Visual fixation in the vegetative state: an observational case series PET study.
Bruno, Marie-Aurélie ; Vanhaudenhuyse, Audrey ; Schnakers, Caroline et al
in BMC Neurology (2010), 10
BACKGROUND: Assessment of visual fixation is commonly used in the clinical examination of patients with disorders of consciousness. However, different international guidelines seem to disagree whether ... [more ▼]
BACKGROUND: Assessment of visual fixation is commonly used in the clinical examination of patients with disorders of consciousness. However, different international guidelines seem to disagree whether fixation is compatible with the diagnosis of the vegetative state (i.e., represents "automatic" subcortical processing) or is a sufficient sign of consciousness and higher order cortical processing. METHODS: We here studied cerebral metabolism in ten patients with chronic post-anoxic encephalopathy and 39 age-matched healthy controls. Five patients were in a vegetative state (without fixation) and five presented visual fixation but otherwise showed all criteria typical of the vegetative state. Patients were matched for age, etiology and time since insult and were followed by repeated Coma Recovery Scale-Revised (CRS-R) assessments for at least 1 year. Sustained visual fixation was considered as present when the eyes refixated a moving target for more than 2 seconds as defined by CRS-R criteria. RESULTS: Patients without fixation showed metabolic dysfunction in a widespread fronto-parietal cortical network (with only sparing of the brainstem and cerebellum) which was not different from the brain function seen in patients with visual fixation. Cortico-cortical functional connectivity with visual cortex showed no difference between both patient groups. Recovery rates did not differ between patients without or with fixation (none of the patients showed good outcome). CONCLUSIONS: Our findings suggest that sustained visual fixation in (non-traumatic) disorders of consciousness does not necessarily reflect consciousness and higher order cortical brain function. [less ▲]Detailed reference viewed: 27 (4 ULg)
Central neuromodulation in cluster headache patients treated with occipital nerve stimulators: A PET study
Magis, Delphine ; Bruno, Marie-Aurélie ; Fumal, Arnaud et al
in Acta Neurologica Belgica (2010), 110(Suppl 1), 17
OBJECTIVES: Use functional brain imaging to explore activity changes in centres involved in trigeminal pain processing and control before and after occipital neurostimulation in drug-resistant chronic ... [more ▼]
OBJECTIVES: Use functional brain imaging to explore activity changes in centres involved in trigeminal pain processing and control before and after occipital neurostimulation in drug-resistant chronic cluster headache patients. BACKGROUND: Occipital nerve stimulation (ONS) provides relief to about 60% of patients suffering from drug-resistant chronic cluster headache (drCCH). Its mode of action, however, remains elusive, but the long latency to meaningful effect suggests that ONS induces slow neuromodulation. METHODS: Ten drCCH patients underwent an 18FDG-PET scan after ONS durations varying between 0 and 30 months. All were scanned with ongoing ONS (ON) and with the stimulator switched OFF. RESULTS: After 6-30 months of ONS, 3 patients were pain free and 4 had a ≥ 90% reduction of attack frequency (responders). In patients overall compared to controls, several areas of the pain matrix were hypermetabolic: ipsilateral hypothalamus, midbrain and ipsilateral lower pons. All normalized after ONS, except the hypothalamus. Switching ON or OFF the stimulator had little influence on brain glucose metabolism. The perigenual anterior cingulate cortex (PACC) was hyperactive in ONS responders compared to non-responders. INTERPRETATION AND CONCLUSIONS: Metabolic normalization in the pain neuromatrix and lack of short-term changes induced by the stimulation support the hypothesis that ONS acts in drCCH through slow neuromodulatory processes. Selective activation in responders of PACC, a pivotal structure in the endogenous opioid system, suggests that ONS may restore balance within dysfunctioning pain control centres. That ONS is nothing but a symptomatic treatment might be illustrated by the persistent hypothalamic hypermetabolism which could explain why autonomic attacks may persist despite pain relief and why cluster attacks recur shortly after stimulator arrest. [less ▲]Detailed reference viewed: 34 (4 ULg)
Tumor-like MRS and PET findings in a case of radiation-induced brain necrosis, away from any tumor: an intringuing case report
Nguyen Khac, Minh-Tuan ; Hustinx, Roland ; Deprez, Manuel et al
Conference (2009, March 21)Detailed reference viewed: 35 (6 ULg)
The Role of PET/CT in the Monitoring and Diagnosis of Pediatric Inflammatory Bowel Disease.
Hustinx, Roland ; Louis, Edouard
in PET Clinics (2009), 3Detailed reference viewed: 18 (4 ULg)
Detecting consciousness in a total Locked-in syndrome: an active event related paradigm
Schnakers, Caroline ; ; et al
in Neurocase : Case Studies in Neuropsychology, Neuropsychiatry & Behavioural Neurology (2009), 25
Total locked-in syndrome is characterized by tetraplegia, anarthria and paralysis of eye motility. In this study, consciousness was detected in a 21-year-old woman who presented a total locked-in syndrome ... [more ▼]
Total locked-in syndrome is characterized by tetraplegia, anarthria and paralysis of eye motility. In this study, consciousness was detected in a 21-year-old woman who presented a total locked-in syndrome after a basilar artery thrombosis (49 days post-injury) using an active event-related paradigm. The patient was presented sequences of names containing the patient's own name and other names. The patient was instructed to count her own name or to count another target name. Similar to 4 age- and gender-matched healthy controls, the P3 response recorded for the voluntarily counted own name was larger than while passively listening. This P3 response was observed 14 days before the first behavioral signs of consciousness. This study shows that our active event-related paradigm allowed to identify voluntary brain activity in a patient who would behaviorally be diagnosed as comatose. [less ▲]Detailed reference viewed: 66 (9 ULg)
Nuclear (scintigraphic) methods and FDG-PET in rheumatoid osteoarthritis
Ribbens, Clio ; Hustinx, Roland
in Bruno, Michael A.; Mosher, Timothy J.; Gold, Gary E. (Eds.) Arthritis in Color. Advance Imaging of Arthritis. (2009)Detailed reference viewed: 26 (7 ULg)
Les anticorps monoclonaux en hématologie en 2009
Bonnet, Christophe ; Beguin, Yves ; De Prijck, Bernard et al
in Revue Médicale de Liège (2009), 64
Directed against the CD20 antigen on B lymphocytes, rituximab (MabThera) is now incorporated in the first line therapy of symptomatic follicular as well as diffuse large B cell non-Hodgkin's lymphoma and ... [more ▼]
Directed against the CD20 antigen on B lymphocytes, rituximab (MabThera) is now incorporated in the first line therapy of symptomatic follicular as well as diffuse large B cell non-Hodgkin's lymphoma and offers superior response and survival rates. 90Y ibritumomab tiuxetan (Zevalin) combines the specificity of rituximab for the CD20 antigen and the therapeutic effect of β irradiation. Given in monotherapy, it constitutes an interesting alternative therapy for follicular lymphomas in second relapse. Alemtuzumab (MabCampath) recognizes the CD52 antigen and offers encouraging results in chronic lymphocytic leukemia resistant to classical chemotherapy. [less ▲]Detailed reference viewed: 194 (14 ULg)
Functional imaging of abdominal aortic aneurysms : can it predict probability of rupture.
Sakalihasan, Natzi ; Hustinx, Roland ; et al
in VASCULAR ANEURYSMS (2009)Detailed reference viewed: 19 (5 ULg)
Evaluation of inflammatory cells in abdominal aortic aneurysmal wall by tomography emission positron
Sakalihasan, Natzi ; Hustinx, Roland ; et al
in Médecine Nucléaire : Imagerie Fonctionnelle et Métabolique (2009), 33/5Detailed reference viewed: 18 (11 ULg)
PET/CT in gastrointestinal tumors : fast technological changes lead to improved patient management
in PET Clinics (2008), 3Detailed reference viewed: 15 (3 ULg)
Can Positron Emission Tomography (PET) predict the risk of rupture of abdominal aortic aneurysm(AAA)?
Sakalihasan, Natzi ; Hustinx, Roland ; et al
in Controversies and updates in vascular surgery 2008 (2008)Detailed reference viewed: 25 (4 ULg)
Indications cliniques de la radiotherapie metabolique dans les lymphomes
Witvrouw, Nancy ; De Prijck, Bernard ; Hustinx, Roland
in Revue Médicale Suisse (2008), 4(168), 1818-22
In their later stages low grade lymphoma are incurable. These lymphomas being radio-sensitive, a treatment of metabolic radioimmunotherapy, using monoclonal antibodies (anti-CD20) as the carrier has been ... [more ▼]
In their later stages low grade lymphoma are incurable. These lymphomas being radio-sensitive, a treatment of metabolic radioimmunotherapy, using monoclonal antibodies (anti-CD20) as the carrier has been developed. The aim of this treatment is to use these antibodies to target radiation to tumor tissues while limiting toxicity to normal cells. Ibritumomab tiuxetan (Zevalin) is currently prescribed for patients with relapsed or refractory low-grade follicular lymphoma after rituximab treatment. This outpatient treatment has a high level of overall response rate including complete response and that for a long period. The side effects are essentially hematological and reversible. In the near future many more indications should become apparent and Zevalin should become an important tool in the B-cell lymphoma (low and high grade). [less ▲]Detailed reference viewed: 74 (4 ULg)
Evaluation of primary brain tumors with F-TYR and FDG PET : correlation with pathology and survival.
LOVINFOSSE, Pierre ; ; MARTIN, Didier et al
in Journal of Nuclear Medicine (The) (2008), 49(SUPPL), 77Detailed reference viewed: 5 (0 ULg)
PET/CT for assessing bone involvement in prostate and breast cancer.
WITHOFS, Nadia ; GRAYET, Benjamin ; et al
in Journal of Nuclear Medicine (The) (2008), 49(SUPPL), 21Detailed reference viewed: 5 (0 ULg)
Is FDG-PET/CT an early indicator of the clinical response to rituximab in rheumatoid arthritis ?
NAMUR, Gauthier ; KAISER, Marie-Joëlle ; et al
in Journal of Nuclear Medicine (The) (2008), 49(SUPPL), 10Detailed reference viewed: 9 (0 ULg)
Intrinsic brain activity in altered states of consciousness: how conscious is the default mode of brain function?
Boly, Mélanie ; Phillips, Christophe ; Tshibanda, Luaba et al
in Annals of the New York Academy of Sciences (2008), 1129
Spontaneous brain activity has recently received increasing interest in the neuroimaging community. However, the value of resting-state studies to a better understanding of brain-behavior relationships ... [more ▼]
Spontaneous brain activity has recently received increasing interest in the neuroimaging community. However, the value of resting-state studies to a better understanding of brain-behavior relationships has been challenged. That altered states of consciousness are a privileged way to study the relationships between spontaneous brain activity and behavior is proposed, and common resting-state brain activity features observed in various states of altered consciousness are reviewed. Early positron emission tomography studies showed that states of extremely low or high brain activity are often associated with unconsciousness. However, this relationship is not absolute, and the precise link between global brain metabolism and awareness remains yet difficult to assert. In contrast, voxel-based analyses identified a systematic impairment of associative frontoparieto-cingulate areas in altered states of consciousness, such as sleep, anesthesia, coma, vegetative state, epileptic loss of consciousness, and somnambulism. In parallel, recent functional magnetic resonance imaging studies have identified structured patterns of slow neuronal oscillations in the resting human brain. Similar coherent blood oxygen level-dependent (BOLD) systemwide patterns can also be found, in particular in the default-mode network, in several states of unconsciousness, such as coma, anesthesia, and slow-wave sleep. The latter results suggest that slow coherent spontaneous BOLD fluctuations cannot be exclusively a reflection of conscious mental activity, but may reflect default brain connectivity shaping brain areas of most likely interactions in a way that transcends levels of consciousness, and whose functional significance remains largely in the dark. [less ▲]Detailed reference viewed: 83 (8 ULg)