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Neuroimage-Based Consciousness Evaluation of Patients with Secondary Doubtful Hydrocephalus Before and After Lumbar Drainage

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Abstract

Hydrocephalus is often treated with a cerebrospinal fluid shunt (CFS) for excessive amounts of cerebrospinal fluid in the brain. However, it is very difficult to distinguish whether the ventricular enlargement is due to hydrocephalus or other causes, such as brain atrophy after brain damage and surgery. The non-trivial evaluation of the consciousness level, along with a continuous drainage test of the lumbar cistern is thus clinically important before the decision for CFS is made. We studied 32 secondary mild hydrocephalus patients with different consciousness levels, who received T1 and diffusion tensor imaging magnetic resonance scans before and after lumbar cerebrospinal fluid drainage. We applied a novel machine-learning method to find the most discriminative features from the multi-modal neuroimages. Then, we built a regression model to regress the JFK Coma Recovery Scale-Revised (CRS-R) scores to quantify the level of consciousness. The experimental results showed that our method not only approximated the CRS-R scores but also tracked the temporal changes in individual patients. The regression model has high potential for the evaluation of consciousness in clinical practice.

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Acknowledgements

This work was supported by the National Natural Science Foundation of China (81571025 and 81702461), the National Key Research and Development Program of China (2018YFC0116400), the International Cooperation Project from Shanghai Science Foundation (18410711300), Shanghai Science and Technology Development Funds (16JC1420100), the Shanghai Sailing Program (17YF1426600), STCSM (19QC1400600, 17411953300), the Shanghai Pujiang Program (19PJ1406800), the Shanghai Municipal Science and Technology Major Project (No.2018SHZDZX01) and ZJlab, and the Interdisciplinary Program of Shanghai Jiao Tong University.

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Author notes

  1. Jiayu Huo and Zengxin Qi have contributed equally to this work.

Authors and Affiliations

  1. Institute for Medical Imaging Technology, Shanghai Jiao Tong University, Shanghai, 200030, China

    Jiayu Huo, Sen Chen, Qian Wang & Lichi Zhang

  2. Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200030, China

    Zengxin Qi, Xuehai Wu, Di Zang, Tanikawa Hiromi & Jiaxing Tan

  3. Neurosurgical Institute of Fudan University, Shanghai Clinical Medical Center of Neurosurgery, Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200030, China

    Zengxin Qi, Xuehai Wu, Di Zang, Tanikawa Hiromi & Jiaxing Tan

  4. State Key Laboratory of Medical Neurobiology and Ministry of Education Frontiers Center for Brain Science, School of Basic Medical Sciences and Institutes of Brain Science, Fudan University, Shanghai, 200030, China

    Zengxin Qi, Xuehai Wu, Di Zang, Tanikawa Hiromi & Jiaxing Tan

  5. Department of Radiology, Huashan Hospital, Fudan University, Shanghai, 200030, China

    Weijun Tang

  6. Department of Radiology and Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA

    Dinggang Shen

  7. Department of Brain and Cognitive Engineering, Korea University, Seoul, 02841, Republic of Korea

    Dinggang Shen

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  1. Jiayu Huo
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  2. Zengxin Qi
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  3. Sen Chen
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  4. Qian Wang
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  8. Jiaxing Tan
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  9. Lichi Zhang
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  10. Weijun Tang
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  11. Dinggang Shen
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Corresponding authors

Correspondence to Lichi Zhang or Weijun Tang.

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Huo, J., Qi, Z., Chen, S. et al. Neuroimage-Based Consciousness Evaluation of Patients with Secondary Doubtful Hydrocephalus Before and After Lumbar Drainage. Neurosci. Bull. 36, 985–996 (2020). https://doi.org/10.1007/s12264-020-00542-2

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  • DOI: https://doi.org/10.1007/s12264-020-00542-2

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