References of "Laureys, Steven"
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See detailPain and Nociception in Disorders of Consciousness
Chatelle, Camille ULg; LAUREYS, Steven ULg; Demertzi, Athina ULg

in Luis Garcia-Larrea, France; Jackson, Philip L. (Eds.) Pain and the Conscious Brain (2016)

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See detailA human brain network derived from coma-causing brainstem lesions
Fischer, David; Boes, A.D; Demertzi, Athina ULg et al

in Neurology (2016), 87(23), 2427-2434

OBJECTIVE To characterize a brainstem location specific to coma-causing lesions, and its functional connectivity network. METHODS We compared 12 coma-causing brainstem lesions to 24 control brainstem ... [more ▼]

OBJECTIVE To characterize a brainstem location specific to coma-causing lesions, and its functional connectivity network. METHODS We compared 12 coma-causing brainstem lesions to 24 control brainstem lesions using voxel-based lesion-symptom mapping in a case-control design to identify a site significantly associated with coma. We next used resting-state functional connectivity from a healthy cohort to identify a network of regions functionally connected to this brainstem site. We further investigated the cortical regions of this network by comparing their spatial topography to that of known networks and by evaluating their functional connectivity in patients with disorders of consciousness. RESULTS A small region in the rostral dorsolateral pontine tegmentum was significantly associated with coma-causing lesions. In healthy adults, this brainstem site was functionally connected to the ventral anterior insula (AI) and pregenual anterior cingulate cortex (pACC). These cortical areas aligned poorly with previously defined resting-state networks, better matching the distribution of von Economo neurons. Finally, connectivity between the AI and pACC was disrupted in patients with disorders of consciousness, and to a greater degree than other brain networks. CONCLUSIONS Injury to a small region in the pontine tegmentum is significantly associated with coma. This brainstem site is functionally connected to 2 cortical regions, the AI and pACC, which become disconnected in disorders of consciousness. This network of brain regions may have a role in the maintenance of human consciousness [less ▲]

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See detailNeural correlates of consciousness in patients who have emerged from a minimally conscious state: A cross-sectional multimodal imaging study
Di Perri, Carol ULg; Bahri, Mohamed Ali ULg; Amico, Enrico ULg et al

in Lancet Neurology (2016), 15

Background Between pathologically impaired consciousness and normal consciousness exists a scarcely researched transition zone, referred to as emergence from minimally conscious state, in which patients ... [more ▼]

Background Between pathologically impaired consciousness and normal consciousness exists a scarcely researched transition zone, referred to as emergence from minimally conscious state, in which patients regain the capacity for functional communication, object use, or both. We investigated neural correlates of consciousness in these patients compared with patients with disorders of consciousness and healthy controls, by multimodal imaging. Methods In this cross-sectional, multimodal imaging study, patients with unresponsive wakefulness syndrome, patients in a minimally conscious state, and patients who had emerged from a minimally conscious state, diagnosed with the Coma Recovery Scale–Revised, were recruited from the neurology department of the Centre Hospitalier Universitaire de Liège, Belgium. Key exclusion criteria were neuroimaging examination in an acute state, sedation or anaesthesia during scanning, large focal brain damage, motion parameters of more than 3 mm in translation and 3° in rotation, and suboptimal segmentation and normalisation. We acquired resting state functional and structural MRI data and ¹⁸F-fl uorodeoxyglucose (FDG) PET data; we used seed-based functional MRI (fMRI) analysis to investigate positive default mode network connectivity (within-network correlations) and negative default mode network connectivity (between-network anticorrelations). We correlated FDG-PET brain metabolism with fMRI connectivity. We used voxel- based morphometry to test the eff ect of anatomical deformations on functional connectivity. Findings We recruited a convenience sample of 58 patients (21 [36%] with unresponsive wakefulness syndrome, 24 [41%] in a minimally conscious state, and 13 [22%] who had emerged from a minimally conscious state) and 35 healthy controls between Oct 1, 2009, and Oct 31, 2014. We detected consciousness-level-dependent increases (from unresponsive wakefulness syndrome, minimally conscious state, emergence from minimally conscious state, to healthy controls) for positive and negative default mode network connectivity, brain metabolism, and grey matter volume (p<0·05 false discovery rate corrected for multiple comparisons). Positive default mode network connectivity diff ered between patients and controls but not among patient groups (F test p<0·0001). Negative default mode network connectivity was only detected in healthy controls and in those who had emerged from a minimally conscious state; patients with unresponsive wakefulness syndrome or in a minimally conscious state showed pathological between-network positive connectivity (hyperconnectivity; F test p<0·0001). Brain metabolism correlated with positive default mode network connectivity (Spearman’s r=0·50 [95% CI 0·26 to 0·61]; p<0·0001) and negative default mode network connectivity (Spearman’s r=–0·52 [–0·35 to –0·67); p<0·0001). Grey matter volume did not diff er between the studied groups (F test p=0·06). Interpretation Partial preservation of between-network anticorrelations, which are seemingly of neuronal origin and cannot be solely explained by morphological deformations, characterise patients who have emerged from a minimally conscious state. Conversely, patients with disorders of consciousness show pathological between-network correlations. Apart from a deeper understanding of the neural correlates of consciousness, these fi ndings have clinical implications and might be particularly relevant for outcome prediction and could inspire new therapeutic options. [less ▲]

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See detailPositron Emission Tomography: Basic Principles, New Applications, and Studies Under Anesthesia
KIRSCH, Murielle ULg; Wannez, Sarah ULg; Thibaut, Aurore ULg et al

in International Anesthesiology Clinics (2016)

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See detailLarge-scale signatures of unconsciousness are consistent with a departure from critical dynamics
Tagliazucchi, E.; Chialvo, D. R.; Siniatchkin, M. et al

in Journal of the Royal Society Interface (2016), 13(114),

Loss of cortical integration and changes in the dynamics of electrophysiological brain signals characterize the transition from wakefulness towards unconsciousness. In this study, we arrive at a basic ... [more ▼]

Loss of cortical integration and changes in the dynamics of electrophysiological brain signals characterize the transition from wakefulness towards unconsciousness. In this study, we arrive at a basic model explaining these observations based on the theory of phase transitions in complex systems. We studied the link between spatial and temporal correlations of large-scale brain activity recorded with functional magnetic resonance imaging during wakefulness, propofol-induced sedation and loss of consciousness and during the subsequent recovery. We observed that during unconsciousness activity in frontothalamic regions exhibited a reduction of long-range temporal correlations and a departure of functional connectivity from anatomical constraints. A model of a system exhibiting a phase transition reproduced our findings, as well as the diminished sensitivity of the cortex to external perturbations during unconsciousness. This framework unifies different observations about brain activity during unconsciousness and predicts that the principles we identified are universal and independent from its causes. © 2016 The Author(s) Published by the Royal Society. All rights reserved. [less ▲]

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See detailImaging the Central Nervous System
Bodart, Olivier ULg; Laureys, Steven ULg

in Webb, A.; Angus, D.; Finfer, S. (Eds.) et al Oxford Textbook of Critical Care, Second Edition (2016)

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See detailIs the Nociception Coma Scale-Revised a Useful Clinical Tool for Managing Pain in Patients with Disorders of Consciousness?
Chatelle, Camille ULg; De Val, Marie Daniele; Catano, Antonio et al

in The Clinical journal of pain (2016)

OBJECTIVES: Our objective was to assess the clinical interest of the Nociception Coma Scale Revised (NCS-R) in pain management of patients with disorders of consciousness. METHODS: Thirty-nine patients ... [more ▼]

OBJECTIVES: Our objective was to assess the clinical interest of the Nociception Coma Scale Revised (NCS-R) in pain management of patients with disorders of consciousness. METHODS: Thirty-nine patients with potential painful conditions (e.g., due to fractures, decubitus ulcers or spasticity) were assessed during nursing cares before and after the administration of an analgesic treatment tailored to each patient's clinical status. In addition to the NCS-R, the Glasgow Coma Scale (GCS) was used before and during treatment in order to observe fluctuations in consciousness. Twenty-three of them had no analgesic treatment prior to the assessment whereas the analgesic treatment has been adapted in the other 16 patients. We performed non-parametric Wilcoxon tests to investigate the difference in the NCS-R and GCS total scores but also in the NCS-R subscores before versus during treatment. The effect of the level of consciousness and the etiology were assessed using a U Mann Whitney. RESULTS: NCS-R total scores were statistically lower during treatment when compared to the scores obtained before treatment. We also found that the motor, verbal and facial expression subscores were lower during treatment than before treatment. On the other hand, we found no difference between the GCS total scores obtained before versus during treatment. DISCUSSION: Our results suggest that the NCS-R is an interesting clinical tool for pain management. Besides, this tool seems useful when a balance is needed between reduced pain and preserved level of consciousness in patients with disorders of consciousness. [less ▲]

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See detailAssessing Pain and Communication in Disorders of Consciousness
Chatelle, Camille ULg; LAUREYS, Steven ULg

Book published by Psychology Press (2015)

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See detailBrain stimulation in patients with disorders of consciousness
Thibaut, Aurore ULg; Laureys, Steven ULg

in Principles and Practice of Clinical Research (2015), 1(3),

Background and Aim: There is a long history of brain stimulation in medical science, and it was tested for years trying to treat several neurological diseases. On the other hand, the treatment choices for ... [more ▼]

Background and Aim: There is a long history of brain stimulation in medical science, and it was tested for years trying to treat several neurological diseases. On the other hand, the treatment choices for patients with severe brain injury resulting in disorders of consciousness (DOC) are still limited and research in this field remains challenging. In the current literature, only a few techniques of brain stimulation were studied in this population of patients. This review describes noninvasive techniques, namely transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), which permit to stimulate the brain through the scalp, as well as the current status of deep brain stimulation (DBS) as treatment for patients with DOC. For each technique (i.e. TMS, tDCS and DBS) a systematic search on Pubmed was performed including the term “vegetative state” or “minimally conscious state” or “disorders of consciousness” and 16 articles matched the criteria. Conclusion: Currently, repetitive TMS (rTMS) and tDCS studies have shown encouraging results, with transient improvements of behavioral signs of consciousness in patients in minimally conscious state (MCS). DBS showed more impressive and extensive behavioral improvement after the implantation of an electrical stimulator in the thalamus. However, this procedure is riskier and the number of patients who can benefit from this intervention is limited. All these therapeutic approaches are still in their infancy. In the years to follow, controlled clinical studies on potential treatments for patients with DOC should multiply and therapeutic measures should be more accessible, controlled and effective. [less ▲]

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See detailBreakthrough in cardiac arrest: reports from the 4th Paris International Conference.
Kudenchuk, PJ; Sandroni, C; Drinhaus, HR et al

in Annals of Intensive Care (2015)

Jean-Luc Diehl The French Intensive Care Society organized on 5th and 6th June 2014 its 4th Paris International Conference in Intensive Care", whose principle is to bring together the best international ... [more ▼]

Jean-Luc Diehl The French Intensive Care Society organized on 5th and 6th June 2014 its 4th Paris International Conference in Intensive Care", whose principle is to bring together the best international experts on a hot topic in critical care medicine. The 2014 theme was "Breakthrough in cardiac arrest", with many high-quality updates on epidemiology, public health data, pre-hospital and in-ICU cares. The present review includes short summaries of the major presentations, classified into six main chapters: Epidemiology of CA Pre-hospital management Post-resuscitation management: targeted temperature management Post-resuscitation management: optimizing organ perfusion and metabolic parameters Neurological assessment of brain damages Public healthcare." [less ▲]

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See detailPrevalence of increases in functional connectivity in visual, somatosensory and language areas in congenital blindness
Heine, Lizette ULg; Bahri, Mohamed Ali ULg; cavaliere, Carlo et al

in Frontiers in Neuroanatomy (2015), 3(295),

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See detailCerebral functional connectivity periodically (de)synchronizes with anatomical constraints
Liegeois, Raphaël ULg; Ziegler, Erik; Bahri, Mohamed Ali ULg et al

in Brain Structure and Function (2015)

This paper studies the link between resting-state functional connectivity (FC), measured by the correlations of the fMRI BOLD time courses, and structural connectivity (SC), estimated through fiber ... [more ▼]

This paper studies the link between resting-state functional connectivity (FC), measured by the correlations of the fMRI BOLD time courses, and structural connectivity (SC), estimated through fiber tractography. Instead of a static analysis based on the correlation between SC and the FC averaged over the entire fMRI time series, we propose a dynamic analysis, based on the time evolution of the correlation between SC and a suitably windowed FC. Assessing the statistical significance of the time series against random phase permutations, our data show a pronounced peak of significance for time window widths around 20-30 TR (40-60 sec). Using the appropriate window width, we show that FC patterns oscillate between phases of high modularity, primarily shaped by anatomy, and phases of low modularity, primarily shaped by inter-network connectivity. Building upon recent results in dynamic FC, this emphasizes the potential role of SC as a transitory architecture between different highly connected resting state FC patterns. Finally, we show that networks implied in consciousness-related processes, such as the default mode network (DMN), contribute more to these brain-level fluctuations compared to other networks, such as the motor or somatosensory networks. This suggests that the fluctuations between FC and SC are capturing mind-wandering effects. [less ▲]

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See detailRecovery of language comprehension in the minimally conscious state studied by FDG-PET
Wannez, Sarah ULg; Thibaut, Aurore ULg; Vitali-Roscini, Gaia et al

Poster (2015, June 21)

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See detailControlled clinical trial of repeated left prefrontal transcranial direct current stimulation in patients with chronic minimally conscious state
Martial, Charlotte ULg; Thibaut, Aurore ULg; Wannez, Sarah ULg et al

Poster (2015, June)

A recent study showed that single-session anodal transcranial direct current stimulation (tDCS) applied to the left dorsolateral prefrontal cortex (LDLPF) transiently improves consciousness in 43% of ... [more ▼]

A recent study showed that single-session anodal transcranial direct current stimulation (tDCS) applied to the left dorsolateral prefrontal cortex (LDLPF) transiently improves consciousness in 43% of patients in minimally conscious state (MCS) (Thibaut et al., 2014). We here test the potential effects and safety of repeated tDCS in severely brain-damaged patients with MCS. In this double-blind cross-over sham-controlled experimental design, we delivered two sessions of repeated (5 days of stimulation) tDCS, either anodal or sham in a randomized order. We stimulated the LDLPF cortex during twenty minutes in 20 MCS patients (12 men, aged 48±16 years, time since onset 78±95 months, 12 post-traumatic). Consciousness was assessed by the French adaptation of the Coma Recovery Scale Revised (CRS-R; Schnakers et al., 2008) before and after each stimulation. A treatment effect was observed for the comparison between CRS-R total scores at baseline and after 5 days of real tDCS (p<0.01). Behaviorally, 10/20 patients showed a tDCS-related improvement; 5 patients responded after the first stimulation and 5 other patients responded after 2, 3 or 4 days of stimulation. No side effect (e.g. epilepsy) was reported. Our results demonstrate that repeated (5 days) anodal LDLPF tDCS is safe and might improve signs of consciousness in about half of patients in MCS. It is important to note that the first session is not predictive for a future positive effect of the efficacy of the non-invasive electrical stimulation. [less ▲]

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See detailCognitive auditory evoked potentials in coma: can you hear me?
Piarulli, Andrea; Charland-Verville, Vanessa ULg; Laureys, Steven ULg

in Brain : A Journal of Neurology (2015), 138(Pt5), 1129-1137

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See detailCerebral FDG uptake changes with supraorbital transcutaneous electrical stimulation for episodic migraine prevention
D'Ostilio, Kevin ULg; Thibaut, Aurore ULg; Laureys, Steven ULg et al

Conference (2015, May)

Background: A recent multicentre RCT has shown that supraorbital transcutaneous stimulation (STS) targeting branches of the ophtalmic nerve with the Cefaly® device is effective as a preventive therapy for ... [more ▼]

Background: A recent multicentre RCT has shown that supraorbital transcutaneous stimulation (STS) targeting branches of the ophtalmic nerve with the Cefaly® device is effective as a preventive therapy for migraine (Schoenen et al., Neurology 2013). However, the mechanisms of action in the central nervous system remain unknown. Here, we conducted voxel-based analyses of [18]FDG-PET to evaluate metabolic changes immediately after the first STS session and after 3 months of treatment in patients with migraine. Methods: Twenty-eight subjects participated in the experiment: 14 patients with episodic migraine (ICHD3 beta criteria) and 14 age-matched controls. Healthy volunteers underwent only one [18]FDG-PET scan whereas patients were scanned at baseline, directly after a first session of STS and after 3 months of daily treatment. Results: Compliant patients showed a significant decrease in the number of attacks (p = 0.03). When compared to controls, patients (n = 14) at baseline were hypometabolic in the fronto-temporal regions (p < 0.001), especially in the orbitofrontal (OFC) and perigenual anterior cingulate cortex. OFC hypometabolism was not correlated with medication intake. In compliant patients, daily STS for 3 months was followed by a normalization of the fronto-temporal hypometabolism (p< 0.001; OFC: pFWE<0.01). Conclusion: Our study suggests that the OFC is hypoactive in episodic migraine. STS with the Cefaly° device is able to normalize this hypoactivity. This indicates that STS exerts its beneficial effect via slow neuromodulatory mechanisms, as also previously shown for percutaneous occipital nerve stimulation in refractory cluster headache (Magis et al., BMC Neurology 2011). [less ▲]

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