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Brain Imaging and Behavior

, Volume 12, Issue 6, pp 1669–1677 | Cite as

White matter integrity correlates with residual consciousness in patients with severe brain injury

  • Lubin Wang
  • Yi Yang
  • Shanshan Chen
  • Mingmei Ge
  • Jianghong He
  • Zheng Yang
  • Pan LinEmail author
  • Xinhuai WuEmail author
ORIGINAL RESEARCH

Abstract

Previous studies have suggested that white matter disruption plays an important role in disorders of consciousness (DOC) after severe brain injury. Nevertheless, the integrity of white matter architecture supporting consciousness and its relations with clinical severity in patients with DOC remain to be established. In this study, diffusion tensor imaging (DTI) data was collected from 14 DOC patients and 15 healthy control subjects. We combined tract-based spatial statistics (TBSS) with region of interest (ROI) analysis to examine differences of DTI metrics on white matter skeletons between DOC patients and healthy controls, and the association between white matter integrity and patients’ residual consciousness assessed by Coma Recovery Scale-Revised (CRS-R). We found that: (1) patients with DOC had widespread white matter integrity disruptions, especially in the fornix; (2) the alteration of white matter microstructure was mainly attributed to the increase in radial diffusivity, possibly reflecting demyelination; (3) the behavioral CRS-R assessment score was positively correlated with white matter integrity in the fornix, uncinate fasciculus, pontine crossing tract, and posterior limb of internal capsule. Our results suggest that despite the widespread abnormalities of white matter following severe brain injury, the impairment of consciousness is likely to result from disruptions of key pathways that link brain regions in distributed networks.

Keywords

Disorder of consciousness Diffusion tensor imaging Tract-based spatial statistics Fornix Coma Recovery Scale-Revised 

Notes

Funding

This work was supported by the National Natural Science Foundation of China (61673391, 61473221, 81600919), and the Beijing Natural Science Foundation (7164302).

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the patients’ legal guardians and the normal control subjects in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Cognitive and Mental Health Research CenterBeijing Institute of Basic Medical SciencesBeijingChina
  2. 2.Department of NeurosurgeryPLA Army General HospitalBeijingChina
  3. 3.Department of RadiologyPLA Army General HospitalBeijingChina
  4. 4.Key Laboratory of Cognitive Science, College of Biomedical EngineeringSouth-Central University for NationalitiesWuhanChina
  5. 5.Hubei Key Laboratory of Medical Information Analysis and Tumor Diagnosis & Treatment, College of Biomedical EngineeringSouth-Central University for NationalitiesWuhanChina

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