References of "Demertzi, Athina"
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See detailSurvival and consciousness recovery are better in the minimally conscious state than in the vegetative state
Faugeras, Frédéric; Rohaut, Benjamin; Valente, Melanie et al

in Brain Injury (in press)

BACKGROUND The prognosis value of early clinical diagnosis of consciousness impairment is documented by an extremely limited number of studies, whereas it may convey important information to guide medical ... [more ▼]

BACKGROUND The prognosis value of early clinical diagnosis of consciousness impairment is documented by an extremely limited number of studies, whereas it may convey important information to guide medical decisions. OBJECTIVE We aimed at determining if patients diagnosed at an early stage (<90 days after brain injury) as being in the minimally conscious state (MCS) have a better prognosis than patients in the vegetative state/Unresponsive Wakefulness syndrome (VS/UWS), independent of care limitations or withdrawal decisions. METHODS Patients hospitalized in ICUs of the Pitié-Salpêtrière Hospital (Paris, France) from November 2008 to January 2011 were included and evaluated behaviourally with standardized assessment and with the Coma Recovery Scale-Revised as being either in the VS/UWS or in the MCS. They were then prospectively followed until 1July 2011 to evaluate their outcome with the GOSE. We compared survival function and outcomes of these two groups. RESULTS Both survival function and outcomes, including consciousness recovery, were significantly better in the MCS group. This difference of outcome still holds when considering only patients still alive at the end of the study. CONCLUSIONS Early accurate clinical diagnosis of VS/UWS or MCS conveys a strong prognostic value of survival and of consciousness recovery. [less ▲]

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See detailBrain-heart interactions reveal consciousness in non-communicating patients
Raimondo, Federico; Rohaut, Benjamin; Demertzi, Athina ULiege et al

in Annals of Neurology (in press)

Objective: We here aimed at characterizing heart–brain interactions in patients with disorders of consciousness. We tested how this information impacts data-driven classification between unresponsive and ... [more ▼]

Objective: We here aimed at characterizing heart–brain interactions in patients with disorders of consciousness. We tested how this information impacts data-driven classification between unresponsive and minimally conscious patients. Methods: A cohort of 127 patients in vegetative state/unresponsive wakefulness syndrome (VS/UWS; n570) and minimally conscious state (MCS; n557) were presented with the local–global auditory oddball paradigm, which dis- tinguishes 2 levels of processing: short-term deviation of local auditory regularities and global long-term rule viola- tions. In addition to previously validated markers of consciousness extracted from electroencephalograms (EEG), we computed autonomic cardiac markers, such as heart rate (HR) and HR variability (HRV), and cardiac cycle phase shifts triggered by the processing of the auditory stimuli. Results: HR and HRV were similar in patients across groups. The cardiac cycle was not sensitive to the processing of local regularities in either the VS/UWS or MCS patients. In contrast, global regularities induced a phase shift of the cardiac cycle exclusively in the MCS group. The interval between the auditory stimulation and the following R peak was significantly shortened in MCS when the auditory rule was violated. When the information for the cardiac cycle modulations and other consciousness-related EEG markers were combined, single patient classification performance was enhanced compared to classification with solely EEG markers. Interpretation: Our work shows a link between residual cognitive processing and the modulation of autonomic somatic markers. These results open a new window to evaluate patients with disorders of consciousness via the embodied paradigm, according to which body–brain functions contribute to a holistic approach to conscious processing. [less ▲]

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See detailThe effect of spaceflight and microgravity on the human brain
Van Ombergen, Angelique; Demertzi, Athina ULiege; Tomilovskaya et al

in Journal of Neurology (in press)

Microgravity, confinement, isolation, and immobilization are just some of the features astronauts have to cope with during space missions. Consequently, long-duration space travel can have detrimental ... [more ▼]

Microgravity, confinement, isolation, and immobilization are just some of the features astronauts have to cope with during space missions. Consequently, long-duration space travel can have detrimental effects on human physiology. Although research has focused on the cardiovascular and musculoskeletal system in particular, the exact impact of spaceflight on the human central nervous system remains to be determined. Previous studies have reported psychological problems, cephalic fluid shifts, neurovestibular problems, and cognitive alterations, but there is paucity in the knowledge of the underlying neural substrates. Previous space analogue studies and preliminary spaceflight studies have shown an involvement of the cerebellum, cortical sensorimotor, and somatosensory areas and the vestibular pathways. Extending this knowledge is crucial, especially in view of long-duration interplanetary missions (e.g., Mars missions) and space tourism. In addition, the acquired insight could be relevant for vestibular patients, patients with neurodegenerative disorders, as well as the elderly population, coping with multisensory deficit syndromes, immobilization, and inactivity. [less ▲]

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See detailA method for independent component graph analysis of resting-state fMRI. Brain and Behavior 2017, in press
Ribeiro de Paula, Demetrius; Ziegler, Erik; Abeyasinghe, P et al

in Brain and Behavior (in press)

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See detailDisorders of consciousness: new advances in neuroimaging techniques
Soddu, Andrea ULiege; Bruno, Marie-Aurélie ULiege; VANHAUDENHUYSE, Audrey ULiege et al

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

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See detail2 Years outcome of patients in unresponsive wakefulness syndrome/vegetative state and minimally conscious state
Cassol, Helena ULiege; LEDOUX, Didier ULiege; Thibaut, Aurore ULiege et al

Poster (2017, March)

INTRODUCTION: Following severe acute brain damage, patients typically evolve from coma to an unresponsive wakefulness syndrome/vegetative state (UWS/VS; wakefulness without awareness) and later to a ... [more ▼]

INTRODUCTION: Following severe acute brain damage, patients typically evolve from coma to an unresponsive wakefulness syndrome/vegetative state (UWS/VS; wakefulness without awareness) and later to a minimally conscious state (MCS; fluctuating but consistent nonreflex behaviors). MCS is subcategorized in MCS+ (i.e., command following) and MCS- (i.e., visual pursuit, localization of noxious stimulation or contingent behaviours). Reliable and consistent interactive communication and/or functional use of objects indicate the next boundary – emergence from MCS (EMCS). To date, there is still no reliable predictive model of recovery from the UWS/VS and the MCS. A better understanding of patients' outcome would help in decisions regarding patients’ care and rehabilitation, as well as end-of-life decisions. METHODS: We collected demographic information, acute care history and longitudinal follow-up of patients in UWS/VS and MCS admitted in 15 expert centers in Belgium (via the Belgian Federal Public Service Health). Patients were evaluated at 1, 3, 6, 12 and 24 months post injury with the Coma Recovery Scale-Revised and the diagnosis was based on internationally accepted criteria of UWS/VS, MCS or EMCS. Results were considered significant at p<0.001. RESULTS: 24 months follow-up was available for 476 patients including 261 diagnosed in UWS/VS (88 traumatic, 173 non-traumatic) and 215 diagnosed in MCS (80 traumatic, 135 non-traumatic) one month after the injury. Patients who were in MCS one month after the insult were more likely to recover functional communication or object use after 24 months than patients in UWS/VS. Moreover, functional recovery occurred more often in MCS+ (79%) as compared to MCS- (29%), and mortality rate was more important in MCS- patients (68%) as compared to MCS+ (21%). Comparisons within UWS/VS and MCS groups based on etiology showed that traumatic patients had a better outcome at 24 months than non-traumatic patients. Among non-traumatic patients, no difference was found between anoxic patients and patients with other etiologies regarding functional recovery. CONCLUSION: Our study highlights that the outcome is significantly better for patients who are in MCS one month post-injury as compared to patients who remain in UWS/VS at that time. Concerning MCS patients, the outcome is significantly better for patients who are MCS+ one month post-injury as compared to patients who are MCS- at that time. This study also confirms that patients with traumatic etiology have better prognosis than patients with non-traumatic causes. [less ▲]

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See detailSedation of Patients With Disorders of Consciousness During Neuroimaging: Effects on Resting State Functional Brain Connectivity.
KIRSCH, Murielle ULiege; Guldenmund, Pieter; Bahri, Mohamed Ali ULiege et al

in Anesthesia and Analgesia (2017), 124(2),

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See detailNew directions in hypnosis research: strategies for advancing the cognitive and clinical neuroscience of hypnosis
Jensen, Mark P; Jamieson, Graham A; Lutz, Antoine et al

in Neuroscience of Consciousness (2017), 3(1), 1-14

In August of 2015, the International Society of Hypnosis and Confederation Francophone d’hypnose et Therapies Breves co-sponsored a 1-day meeting among hypnosis researchers, just before the International ... [more ▼]

In August of 2015, the International Society of Hypnosis and Confederation Francophone d’hypnose et Therapies Breves co-sponsored a 1-day meeting among hypnosis researchers, just before the International Congress of Hypnosis in Paris, France. One of the goals of the meeting was to discuss the state-of-the- science of hypnosis research from the purview of clinical and cognitive neuroscience. The purpose of this article is to summarize the key issues that were raised during the discussions, including the points of agreement and disagreement among the participants (all of whom are authors on this article). Here we first briefly summarize what we view as (i) the most important research findings and developments in the field during the past two decades and (ii) the most salient challenges facing contemporary hypnosis research. Next, we summarize our discussion concerning directions for future hypnosis research and collaborative endeavors that could expand upon recent advances, ad- dress emerging challenges, and facilitate a reemergence of hypnosis research as a vital field within cognitive and clinical neuroscience. [less ▲]

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See detailPrevalence of coma-recovery scale-revised signs of consciousness in patients in minimally conscious state
Wannez, Sarah ULiege; Gosseries, Olivia ULiege; Azzolini, Deborah et al

in Neuropsychological Rehabilitation (2017)

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See detailResting-state Network-specific Breakdown of Functional Connectivity during Ketamine Alteration of Consciousness in Volunteers
BONHOMME, Vincent ULiege; VANHAUDENHUYSE, Audrey ULiege; Demertzi, Athina ULiege et al

in Anesthesiology (2016), 125(5), 873-878

Background: Consciousness-altering anesthetic agents disturb connectivity between brain regions composing the resting-state consciousness networks (RSNs). The default mode network (DMn), executive control ... [more ▼]

Background: Consciousness-altering anesthetic agents disturb connectivity between brain regions composing the resting-state consciousness networks (RSNs). The default mode network (DMn), executive control network, salience network (SALn), auditory network, sensorimotor network (SMn), and visual network sustain mentation. Ketamine modifies consciousness differently from other agents, producing psychedelic dreaming and no apparent interaction with the environment. The authors used functional magnetic resonance imaging to explore ketamine-induced changes in RSNs connectivity. Methods: Fourteen healthy volunteers received stepwise intravenous infusions of ketamine up to loss of responsiveness. Because of agitation, data from six subjects were excluded from analysis. RSNs connectivity was compared between absence of ketamine (wake state [W1]), light ketamine sedation, and ketamine-induced unresponsiveness (deep sedation [S2]). Results: Increasing the depth of ketamine sedation from W1 to S2 altered DMn and SALn connectivity and suppressed the anticorrelated activity between DMn and other brain regions. During S2, DMn connectivity, particularly between the medial prefrontal cortex and the remaining network (effect size β [95% CI]: W1 = 0.20 [0.18 to 0.22]; S2 = 0.07 [0.04 to 0.09]), and DMn anticorrelated activity (e.g., right sensory cortex: W1 = −0.07 [−0.09 to −0.04]; S2 = 0.04 [0.01 to 0.06]) were broken down. SALn connectivity was nonuniformly suppressed (e.g., left parietal operculum: W1 = 0.08 [0.06 to 0.09]; S2 = 0.05 [0.02 to 0.07]). Executive control networks, auditory network, SMn, and visual network were minimally affected. Conclusions: Ketamine induces specific changes in connectivity within and between RSNs. Breakdown of frontoparietal DMn connectivity and DMn anticorrelation and sensory and SMn connectivity preservation are common to ketamine and propofol-induced alterations of consciousness. [less ▲]

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See detailRepeated Behavioral Assessments in Patients with Disorders of Consciousness
Wannez, Sarah ULiege; Annen, Jitka ULiege; Aubinet, Charlène ULiege 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 detailCortical reorganization in an astronaut's brain after long-duration spaceflight.
Demertzi, Athina ULiege; Van Ombergen, Angelique; Tomilovskaya, Elena et al

in Brain Structure & Function (2016), 221(5), 2873-2876

To date, hampered physiological function after exposure to microgravity has been primarily attributed to deprived peripheral neuro-sensory systems. For the first time, this study elucidates alterations in ... [more ▼]

To date, hampered physiological function after exposure to microgravity has been primarily attributed to deprived peripheral neuro-sensory systems. For the first time, this study elucidates alterations in human brain function after long-duration spaceflight. More specifically, we found significant differences in resting-state functional connectivity between motor cortex and cerebellum, as well as changes within the default mode network. In addition, the cosmonaut showed changes in the supplementary motor areas during a motor imagery task. These results highlight the underlying neural basis for the observed physiological deconditioning due to spaceflight and are relevant for future interplanetary missions and vestibular patients. [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 ULiege; Gomez, Francisco; Heine, Lizette ULiege et al

in Brain and Behavior (2016), 6(1), 1-15

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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