Disorder of Consciousness
Conditions
Brief summary
To compare functional connectivity after severe traumatic brain injury (TBI) between a group of post-comatose TBI with restored consciousness and a group of post-comatose TBI with persistant disorder of consciousness at admission in rehabilitation
Detailed description
Recovery of consciousness can be impaired in severe traumatic brain injury (TBI). Prognostic factors are sparse and mostly clinical (mainly the initial Glasgow coma scale GCS) (1). Functional magnetic resonance imaging (fMRI) could allow a better understanding of functional recovery. Graph method has been applied to fMRI signal analysis in disorder of consciousness (DOC) due to post-anoxic encephalopathy. Comatose state was characterized by dramatic change in local connectivity (hub location) without significant change in global connectivity (2). The present study aims at describing functional connectivity in DOC following severe TBI. We will record resting state fMRI in TBI patients in two clinical conditions: conscious state versus DOC state.
Interventions
PROCEDUREMRI: functional (resting state) and structural (DTI)
One hour brain MRI recording without active task for the patient, no sedation
Sponsors
University Hospital, Grenoble
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* severe TBI * no general anesthesia since 7 days * no neuroleptic nor hypnotic drug since 3 days * medical criteria fulfilled to be discharged from ICU * medical insurance
Exclusion criteria
* age \< 18 * contra indication to MRI * consent refusal from the family * neurological trouble before TBI * patient protected by law
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| cortical functional connectivity | connectivity index measured on MRI recorded at discharge from intensive care unit (ICU) (30 days post-TBI on average) and compared between the two groups of patients (group normal level of consciousness versus group disorder of consciousness) | the index is calculated from methodology of the article cited below (2) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| consciousness level measured with Coma recovery scale -revised (CRS-R) | CRS-R score at discharge from intensive care unit (ICU) (30 days post-TBI on average) | — |
| cortical functional connectivity change | connectivity index change (measured on MRI done day 60 after first MRI and compared to MRI done on day 0 | — |
| Slow wave sleep quantification | EEG at discharge from intensive care unit (ICU) (30 days post-TBI on average) | Electroencephalographic recording on 12 consecutive hours by night |
| structural connectivity | DTI At discharge from intensive care unit (ICU) (30 days post-TBI on average) | fibers density between region of interest by DTI |
Countries
France
Outcome results
None listed