Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain.
J Neurotrauma. 2010 Jul;27(7):1187-93. doi: 10.1089/neu.2010.1297.
The thalamus is known to play a key role in arousal regulation and support of human consciousness. Neuropathological studies have identified thalamic damage as one of the most common abnormalities present in the brains of patients who were in a vegetative state (VS) or a minimally-conscious state (MCS) state at the time of their deaths. Nonetheless, no in vivo studies of thalamic abnormalities in these patients have been conducted. Using high-resolution T1-weighted magnetic resonance images and a novel approach to shape analysis, we investigated thalamic global and regional changes in a sample of patients in a VS or an MCS. Group comparisons and correlations with clinical variables were performed for the total thalamic volume and for each surface vertex. Total thalamic volume was significantly lower in patients than in healthy volunteers. Shape analysis revealed significant bilateral regional atrophy in the dorso-medial body in patients compared to controls; this atrophy was more widespread in VS than in MCS patients. Lower thalamic volume was significantly correlated with worse Disability Rating Scale scores. Shape analysis suggested that the dorso-medial nucleus and the internal medullar lamina were the main regions responsible for this correlation. Our findings suggest that MCS and VS patients present different patterns of regional thalamic abnormalities, and that these differences partially explain their clinical profile.
丘脑被认为在觉醒调节和支持人类意识方面发挥着关键作用。神经病理学研究已经确定，丘脑损伤是死亡时处于植物状态（VS）或最小意识状态（MCS）的患者大脑中最常见的异常之一。尽管如此，这些患者的丘脑异常的体内研究尚未进行。本研究使用高分辨率 T1 加权磁共振图像和一种新的形状分析方法，研究了 VS 或 MCS 患者样本中的丘脑整体和区域变化。对总丘脑体积和每个表面顶点进行了组间比较和与临床变量的相关性分析。与健康志愿者相比，患者的总丘脑体积明显降低。与对照组相比，患者的背内侧体存在双侧区域萎缩，在 VS 患者中比在 MCS 患者中更为广泛；较低的丘脑体积与较差的残疾评定量表评分显著相关。形状分析表明，背内侧核和内髓板是导致这种相关性的主要区域。我们的研究结果表明，MCS 和 VS 患者存在不同的丘脑区域异常模式，这些差异部分解释了他们的临床特征。
