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- Title
Brain Metabolism but Not Gray Matter Volume Underlies the Presence of Language Function in the Minimally Conscious State (MCS): MCS+ Versus MCS− Neuroimaging Differences.
- Authors
Aubinet, Charlène; Cassol, Helena; Gosseries, Olivia; Bahri, Mohamed Ali; Larroque, Stephen Karl; Majerus, Steve; Martial, Charlotte; Martens, Géraldine; Carrière, Manon; Chatelle, Camille; Laureys, Steven; Thibaut, Aurore
- Abstract
Background. The minimally conscious state (MCS) is subcategorized into MCS− and MCS+, depending on the absence or presence, respectively, of high-level behavioral responses such as command-following. Objective. We aim to investigate the functional and structural neuroanatomy underlying the presence of these responses in MCS− and MCS+ patients. Methods. In this cross-sectional retrospective study, chronic MCS patients were diagnosed using repeated Coma Recovery Scale–Revised assessments. Fluorodeoxyglucose-positron emission tomography data were acquired on 57 patients (16 MCS−; 41 MCS+) and magnetic resonance imaging with voxel-based morphometry analysis was performed on 66 patients (17 MCS−; 49 MCS+). Brain glucose metabolism and gray matter integrity were compared between patient groups and control groups. A metabolic functional connectivity analysis testing the hypothesis of preserved language network in MCS+ compared with MCS− was also done. Results. Patients in MCS+ presented higher metabolism mainly in the left middle temporal cortex, known to be important for semantic processing, compared with the MCS− group. The left angular gyrus was also functionally disconnected from the left prefrontal cortex in MCS− compared with MCS+ group. No significant differences were found in gray matter volume between patient groups. Conclusions. The clinical subcategorization of MCS is supported by differences in brain metabolism but not in gray matter structure, suggesting that brain function in the language network is the main support for recovery of command-following, intelligible verbalization and/or intentional communication in the MCS. Better characterizing the neural correlates of residual cognitive abilities of MCS patients contributes to reduce their misdiagnosis and to adapt therapeutic approaches.
- Subjects
AUDITORY cortex physiology; BRAIN metabolism; DEOXY sugars; LANGUAGE acquisition; LOSS of consciousness; MAGNETIC resonance imaging; NEURORADIOLOGY; RADIOPHARMACEUTICALS; SEMANTICS; TEMPORAL lobe; POSITRON emission tomography; CROSS-sectional method; RETROSPECTIVE studies; GRAY matter (Nerve tissue)
- Publication
Neurorehabilitation & Neural Repair, 2020, Vol 34, Issue 2, p172
- ISSN
1545-9683
- Publication type
Article
- DOI
10.1177/1545968319899914