Ascending arousal network connectivity during recovery from traumatic coma

Model System:

TBI

Reference Type:

Journal article

Accession No.:

J89292

Journal:

NeuroImage: Clinical

Year, Volume, Issue, Page(s):

2020 , 28, , 102503

Publication Website:

Abstract:

Study examined longitudinal changes in ascending arousal network (AAN) connectivity during post-traumatic recovery of consciousness and identified AAN connections that may discriminate between patients with or without a chronic disorder of consciousness (DoC) after severe traumatic brain injury. Sixteen patients with acute traumatic coma and 16 matched healthy controls were scanned with high angular resolution diffusion imaging. All patients recovered consciousness (Recovery Cohort). Nine were scanned longitudinally: first in the intensive care unit (Acute), then at ≥5 months post-injury (Follow-up). Six separate patients with post-traumatic DoC were scanned ≥5 months post-injury (Chronic-DoC Cohort). For each AAN pathway, the median relative change in Acute-to-Follow-up Connectivity Probability (CP) was computed in the Recovery Cohort. Wilcoxon tests with Bonferroni correction were then used to compare CP in each AAN pathway in the Recovery Cohort at Follow-up versus the Chronic-DoC Cohort. Principal component analysis (PCA) was used to determine whether linear combinations of AAN CP values could separate the Chronic-DoC Cohort from the Recovery Cohort and the healthy controls. In the Recovery Cohort, the largest relative AAN CP changes were in the brainstem-to-thalamus and forebrain-to-occipital lobe pathways. The AAN connections that differed in the cross-sectional analysis between the Recovery Cohort at Follow-up and the Chronic-DoC Cohort included brainstem-to-hypothalamus, brainstem-to-temporal lobe, and thalamus-to-temporal lobe. Plotting the first two principal components of AAN connectivity resulted in a linear separation of Chronic-DoC patients from other study groups. The results provide evidence for a longitudinal increase in brainstem-thalamic connectivity during recovery of consciousness after traumatic coma. The observations provide the basis for further investigation into AAN connectivity as a biomarker for recovery of consciousness after traumatic coma.

Author(s):