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Regional Homogeneity Alterations in Patients with Impaired Consciousness. An Observational Resting-State fMRI Study

  • Functional Neuroradiology
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Abstract

Purpose

It is always challenging to correctly differentiate between minimally conscious state (MCS) and vegetative state/unresponsive wakefulness syndrome (VS/UWS) among disorders of consciousness (DOC) patients. However, the underlying neural mechanisms of awareness identification remain incompletely understood.

Methods

Using regional homogeneity (ReHo) analysis, we evaluated how regional connectivity of brain regions is disrupted in MCS and VS/UWS patients. Resting-state functional magnetic resonance imaging was conducted in 14 MCS patients, 25 VS/UWS patients, and 30 age-matched healthy individuals.

Results

We found that MCS and VS/UWS patients demonstrated DOC-dependent reduced ReHo within widespread brain regions including posterior cingulate cortices (PCC), medial prefrontal cortices (mPFC), and bilateral fronto-parieto-temporal cortices and showed increased ReHo in limbic structures. Moreover, a positive correlation between Coma Recovery Scale-Revised (CRS-R) total scores and reduced ReHo in the left precuneus was observed in VS/UWS patients, despite the linear trend was not found in MCS patients. In addition, ReHo were also observed reduced in three mainly intrinsic connectivity networks (ICNs), including default mode network (DMN), executive control network (ECN), and salience network (SN). Notably, as the clinical symptoms of consciousness disorders worsen from MCS to VS/UWS, ReHo in dorsal DMN, left ECN, and posterior SN became significantly reduced.

Conclusion

These findings make a further understanding of the underlying neural mechanism of regional connectivity among DOC patients and provide additional neuroimaging-based biomarkers for the clinical diagnosis of MCS and VS/UWS patients.

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Acknowledgements

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Radiology, Seventh Medical Center of Chinese, PLA General Hospital, No.5 Nanmencang, Dongcheng District, Beijing, 100700, China

    Yituo Wang, Ying Li, Xiaohu Ma, Ying Peng, Gang Hu, Bing Wu & Xinhuai Wu

  2. Beijing Engineering Research Center of Mixed Reality and Advanced Display, School of Optics and Photonics, Beijing Institute of Technology, No.5 Zhongguancun South Street, Haidian District, Beijing, 100081, China

    Shanshan Chen

Authors
  1. Yituo Wang
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  2. Ying Li
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  3. Xiaohu Ma
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  4. Shanshan Chen
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  5. Ying Peng
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  6. Gang Hu
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  7. Bing Wu
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  8. Xinhuai Wu
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Corresponding author

Correspondence to Xinhuai Wu.

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Conflict of interest statement

The authors declare no competing interests.

Ethics approval

Ethical approval was waived by the local Ethics Committee of Seventh Medical Center of Chinese PLA General Hospital in view of the retrospective nature of the study, and all the procedures being performed were part of the routine care.

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Informed consent was obtained from healthy volunteers and from the legal surrogate of each patient included in the study.

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The authors affirm that human research participants provided informed consent for publication of the images in Figs. 1 and 2.

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Wang, Y., Li, Y., Ma, X. et al. Regional Homogeneity Alterations in Patients with Impaired Consciousness. An Observational Resting-State fMRI Study. Neuroradiology 64, 1391–1399 (2022). https://doi.org/10.1007/s00234-022-02911-2

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  • DOI: https://doi.org/10.1007/s00234-022-02911-2

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