Department of Neurology, Centre Hospitalier Universitaire Sart Tilman, University of Liege, Liege, Belgium
| | - Ariane Lewis
- Department of Neurology and Neurosurgery, New York University Langone Health, New York, NY, USA
| | - Geoffrey Ling
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sarah L Livesay
- Department of Adult Health and Gerontological Nursing, College of Nursing, Rush University, Chicago, IL, USA
| | - Victoria McCredie
- Interdepartmental Division of Critical Care, Department of Respirology, University of Toronto, Toronto, ON, Canada
| | - Molly McNett
- College of Nursing, Ohio State University, Columbus, OH, USA
| | - David Menon
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
| | - Erika Molteni
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - DaiWai Olson
- Neuroscience Intensive Care Unit, O'Donnell Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kristine O'Phelan
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Soojin Park
- Department of Neurology and Neurocritical Care, Columbia University, New York, NY, USA
| | - Len Polizzotto
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Jose Javier Provencio
- Department of Neurology and Neuroscience, University of Virginia, Charlottesville, VA, USA
| | - Louis Puybasset
- Department of Neuroradiology, University of Paris VI, Pierre et Marie Curie, Pitié-Salpêtrière Hospital, Paris, France
| | - Chethan P Venkatasubba Rao
- Division of Vascular Neurology and Neurocritical Care, CHI St. Luke's Health-Baylor St. Luke's Medical Center, Baylor College of Medicine, Houston, TX, USA
| | - Courtney Robertson
- Departments of Anesthesiology and Critical Care Medicine, and Pediatrics, Johns Hopkins Children's Center, The Johns Hopkins University School of Medcine, Baltimore, MD, USA
| | - Benjamin Rohaut
- Neuroscience Intensive Care Unit, Department of Neurology, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - Michael Rubin
- Neurological Surgery and Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tarek Sharshar
- Department of Intensive Care, Paris Descartes University, Paris, France
| | | | - Gisele Sampaio Silva
- Hospital Israelita Albert Einstein, Academic Research Organization and Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Wade Smith
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Robert D Stevens
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aurore Thibaut
- Coma Science Group, GIGA Consciousness, University of Liege, Liege, Belgium
- Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Paul Vespa
- Ronald Reagan UCLA Medical Center, UCLA Santa Monica Medical Center, Santa Monica, CA, USA
| | - Amy K Wagner
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Wendy C Ziai
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elizabeth Zink
- Department of Neuroscience Nursing, The Johns Hopkins Hospital, The Johns Hopkins University, Baltimore, MD, USA
| | - Jose I Suarez
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | |
Collapse
|
45
|
Panda R, Thibaut A, Lopez-Gonzalez A, Escrichs A, Bahri MA, Hillebrand A, Deco G, Laureys S, Gosseries O, Annen J, Tewarie P. Disruption in structural-functional network repertoire and time-resolved subcortical fronto-temporoparietal connectivity in disorders of consciousness. eLife 2022; 11:77462. [PMID: 35916363 PMCID: PMC9385205 DOI: 10.7554/elife.77462] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Understanding recovery of consciousness and elucidating its underlying mechanism is believed to be crucial in the field of basic neuroscience and medicine. Ideas such as the global neuronal workspace (GNW) and the mesocircuit theory hypothesize that failure of recovery in conscious states coincide with loss of connectivity between subcortical and frontoparietal areas, a loss of the repertoire of functional networks states and metastable brain activation. We adopted a time-resolved functional connectivity framework to explore these ideas and assessed the repertoire of functional network states as a potential marker of consciousness and its potential ability to tell apart patients in the unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS). In addition, the prediction of these functional network states by underlying hidden spatial patterns in the anatomical network, that is so-called eigenmodes, was supplemented as potential markers. By analysing time-resolved functional connectivity from functional MRI data, we demonstrated a reduction of metastability and functional network repertoire in UWS compared to MCS patients. This was expressed in terms of diminished dwell times and loss of nonstationarity in the default mode network and subcortical fronto-temporoparietal network in UWS compared to MCS patients. We further demonstrated that these findings co-occurred with a loss of dynamic interplay between structural eigenmodes and emerging time-resolved functional connectivity in UWS. These results are, amongst others, in support of the GNW theory and the mesocircuit hypothesis, underpinning the role of time-resolved thalamo-cortical connections and metastability in the recovery of consciousness.
Collapse
Affiliation(s)
| | | | - Ane Lopez-Gonzalez
- Center for Brain and Cognition, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Mohamed Ali Bahri
- GIGA-Cyclotron Research Centre-In Vivo Imaging, University of Liège, Liège, Belgium
| | - Arjan Hillebrand
- Department of Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Gustavo Deco
- Center for Brain and Cognition, Universitat Pompeu Fabra, Barcelona, Spain
| | | | | | - Jitka Annen
- Coma Science Group, University of Liège, Liège, Belgium
| | - Prejaas Tewarie
- School of Physics, University of Nottingham, Nottingham, United Kingdom
| |
Collapse
|
46
|
Mainali S, Aiyagari V, Alexander S, Bodien Y, Boerwinkle V, Boly M, Brown E, Brown J, Claassen J, Edlow BL, Fink EL, Fins JJ, Foreman B, Frontera J, Geocadin RG, Giacino J, Gilmore EJ, Gosseries O, Hammond F, Helbok R, Claude Hemphill J, Hirsch K, Kim K, Laureys S, Lewis A, Ling G, Livesay SL, McCredie V, McNett M, Menon D, Molteni E, Olson D, O'Phelan K, Park S, Polizzotto L, Javier Provencio J, Puybasset L, Venkatasubba Rao CP, Robertson C, Rohaut B, Rubin M, Sharshar T, Shutter L, Sampaio Silva G, Smith W, Stevens RD, Thibaut A, Vespa P, Wagner AK, Ziai WC, Zink E, I Suarez J. Proceedings of the Second Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness. Neurocrit Care 2022; 37:326-350. [PMID: 35534661 PMCID: PMC9283342 DOI: 10.1007/s12028-022-01505-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/29/2022] [Indexed: 12/21/2022]
Abstract
This proceedings article presents actionable research targets on the basis of the presentations and discussions at the 2nd Curing Coma National Institutes of Health (NIH) symposium held from May 3 to May 5, 2021. Here, we summarize the background, research priorities, panel discussions, and deliverables discussed during the symposium across six major domains related to disorders of consciousness. The six domains include (1) Biology of Coma, (2) Coma Database, (3) Neuroprognostication, (4) Care of Comatose Patients, (5) Early Clinical Trials, and (6) Long-term Recovery. Following the 1st Curing Coma NIH virtual symposium held on September 9 to September 10, 2020, six workgroups, each consisting of field experts in respective domains, were formed and tasked with identifying gaps and developing key priorities and deliverables to advance the mission of the Curing Coma Campaign. The highly interactive and inspiring presentations and panel discussions during the 3-day virtual NIH symposium identified several action items for the Curing Coma Campaign mission, which we summarize in this article.
Collapse
Affiliation(s)
- Shraddha Mainali
- Department of Neurology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
| | - Venkatesh Aiyagari
- Neurological Surgery and Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sheila Alexander
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yelena Bodien
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Varina Boerwinkle
- Division of Neurology, Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Melanie Boly
- Departments of Neurology and Psychiatry, Wisconsin Institute for Sleep and Consciousness, University of Wisconsin, Madison, WI, USA
| | - Emery Brown
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jeremy Brown
- Office of Emergency Care Research, Division of Clinical Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA
| | - Jan Claassen
- Department of Neurology, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Brian L Edlow
- Department of Neurology, Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Ericka L Fink
- Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Joseph J Fins
- Division of Medical Ethics, Weill Cornell Medical College, New York, NY, USA
- Yale Law School, New Haven, CT, USA
| | - Brandon Foreman
- Division of Neurocritical Care, Department of Neurology and Rehabilitation Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Jennifer Frontera
- Department of Neurology, New York University School of Medicine, New York, NY, USA
| | - Romergryko G Geocadin
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joseph Giacino
- Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Emily J Gilmore
- Comprehensive Epilepsy Center, Department of Neurology, Yale University, New Haven, CT, USA
| | - Olivia Gosseries
- Coma Science Group, GIGA Consciousness, University of Liege, Liege, Belgium
- Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Flora Hammond
- Indiana University Department of Physical Medicine and Rehabilitation, University of Indiana School of Medicine, Indianapolis, IN, USA
| | - Raimund Helbok
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - J Claude Hemphill
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Karen Hirsch
- Division of Neurocritical Care, Department of Neurology, Stanford University, Stanford, CA, USA
| | - Keri Kim
- College of Pharmacy, University of Illinois, Chicago, IL, USA
| | - Steven Laureys
- Coma Science Group, Cyclotron Research Center, University of Liege, Liege, Belgium
- Department of Neurology, Centre Hospitalier Universitaire Sart Tilman, University of Liege, Liege, Belgium
| | - Ariane Lewis
- Department of Neurology and Neurosurgery, New York University Langone Health, New York, NY, USA
| | - Geoffrey Ling
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sarah L Livesay
- Department of Adult Health and Gerontological Nursing, College of Nursing, Rush University, Chicago, IL, USA
| | - Victoria McCredie
- Interdepartmental Division of Critical Care, Department of Respirology, University of Toronto, Toronto, ON, Canada
| | - Molly McNett
- College of Nursing, Ohio State University, Columbus, OH, USA
| | - David Menon
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
| | - Erika Molteni
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - DaiWai Olson
- Neuroscience Intensive Care Unit, O'Donnell Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Kristine O'Phelan
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Soojin Park
- Department of Neurology and Neurocritical Care, Columbia University, New York, NY, USA
| | - Len Polizzotto
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Jose Javier Provencio
- Department of Neurology and Neuroscience, University of Virginia, Charlottesville, VA, USA
| | - Louis Puybasset
- Department of Neuroradiology, University of Paris VI, Pierre et Marie Curie, Pitié-Salpêtrière Hospital, Paris, France
| | - Chethan P Venkatasubba Rao
- Division of Vascular Neurology and Neurocritical Care, CHI St. Luke's Health-Baylor St. Luke's Medical Center, Baylor College of Medicine, Houston, TX, USA
| | - Courtney Robertson
- Departments of Anesthesiology and Critical Care Medicine, and Pediatrics, Johns Hopkins Children's Center, The Johns Hopkins University School of Medcine, Baltimore, MD, USA
| | - Benjamin Rohaut
- Neuroscience Intensive Care Unit, Department of Neurology, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - Michael Rubin
- Neurological Surgery and Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tarek Sharshar
- Department of Intensive Care, Paris Descartes University, Paris, France
| | | | - Gisele Sampaio Silva
- Hospital Israelita Albert Einstein, Academic Research Organization and Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Wade Smith
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Robert D Stevens
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aurore Thibaut
- Coma Science Group, GIGA Consciousness, University of Liege, Liege, Belgium
- Centre du Cerveau, University Hospital of Liege, Liege, Belgium
| | - Paul Vespa
- Ronald Reagan UCLA Medical Center, UCLA Santa Monica Medical Center, Santa Monica, CA, USA
| | - Amy K Wagner
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Wendy C Ziai
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Elizabeth Zink
- Department of Neuroscience Nursing, The Johns Hopkins Hospital, The Johns Hopkins University, Baltimore, MD, USA
| | - Jose I Suarez
- Division of Neurosciences Critical Care, Departments of Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | |
Collapse
|
47
|
Volovici V, Pisică D, Gravesteijn BY, Dirven CMF, Steyerberg EW, Ercole A, Stocchetti N, Nelson D, Menon DK, Citerio G, van der Jagt M, Maas AIR, Haitsma IK, Lingsma HF, Åkerlund C, Amrein K, Andelic N, Andreassen L, Audibert G, Azouvi P, Azzolini ML, Bartels R, Beer R, Bellander BM, Benali H, Berardino M, Beretta L, Beqiri E, Blaabjerg M, Lund SB, Brorsson C, Buki A, Cabeleira M, Caccioppola A, Calappi E, Calvi MR, Cameron P, Lozano GC, Castaño-León AM, Cavallo S, Chevallard G, Chieregato A, Coburn M, Coles J, Cooper JD, Correia M, Czeiter E, Czosnyka M, Dahyot-Fizelier C, Dark P, De Keyser V, Degos V, Corte FD, Boogert HD, Depreitere B, Dilvesi D, Dixit A, Dreier J, Dulière GL, Ezer E, Fabricius M, Foks K, Frisvold S, Furmanov A, Galanaud D, Gantner D, Ghuysen A, Giga L, Golubovic J, Gomez PA, Grossi F, Gupta D, Haitsma I, Helseth E, Hutchinson PJ, Jankowski S, Johnson F, Karan M, Kolias AG, Kondziella D, Koraropoulos E, Koskinen LO, Kovács N, Kowark A, Lagares A, Laureys S, Ledoux D, Lejeune A, Lightfoot R, Manara A, Martino C, Maréchal H, Mattern J, McMahon C, Menovsky T, Misset B, Muraleedharan V, Murray L, Negru A, Newcombe V, Nyirádi J, Ortolano F, Payen JF, Perlbarg V, Persona P, Piippo-Karjalainen A, Ples H, Pomposo I, Posti JP, Puybasset L, Radoi A, Ragauskas A, Raj R, Rhodes J, Richter S, Rocka S, Roe C, Roise O, Rosenfeld JV, Rosenlund C, Rosenthal G, Rossaint R, Rossi S, Sahuquillo J, Sandrød O, Sakowitz O, Sanchez-Porras R, Schirmer-Mikalsen K, Schou RF, Smielewski P, Sorinola A, Stamatakis E, Sundström N, Takala R, Tamás V, Tamosuitis T, Tenovuo O, Thomas M, Tibboel D, Tolias C, Trapani T, Tudora CM, Vajkoczy P, Vallance S, Valeinis E, Vámos Z, Van der Steen G, van Wijk RPJ, Vargiolu A, Vega E, Vik A, Vilcinis R, Vulekovic P, Williams G, Winzeck S, Wolf S, Younsi A, Zeiler FA, Ziverte A, Clusmann H, Voormolen D, van Dijck JTJM, van Essen TA. Comparative effectiveness of intracranial hypertension management guided by ventricular versus intraparenchymal pressure monitoring: a CENTER-TBI study. Acta Neurochir (Wien) 2022; 164:1693-1705. [PMID: 35648213 PMCID: PMC9233652 DOI: 10.1007/s00701-022-05257-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 05/11/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE To compare outcomes between patients with primary external ventricular device (EVD)-driven treatment of intracranial hypertension and those with primary intraparenchymal monitor (IP)-driven treatment. METHODS The CENTER-TBI study is a prospective, multicenter, longitudinal observational cohort study that enrolled patients of all TBI severities from 62 participating centers (mainly level I trauma centers) across Europe between 2015 and 2017. Functional outcome was assessed at 6 months and a year. We used multivariable adjusted instrumental variable (IV) analysis with "center" as instrument and logistic regression with covariate adjustment to determine the effect estimate of EVD on 6-month functional outcome. RESULTS A total of 878 patients of all TBI severities with an indication for intracranial pressure (ICP) monitoring were included in the present study, of whom 739 (84%) patients had an IP monitor and 139 (16%) an EVD. Patients included were predominantly male (74% in the IP monitor and 76% in the EVD group), with a median age of 46 years in the IP group and 48 in the EVD group. Six-month GOS-E was similar between IP and EVD patients (adjusted odds ratio (aOR) and 95% confidence interval [CI] OR 0.74 and 95% CI [0.36-1.52], adjusted IV analysis). The length of intensive care unit stay was greater in the EVD group than in the IP group (adjusted rate ratio [95% CI] 1.70 [1.34-2.12], IV analysis). One hundred eighty-seven of the 739 patients in the IP group (25%) required an EVD due to refractory ICPs. CONCLUSION We found no major differences in outcomes of patients with TBI when comparing EVD-guided and IP monitor-guided ICP management. In our cohort, a quarter of patients that initially received an IP monitor required an EVD later for ICP control. The prevalence of complications was higher in the EVD group. PROTOCOL The core study is registered with ClinicalTrials.gov , number NCT02210221, and the Resource Identification Portal (RRID: SCR_015582).
Collapse
|
48
|
Mat B, Sanz L, Arzi A, Boly M, Laureys S, Gosseries O. New behavioral signs of consciousness in patients with severe brain injuries. Semin Neurol 2022; 42:259-272. [PMID: 35738292 DOI: 10.1055/a-1883-0861] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Beril Mat
- Neurology, University of Wisconsin-Madison, Madison, United States.,Coma Science Group, University of Liege, Liege, Belgium
| | - Leandro Sanz
- Coma Science Group, University of Liege, Liege, Belgium
| | - Anat Arzi
- The Hebrew University of Jerusalem Department of Cognitive and Brain Sciences, Jerusalem, Israel
| | - Melanie Boly
- Neurology, University of Wisconsin-Madison, Madison, United States.,Psychiatry, University of Wisconsin-Madison, Madison, United States
| | | | | |
Collapse
|
49
|
Vitello MM, Szymkowicz E, Laureys S, Alnagger N, Gosseries O, Thibaut A. Neuroimaging and neurophysiological diagnosis and prognosis in paediatric disorders of consciousness. Dev Med Child Neurol 2022; 64:681-690. [PMID: 35089596 DOI: 10.1111/dmcn.15150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 12/01/2022]
Abstract
The diagnosis and prognosis of disorders of consciousness (DOC) such as coma, unresponsive wakefulness syndrome, or minimally conscious state are especially challenging in children. In some paediatric patients with severe acquired brain injury, medical comorbidities or developmental factors may obscure the detection of signs of consciousness via clinical assessments, thus leading to misdiagnosis. To circumvent these biases, patients benefit from multimodal assessments that combine behavioural, neuroimaging, and neurophysiological measures. In this review, we provide original data for such diagnostic procedures in children. Neuroimaging is largely underdocumented in children and most neurophysiological research consists of a cohort study design aimed at providing prognostic markers for clinical outcomes. The scarcity of available data on complementary diagnostic approaches in children makes it difficult to establish clear paediatric guidelines. Although there is preliminary evidence for the applicability of paradigms involving event-related potentials as support for diagnosis in children, more well-designed studies need to be conducted to promote evidence-based practices in paediatric DOC.
Collapse
Affiliation(s)
- Marie M Vitello
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Emilie Szymkowicz
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Naji Alnagger
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Aurore Thibaut
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.,Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| |
Collapse
|
50
|
van Essen TA, Lingsma HF, Pisică D, Singh RD, Volovici V, den Boogert HF, Younsi A, Peppel LD, Heijenbrok-Kal MH, Ribbers GM, Walchenbach R, Menon DK, Hutchinson P, Depreitere B, Steyerberg EW, Maas AIR, de Ruiter GCW, Peul WC, Åkerlund C, Amrein K, Andelic N, Andreassen L, Anke A, Antoni A, Audibert G, Azouvi P, Azzolini ML, Bartels R, Barzó P, Beauvais R, Beer R, Bellander BM, Belli A, Benali H, Berardino M, Beretta L, Blaabjerg M, Bragge P, Brazinova A, Brinck V, Brooker J, Brorsson C, Buki A, Bullinger M, Cabeleira M, Caccioppola A, Calappi E, Calvi MR, Cameron P, Carbayo Lozano G, Carbonara M, Castaño-León AM, Cavallo S, Chevallard G, Chieregato A, Citerio G, Clusmann H, Coburn MS, Coles J, Cooper JD, Correia M, Čović A, Curry N, Czeiter E, Czosnyka M, Dahyot-Fizelier C, Dark P, Dawes H, De Keyser V, Degos V, Della Corte F, Đilvesi Đ, Dixit A, Donoghue E, Dreier J, Dulière GL, Ercole A, Esser P, Ezer E, Fabricius M, Feigin VL, Foks K, Frisvold S, Furmanov A, Gagliardo P, Galanaud D, Gantner D, Gao G, George P, Ghuysen A, Giga L, Glocker B, Golubović J, Gomez PA, Gratz J, Gravesteijn B, Grossi F, Gruen RL, Gupta D, Haagsma JA, Haitsma I, Helbok R, Helseth E, Horton L, Huijben J, Jacobs B, Jankowski S, Jarrett M, Jiang JY, Johnson F, Jones K, Karan M, Kolias AG, Kompanje E, Kondziella D, Kornaropoulos E, Koskinen LO, Kovács N, Lagares A, Lanyon L, Laureys S, Lecky F, Ledoux D, Lefering R, Legrand V, Lejeune A, Levi L, Lightfoot R, Maegele M, Majdan M, Manara A, Manley G, Maréchal H, Martino C, Mattern J, McMahon C, Melegh B, Menovsky T, Mikolic A, Misset B, Muraleedharan V, Murray L, Nair N, Negru A, Nelson D, Newcombe V, Nieboer D, Nyirádi J, Oresic M, Ortolano F, Otesile O, Palotie A, Parizel PM, Payen JF, Perera N, Perlbarg V, Persona P, Piippo-Karjalainen A, Pirinen M, Ples H, Polinder S, Pomposo I, Posti JP, Puybasset L, Rădoi A, Ragauskas A, Raj R, Rambadagalla M, Rehorčíková V, Retel Helmrich I, Rhodes J, Richardson S, Richter S, Ripatti S, Rocka S, Roe C, Roise O, Rosand J, Rosenfeld J, Rosenlund C, Rosenthal G, Rossaint R, Rossi S, Rueckert D, Rusnák M, Sahuquillo J, Sakowitz O, Sanchez-Porras R, Sandor J, Schäfer N, Schmidt S, Schoechl H, Schoonman G, Schou RF, Schwendenwein E, Sewalt C, Skandsen T, Smielewski P, Sorinola A, Stamatakis E, Stanworth S, Kowark A, Stevens R, Stewart W, Stocchetti N, Sundström N, Takala R, Tamás V, Tamosuitis T, Taylor MS, Te Ao B, Tenovuo O, Theadom A, Thomas M, Tibboel D, Timmers M, Tolias C, Trapani T, Tudora CM, Unterberg A, Vajkoczy P, Valeinis E, Vallance S, Vámos Z, Van der Jagt M, van der Naalt J, Van der Steen G, van Dijck JT, Van Hecke W, van Heugten C, Van Praag D, Van Veen E, van Wijk R, Vande Vyvere T, Vargiolu A, Vega E, Velt K, Verheyden J, Vespa PM, Vik A, Vilcinis R, von Steinbüchel N, Voormolen D, Vulekovic P, Wang KK, Wiegers E, Williams G, Wilson L, Winzeck S, Wolf S, Yang Z, Ylén P, Zeiler FA, Ziverte A, Zoerle T. Surgery versus conservative treatment for traumatic acute subdural haematoma: a prospective, multicentre, observational, comparative effectiveness study. Lancet Neurol 2022; 21:620-631. [DOI: 10.1016/s1474-4422(22)00166-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 01/05/2023]
|