%0 Journal Article
%T Disorder of consciousness related pattern could distinguish minimally conscious state from unresponsive wakefulness syndrome: A F-18-FDG-PET study.
%A He Z
%A Lu R
%A Ge J
%A Guan Y
%A Chen Y
%A Liu G
%A Xie H
%A Bai Y
%A Wu Y
%A Wu J
%A Jia J
%J Brain Res Bull
%V 215
%N 0
%D 2024 Sep 2
%M 38964662
%F 3.715
%R 10.1016/j.brainresbull.2024.111023
%X <B>BACKGROUND: </B>Accurate evaluation of level of disorder of consciousness (DOC) is clinically challenging.<BR><B>OBJECTIVE: </B>This study aimed to establish a distinctive DOC-related pattern (DOCRP) for assessing disease severity and distinguishing unresponsive wakefulness syndrome (UWS) from minimally conscious state (MCS).<BR><B>METHODS: </B>Fifteen patients with DOC and eighteen health subjects with F-18-fluorodeoxyglucose (F-18-FDG) positron emission tomography (PET) were enrolled in this study. All patients were assessed by Coma Recovery Scale-Revised (CRS-R) and all individuals were randomly divided into two cohorts (Cohort A and B). DOCRP was identified in Cohort A and subsequently validated in Cohort B and A+B. We also assessed the discriminatory power of DOCRP between MCS and UWS.<BR><B>RESULTS: </B>The DOCRP was characterized bilaterally by relatively decreased metabolism in the medial and lateral frontal lobes, parieto-temporal lobes, cingulate gyrus and caudate, associated with relatively increased metabolism in the cerebellum and brainstem. DOCRP expression exhibited high accuracy in differentiating DOC patients from controls (P<0.0001, AUC=1.000), and furthermore could effectively distinguish MCS from UWS (P=0.037, AUC=0.821, sensitivity: 85.7 %, specificity: 75.0 %). Particularly in the subgroup of DOC patients survived global hypoxic-ischemic brain injury, DOCRP expression exhibited even better discriminatory power between MCS and UWS (P=0.046, AUC=1.000).<BR><B>CONCLUSIONS: </B>DOCRP might serve as an objective biomarker in distinguishing between UWS and MCS, especially in patients survived global hypoxic-ischemic brain injury.<BR><B>BACKGROUND: </B>ChiCTR2300073717 (Chinese clinical trial registry site, http://www.chictr.org).