Wang Yituo, Chen Shanshan, Xia Xiaoyu, Peng Ying, Wu Bing
Department of Radiology, Seventh Medical Center of Chinese PLA General Hospital, Beijing, China.
Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, Beijing, China.
Front Behav Neurosci. 2022 Oct 10;16:1001519. doi: 10.3389/fnbeh.2022.1001519. eCollection 2022.
The purpose of this study was to investigate changes in functional connectivity and regional brain activity between and within the default mode network (DMN), salience network (SN), and executive control network (ECN) among individuals with disorders of consciousness (DOC) in the conditions of minimally conscious state (MCS) and vegetative-state/unresponsive wakefulness syndrome (VS/UWS). Twenty-five VS/UWS patients, 14 MCS patients, and 30 healthy individuals as normal control, completed resting-state fMRI scans. ROI-wise functional connectivity and fractional amplitude of low-frequency fluctuation (fALFF) were implemented to examine group differences. All ROI-wise and fALFF analyses masks were identified from the triple-network model. ROI-wise analyses indicated significantly decreased functional connectivity between posterior cingulate cortex (DMN)-left anterior insula (SN), right anterior insula (SN)-left dorsolateral prefrontal cortex (ECN), and right anterior insula (SN)-right amygdala (SN) in VS/UWS patients compared to MCS patients. Moreover, fALFF were observed reduced in the triple-network across all DOC patients, and as the clinical manifestations of DOC deteriorated from MCS to VS/UWS, fALFF in dorsal DMN, anterior/posterior SN, and left ECN became significantly reduced. Moreover, a positive correlation between fALFF of the left ECN and Coma Recovery Scale-Revised (CRS-R) total scores was found across all DOC patients. These findings contribute to a better understanding of the underlying neural mechanism of functional connectivity and regional brain activity in DOC patients, and this triple-network model provides new connectivity pattern changes that may be integrated in future diagnostic tools based on the neural signatures of conscious states.
本研究的目的是调查在最低意识状态（MCS）和植物状态/无反应觉醒综合征（VS/UWS）条件下，意识障碍（DOC）个体默认模式网络（DMN）、突显网络（SN）和执行控制网络（ECN）之间以及内部的功能连接性和局部脑活动的变化。25名VS/UWS患者、14名MCS患者和30名健康个体作为正常对照，完成了静息态功能磁共振成像扫描。采用基于感兴趣区（ROI）的功能连接性和低频振幅分数（fALFF）来检查组间差异。所有基于ROI的分析和fALFF分析掩码均从三网络模型中确定。基于ROI的分析表明，与MCS患者相比，VS/UWS患者后扣带回皮质（DMN）-左侧前脑岛（SN）、右侧前脑岛（SN）-左侧背外侧前额叶皮质（ECN）以及右侧前脑岛（SN）-右侧杏仁核（SN）之间的功能连接性显著降低。此外，在所有DOC患者的三网络中均观察到fALFF降低，并且随着DOC的临床表现从MCS恶化为VS/UWS，背侧DMN、前/后SN以及左侧ECN中的fALFF显著降低。此外，在所有DOC患者中发现左侧ECN的fALFF与昏迷恢复量表修订版（CRS-R）总分之间存在正相关。这些发现有助于更好地理解DOC患者功能连接性和局部脑活动的潜在神经机制，并且这种三网络模型提供了新的连接模式变化，未来可能会整合到基于意识状态神经特征的诊断工具中。
