References of "THIBAUT, Aurore"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detail2 Years outcome of patients in unresponsive wakefulness syndrome/vegetative state and minimally conscious state
Cassol, Helena ULg; LEDOUX, Didier ULg; Thibaut, Aurore ULg 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 ▲]

Detailed reference viewed: 77 (4 ULg)
Full Text
Peer Reviewed
See detailPrevalence of coma-recovery scale-revised signs of consciousness in patients in minimally conscious state
Wannez, Sarah ULg; Gosseries, Olivia ULg; Azzolini, Deborah et al

in Neuropsychological Rehabilitation (2017)

Detailed reference viewed: 45 (13 ULg)
Full Text
Peer Reviewed
See detailFunctional Connectivity Substrates for tDCS Response in Minimally Conscious State Patients
Cavaliere, Carlo ULg; Aiello, Marco; Di Perri, Carol ULg et al

in Frontiers in Cellular Neuroscience (2016)

Transcranial direct current stimulation (tDCS) is a non-invasive technique recently employed in disorders of consciousness, and determining a transitory recovery of signs of consciousness in almost half ... [more ▼]

Transcranial direct current stimulation (tDCS) is a non-invasive technique recently employed in disorders of consciousness, and determining a transitory recovery of signs of consciousness in almost half of minimally conscious state (MCS) patients. Although the rising evidences about its possible role in the treatment of many neurological and psychiatric conditions exist, no evidences exist about brain functional connectivity substrates underlying tDCS response. We retrospectively evaluated resting state functional Magnetic Resonance Imaging (fMRI) of 16 sub-acute and chronic MCS patients (6 tDCS responders) who successively received a single left dorsolateral prefrontal cortex (DLPFC) tDCS in a double-blind randomized cross-over trial. A seed-based approach for regions of left extrinsic control network (ECN) and default-mode network (DMN) was performed. tDCS responders showed an increased left intra-network connectivity for regions co-activated with left DLPFC, and significantly with left inferior frontal gyrus. Non-responders (NR) MCS patients showed an increased connectivity between left DLPFC and midline cortical structures, including anterior cingulate cortex and precuneus. Our findings suggest that a prior high connectivity with regions belonging to ECN can facilitate transitory recovery of consciousness in a subgroup of MCS patients that underwent tDCS treatment. Therefore, resting state-fMRI could be very valuable in detecting the neuronal conditions necessary for tDCS to improve behavior in MCS. [less ▲]

Detailed reference viewed: 43 (7 ULg)
Full Text
Peer Reviewed
See detailCerebral metabolism before and after external trigeminal nerve stimulation in episodic migraine
MAGIS, Delphine ULg; D'Ostilio, Kevin ULg; Thibaut, Aurore ULg et al

in Cephalalgia : An International Journal of Headache (2016)

Detailed reference viewed: 41 (2 ULg)
Peer Reviewed
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 ▲]

Detailed reference viewed: 128 (30 ULg)
Peer Reviewed
See detailDisorders of Consciousness
Bodart, Olivier ULg; Thibaut, Aurore ULg; Laureys, Steven ULg et al

in Citerio, G.; Smith, M.; Kofke, A. (Eds.) Oxford Textbook of neurocritical care (2016)

Detailed reference viewed: 251 (28 ULg)
Full Text
See detailSleep, Coma, Vegetative and Minimally 4 Conscious States
Di Perri, Carol ULg; Cavaliere, Carlo; Bodart, Olivier ULg et al

in Sleep Disorders Medicine (2016)

Detailed reference viewed: 14 (1 ULg)
Full Text
Peer Reviewed
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), 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 ▲]

Detailed reference viewed: 109 (20 ULg)
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 30 (10 ULg)
Full Text
Peer Reviewed
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)

Detailed reference viewed: 33 (4 ULg)
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 59 (8 ULg)
Full Text
Peer Reviewed
See detailReviews, opinions and insights for future clinical trials: an overview of PPCR journal
Thibaut, Aurore ULg

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

Detailed reference viewed: 22 (0 ULg)
Peer Reviewed
See detailControlled clinical trial of repeated left prefrontal transcranial direct current stimulation in patients with chronic minimally conscious state
Thibaut, Aurore ULg

Poster (2015, July 08)

Thibaut A., Bruno MA., Wannez S., Donneau AF., Martial C., Chatelle C., Laureys S. Background: A recent study showed that single-session anodal transcranial direct current stimulation (tDCS) applied to ... [more ▼]

Thibaut A., Bruno MA., Wannez S., Donneau AF., Martial C., Chatelle C., Laureys S. Background: 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) (1). We here test the potential effects and safety of repeated tDCS in severely brain-damaged patients with MCS. Methods: 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 (Figure 1) 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; 2) before and after each stimulation (Figure 2). Results: 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 (Figure 3). No side effect (e.g. epilepsy, sign of pain, drowsiness) was reported. Conclusion: 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. References: 1. Thibaut A, Bruno MA, Ledoux D, Demertzi A, Laureys S. tDCS in patients with disorders of consciousness: sham-controlled randomized double-blind study. Neurology. 2014 Apr 1;82(13): p. 1112-8. 2. Schnakers C, Majerus S, Giacino J, Vanhandenhuyse A, Bruno MA, Boly M, Moonen G, Damas P, Lambermont B, Lamy M, Damas F, Ventura M, Laureys S. A French validation study of the Coma Recovery Scale-Revised (CRS-R). Brain Injury. 2008 Sep ;22(10): p. 786-92. [less ▲]

Detailed reference viewed: 47 (4 ULg)
Full Text
Peer Reviewed
See detailTreatments for patients with disorders of consciousness
Thibaut, Aurore ULg

Conference (2015, July 07)

Detailed reference viewed: 39 (2 ULg)
Full Text
See detailNeural correlates of tDCS & repeated stimulations
Thibaut, Aurore ULg

Scientific conference (2015, July 05)

Detailed reference viewed: 20 (3 ULg)