Tan Xufei, Zhou Zhen, Gao Jian, Yu Yamei, Wei Ruili, Luo Benyan, Zhang Xiaotong
Department of Clinical Medicine, School of Medicine, Zhejiang University City College, Hangzhou, China.
Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA.
Brain Imaging Behav. 2022 Oct;16(5):1983-1991. doi: 10.1007/s11682-022-00668-z. Epub 2022 Jun 6.
White matter disruption plays an important role in disorders of consciousness (DOC). The aim of this study was to analyze the connectometry between DOC patients and healthy controls and to explore the relationship between diffusion connectometry and levels of consciousness. Fourteen patients with DOC and 13 sex- and age-matched controls were included in this study. The participants underwent diffusion magnetic resonance imaging (MRI) and T1-weighted structural MRI at 7 Tesla. Diffusion MRI connectometry was performed to investigate the differences between groups, and to subsequently study the correlation between Coma Recovery Scale-Revised (CRS-R) indexes and white matter integrity. In DOC patients, the quantitative anisotropy (QA) was significantly reduced in deep white matter tracts, whereas significantly higher QA values were found in the bilateral cerebellum compared with healthy controls. Moreover, the QA values in many tracts within the right hemisphere were higher in patients in a minimally conscious state compared to those in vegetative state/unresponsive wakefulness syndrome, which was reflected by the correlation between diffusion connectometry and CRS-R indexes. These results indicate that the cerebellum may play an important role in DOC, and the lateralization of the cerebral hemisphere in affected patients may suggest neural compensation.
白质破坏在意识障碍（DOC）中起重要作用。本研究旨在分析DOC患者与健康对照之间的连接组学，并探讨扩散连接组学与意识水平之间的关系。本研究纳入了14例DOC患者和13例性别及年龄匹配的对照。参与者在7特斯拉下接受了扩散磁共振成像（MRI）和T1加权结构MRI检查。进行扩散MRI连接组学研究以调查组间差异，并随后研究昏迷恢复量表修订版（CRS-R）指标与白质完整性之间的相关性。在DOC患者中，深部白质束的定量各向异性（QA）显著降低，而与健康对照相比，双侧小脑的QA值显著更高。此外，与植物状态/无反应觉醒综合征患者相比，处于最低意识状态的患者右半球内许多束的QA值更高，这通过扩散连接组学与CRS-R指标之间的相关性得以体现。这些结果表明，小脑可能在DOC中起重要作用，受影响患者大脑半球的侧化可能提示神经代偿。
