References of "Chatelle, Camille"
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See detailDisorders of consciousness: new advances in neuroimaging techniques
Soddu, Andrea ULg; Bruno, Marie-Aurélie ULg; VANHAUDENHUYSE, Audrey ULg et al

in Zanotti, Bruno (Ed.) Vegetative State (in press)

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See detailRepeated Behavioral Assessments in Patients with Disorders of Consciousness
Wannez, Sarah ULg; Annen, Jitka ULg; Aubinet, Charlène ULg et al

Conference (2016, March 04)

The Coma Recovery Scale Revised (CRS-R) is considered as the most sensitive scale to assess patients with disorders of consciousness (DOC). Guidelines recommend repeated assessments because patients might ... [more ▼]

The Coma Recovery Scale Revised (CRS-R) is considered as the most sensitive scale to assess patients with disorders of consciousness (DOC). Guidelines recommend repeated assessments because patients might suffer from consciousness fluctuations, but it is not specified how many assessments are needed. The present study included 131 patients with DOC. They have been assessed at least 6 times during a 14-days period with the CRS-R. Results show that 5 CRS-R assessments are needed to reach a reliable diagnosis, and that all the CRS-R subscales are influenced by consciousness fluctuations. We here showed that consciousness fluctuations influence the behavioral diagnosis, and that 5 assessments within a short period of time are needed to get a reliable clinical diagnosis. [less ▲]

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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 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 detailCorrelation between resting state fMRI total neuronal activity and PET metabolism in healthy controls and patients with disorders of consciousness
Soddu, Andrea ULg; Gomez, Francisco; Heine, Lizette ULg et al

in Brain and Behavior (2016)

Introduction: The mildly invasive 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is a well-established imaging technique to measure ‘resting state’ cerebral metabolism. This technique made ... [more ▼]

Introduction: The mildly invasive 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is a well-established imaging technique to measure ‘resting state’ cerebral metabolism. This technique made it possible to assess changes in metabolic activity in clinical applications, such as the study of severe brain injury and disorders of consciousness. Objective: We assessed the possi- bility of creating functional MRI activity maps, which could estimate the rela- tive levels of activity in FDG-PET cerebral metabolic maps. If no metabolic absolute measures can be extracted, our approach may still be of clinical use in centers without access to FDG-PET. It also overcomes the problem of recogniz- ing individual networks of independent component selection in functional mag- netic resonance imaging (fMRI) resting state analysis. Methods: We extracted resting state fMRI functional connectivity maps using independent component analysis and combined only components of neuronal origin. To assess neu- ronality of components a classification based on support vector machine (SVM) was used. We compared the generated maps with the FDG-PET maps in 16 healthy controls, 11 vegetative state/unresponsive wakefulness syndrome patients and four locked-in patients. Results: The results show a significant similarity with q = 0.75  0.05 for healthy controls and q = 0.58  0.09 for vegetative state/unresponsive wakefulness syndrome patients between the FDG- PET and the fMRI based maps. FDG-PET, fMRI neuronal maps, and the conjunction analysis show decreases in frontoparietal and medial regions in vegetative patients with respect to controls. Subsequent analysis in locked-in syndrome patients produced also consistent maps with healthy controls. Conclusions: The constructed resting state fMRI functional connectivity map points toward the possibility for fMRI resting state to estimate relative levels of activity in a metabolic map. [less ▲]

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See detailPain assessment and treatment
Chatelle, Camille ULg

Conference (2016)

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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 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 detailThe Minimally Conscious State: Clinical Features, Pathophysiology and Therapeutic Implications
Giacino, Joseph T; Edlow, Brian; Chatelle, Camille ULg et al

in LAUREYS, Steven; Giulio, Tononi; Gosseries, Olivia (Eds.) The Neurology of Consciousness 2nd Edition (2015)

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See detailClinical Response to tDCS Depends on Residual Brain Metabolism and Grey Matter Integrity in Patients With Minimally Conscious State.
Thibaut, Aurore ULg; Di Perri, Carol; Chatelle, Camille ULg et al

in Brain stimulation (2015), 8(6), 1116-23

BACKGROUND: Transcranial direct current stimulation (tDCS) was recently shown to promote recovery of voluntary signs of consciousness in some patients in minimally conscious state (MCS). However, it ... [more ▼]

BACKGROUND: Transcranial direct current stimulation (tDCS) was recently shown to promote recovery of voluntary signs of consciousness in some patients in minimally conscious state (MCS). However, it remains unclear why clinical improvement is only observed in a subgroup of patients. OBJECTIVES: In this retrospective study, we investigated the relationship between tDCS responsiveness and neuroimaging data from MCS patients. METHODS: Structural Magnetic Resonance Imaging (MRI), Fluorodeoxyglucose Positron emission tomography (FDG-PET) and clinical electroencephalography (EEG) were acquired in 21 sub-acute and chronic MCS patients (8 tDCS responders) who subsequently (<48 h) received left dorsolateral prefrontal (DLPF) tDCS in a double-blind randomized cross-over trial. The behavioral data have been published elsewhere (Thibaut et al., Neurology, 2014). RESULTS: Grey matter atrophy was observed in non-responders as compared with responders in the left DLPF cortex, the medial-prefrontal cortex, the cingulate cortex, the hippocampi, part of the rolandic regions, and the left thalamus. FDG-PET showed hypometabolism in non-responders as compared with responders in the left DLPF cortex, the medial-prefrontal cortex, the precuneus, and the thalamus. EEG did not show any difference between the two groups. CONCLUSION: Our findings suggest that the transient increase of signs of consciousness following left DLPF tDCS in patients in MCS require grey matter preservation and residual metabolic activity in cortical and subcortical brain areas known to be involved in attention and working memory. These results further underline the critical role of long-range cortico-thalamic connections in consciousness recovery, providing important information for guidelines on the use of tDCS in disorders of consciousness. [less ▲]

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See detailSensitivity and Specificity of the Coma Recovery Scale-Revised Total Score in Detection of Conscious Awareness.
Bodien, Yelena G.; Carlowicz, Cecilia A.; Chatelle, Camille ULg et al

in Archives of physical medicine and rehabilitation (2015)

OBJECTIVE: To describe the sensitivity and specificity of Coma Recovery Scale-Revised (CRS-R) total scores in detecting conscious awareness. DESIGN: Data were retrospectively extracted from the medical ... [more ▼]

OBJECTIVE: To describe the sensitivity and specificity of Coma Recovery Scale-Revised (CRS-R) total scores in detecting conscious awareness. DESIGN: Data were retrospectively extracted from the medical records of patients enrolled in a specialized disorders of consciousness (DOC) program. Sensitivity and specificity analyses were completed using CRS-R-derived diagnoses of minimally conscious state (MCS) or emerged from minimally conscious state (EMCS) as the reference standard for conscious awareness and the total CRS-R score as the test criterion. A receiver operating characteristic curve was constructed to demonstrate the optimal CRS-R total cutoff score for maximizing sensitivity and specificity. SETTING: Specialized DOC program. PARTICIPANTS: Patients enrolled in the DOC program (N=252, 157 men; mean age, 49y; mean time from injury, 48d; traumatic etiology, n=127; nontraumatic etiology, n=125; diagnosis of coma or vegetative state, n=70; diagnosis of MCS or EMCS, n=182). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Sensitivity and specificity of CRS-R total scores in detecting conscious awareness. RESULTS: A CRS-R total score of 10 or higher yielded a sensitivity of .78 for correct identification of patients in MCS or EMCS, and a specificity of 1.00 for correct identification of patients who did not meet criteria for either of these diagnoses (ie, were diagnosed with vegetative state or coma). The area under the curve in the receiver operating characteristic curve analysis is .98. CONCLUSIONS: A total CRS-R score of 10 or higher provides strong evidence of conscious awareness but resulted in a false-negative diagnostic error in 22% of patients who demonstrated conscious awareness based on CRS-R diagnostic criteria. A cutoff score of 8 provides the best balance between sensitivity and specificity, accurately classifying 93% of cases. The optimal total score cutoff will vary depending on the user's objective. [less ▲]

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See detailTutorial on novel techniques for assessing patients with disorders of consciousness
Chatelle, Camille ULg; Sitt, Jacobo; Goldfine, Andrew et al

Conference (2015)

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See detailAn empirical classification scheme for detection of impossible and improbable CRS-R subscore combinations
Chatelle, Camille ULg; Bodien, Yelena Guller; Carlowicz, Cecilia et al

Poster (2015)

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See detailInterfaces cerveau-ordinateur, locked-in syndrome et troubles de la conscience.
Lesenfants, Damien; Chatelle, Camille ULg; Laureys, Steven ULg et al

in Medecine sciences : M/S (2015), 31(10), 904-11

Detecting signs of consciousness in patients with severe brain injury constitutes a real challenge for clinicians. The current gold standard in clinical diagnosis is the behavioral scale relying on motor ... [more ▼]

Detecting signs of consciousness in patients with severe brain injury constitutes a real challenge for clinicians. The current gold standard in clinical diagnosis is the behavioral scale relying on motor abilities, which are often impaired or nonexistent in these patients. In this context, brain-computer interfaces (BCIs) could offer a potential complementary tool to detect signs of consciousness whilst bypassing the usual motor pathway. In addition to complementing behavioral assessments and potentially reducing error rate, BCIs could also serve as a communication tool for paralyzed but conscious patients, e.g., suffering from Locked-In Syndrome. In this paper, we report on recent work conducted by the Coma Science Group on BCI technology, aiming to optimize diagnosis and communication in patients with disorders of consciousness and Locked-In syndrome. [less ▲]

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See detailBrain computer interface for assessing consciousness in severely brain-injured patients
Chatelle, Camille ULg; Lesenfants, Damien; Bodien, Yelena G et al

in Rosetti, Andrea; LAUREYS, Steven (Eds.) Clinical Neurophysiology in Disorders of Consciousness (2015)

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See detailQuantitative rates of brain glucose metabolism distinguish minimally conscious from vegetative state patients.
Stender, Johan; Kupers, Ron; Rodell, Anders et al

in Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism (2015), 35(1), 58-65

The differentiation of the vegetative or unresponsive wakefulness syndrome (VS/UWS) from the minimally conscious state (MCS) is an important clinical issue. The cerebral metabolic rate of glucose (CMRglc ... [more ▼]

The differentiation of the vegetative or unresponsive wakefulness syndrome (VS/UWS) from the minimally conscious state (MCS) is an important clinical issue. The cerebral metabolic rate of glucose (CMRglc) declines when consciousness is lost, and may reveal the residual cognitive function of these patients. However, no quantitative comparisons of cerebral glucose metabolism in VS/UWS and MCS have yet been reported. We calculated the regional and whole-brain CMRglc of 41 patients in the states of VS/UWS (n=14), MCS (n=21) or emergence from MCS (EMCS, n=6), and healthy volunteers (n=29). Global cortical CMRglc in VS/UWS and MCS averaged 42% and 55% of normal, respectively. Differences between VS/UWS and MCS were most pronounced in the frontoparietal cortex, at 42% and 60% of normal. In brainstem and thalamus, metabolism declined equally in the two conditions. In EMCS, metabolic rates were indistinguishable from those of MCS. Ordinal logistic regression predicted that patients are likely to emerge into MCS at CMRglc above 45% of normal. Receiver-operating characteristics showed that patients in MCS and VS/UWS can be differentiated with 82% accuracy, based on cortical metabolism. Together these results reveal a significant correlation between whole-brain energy metabolism and level of consciousness, suggesting that quantitative values of CMRglc reveal consciousness in severely brain-injured patients. [less ▲]

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See detailSpasticity in disorders of consciousness: a behavioral study
Thibaut, Aurore ULg; Chatelle, Camille ULg; Wannez, Sarah ULg et al

in European Journal of Physical Medicine & Rehabilitation (2015)

Background: Spasticity is a frequent complication after severe brain injury, which may impede the rehabilitation process and diminish the patients’ quality of life. Aim: We here investigate the presence ... [more ▼]

Background: Spasticity is a frequent complication after severe brain injury, which may impede the rehabilitation process and diminish the patients’ quality of life. Aim: We here investigate the presence of spasticity in a population of non-communicative patients with disorders of consciousness. We also evaluate the correlation between spasticity and potential factors of co-morbidity, frequency of physical therapy, time since insult presence of pain, presence of tendon retraction, etiology and diagnosis. Design: Cross sectional study. Setting: University Hospital of Liège, Belgium. Population: 65 patients with chronic (>3 months post insult) disorders of consciousness were included (22 women; mean age: 44±14y; 40 with traumatic etiology; 40 in a minimally conscious state; time since insult: 39±37months). Methods: Spasticity was measured with the Modified Ashworth Scale (MAS) and pain was assessed using the Nociception Coma Scale-Revised (NCS-R). Results: Out of 65 patients, 58 demonstrated signs of spasticity (89%; MAS ≥ 1), including 39 who showed severe spasticity (60%; MAS ≥ 3). Patients with spasticity receiving anti-spastic medication were more spastic than unmedicated patients. A negative correlation was observed between the severity of spasticity and the frequency of physical therapy. MAS scores correlated positively with time since injury and NCS-R scores. We did not observe a difference of spasticity between the diagnostic. Conclusion: A large proportion of patients with disorders of consciousness develop severe spasticity, possibly affecting their functional recovery and their quality of life. The observed correlation between degrees of spasticity and pain scores highlights the importance of pain management in these patients with altered states of consciousness. Finally, the relationship between spasticity and treatment (i.e., pharmacological and physical therapy) should be further investigated in order to improve clinical care. Clinical Rehabilitation Impact: Managing spasticity at first signs could improve rehabilitation of patients with disorders of consciousness and maximize their chances of recovery. In addition, decreasing this trouble could allow a better quality of life for these non-communicative patients. [less ▲]

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See detailDetection of response to command using voluntary control of breathing in disorders of consciousness
Charland-Verville, Vanessa ULg; Lesenfants, Damien; Sela, Lee et al

in Frontiers in Human Neuroscience (2014), 8(1020),

BACKGROUND: Detecting signs of consciousness in patients in a vegetative state/unresponsive wakefulness syndrome (UWS/VS) or minimally conscious state (MCS) is known to be very challenging. Plotkin et al ... [more ▼]

BACKGROUND: Detecting signs of consciousness in patients in a vegetative state/unresponsive wakefulness syndrome (UWS/VS) or minimally conscious state (MCS) is known to be very challenging. Plotkin et al. (2010) recently showed the possibility of using a breathing-controlled communication device in patients with locked in syndrome. We here aim to test a breathing-based "sniff controller" that could be used as an alternative diagnostic tool to evaluate response to command in severely brain damaged patients with chronic disorders of consciousness (DOC). METHODS: Twenty-five DOC patients were included. Patients' resting breathing-amplitude was measured during a 5 min resting condition. Next, they were instructed to end the presentation of a music sequence by sniffing vigorously. An automated detection of changes in breathing amplitude (i.e., >1.5 SD of resting) ended the music and hence provided positive feedback to the patient. RESULTS: None of the 11 UWS/VS patients showed a sniff-based response to command. One out of 14 patients with MCS was able to willfully modulate his breathing pattern to answer the command on 16/19 trials (accuracy 84%). Interestingly, this patient failed to show any other motor response to command. DISCUSSION: We here illustrate the possible interest of using breathing-dependent response to command in the detection of residual cognition in patients with DOC after severe brain injury. [less ▲]

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See detailChanges in cerebral metabolism in patients with a minimally conscious state responding to zolpidem.
Chatelle, Camille ULg; Thibaut, Aurore ULg; Gosseries, Olivia ULg et al

in Frontiers in Neuroscience (2014)

BACKGROUND: Zolpidem, a short-acting non-benzodiazepine GABA agonist hypnotic, has been shown to induce paradoxical responses in some patients with disorders of consciousness (DOC), leading to recovery of ... [more ▼]

BACKGROUND: Zolpidem, a short-acting non-benzodiazepine GABA agonist hypnotic, has been shown to induce paradoxical responses in some patients with disorders of consciousness (DOC), leading to recovery of arousal and cognitive abilities. We here assessed zolpidem-induced changes in regional brain metabolism in three patients with known zolpidem response in chronic post-anoxic minimally conscious state (MCS). METHODS: [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) and standardized clinical assessments using the Coma Recovery Scale-Revised were performed after administration of 10 mg zolpidem or placebo in a randomized double blind 2-day protocol. PET data preprocessing and comparison with a healthy age-matched control group were performed using statistical parametric mapping (SPM8). RESULTS: Behaviorally, all patients recovered functional communication after administration of zolpidem (i.e., emergence from the MCS). FDG-PET showed increased metabolism in dorsolateral prefrontal and mesiofrontal cortices after zolpidem but not after placebo administration. CONCLUSION: Our data show a metabolic activation of prefrontal areas, corroborating the proposed mesocircuit hypothesis to explain the paradoxical effect of zolpidem observed in some patients with DOC. It also suggests the key role of the prefrontal cortices in the recovery of functional communication and object use in hypoxic patients with chronic MCS. [less ▲]

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