References of "THIBAUT, Aurore"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detailDiagnostic, pronostic et traitements des troubles de la conscience
Cassol, Helena ULiege; Aubinet, Charlène ULiege; Thibaut, Aurore ULiege et al

in NPG. Neurologie - Psychiatrie - Gériatrie (in press)

Les progrès de la médecine et des soins intensifs ont conduit à une augmentation du nombre de patients survivant à une lésion cérébrale sévère. Bien que certains patients récupèrent rapidement, d’autres ... [more ▼]

Les progrès de la médecine et des soins intensifs ont conduit à une augmentation du nombre de patients survivant à une lésion cérébrale sévère. Bien que certains patients récupèrent rapidement, d’autres demeurent dans un état de conscience altérée (ECA). Ces derniers peuvent évoluer du coma vers un état végétatif/syndrome d'éveil non répondant (EV/ENR), puis vers un état de conscience minimale (ECM). Dans cette revue, nous proposons tout d’abord de décrire les différentes méthodes, comportementales et de neuro-imagerie, utilisées dans le diagnostic des patients en ECA. Nous décrirons ensuite les facteurs susceptibles d’influencer le pronostic et la récupération de ces patients, ainsi que les traitements et la prise en charge qui peuvent être proposés dans le but d’améliorer leur état de conscience. Enfin, nous clôturerons cette revue avec une réflexion sur les considérations éthiques et les questions de fin de vie. [less ▲]

Detailed reference viewed: 37 (0 ULiège)
Full Text
Peer Reviewed
See detailGlobal structural integrity and effective connectivity in patients with disorders of consciousness
BODART, Olivier ULiege; Amico, Enrico; Gomez, Francisco et al

in Brain Stimulation (in press)

Background Previous studies have separately reported impaired functional, structural, and effective connectivity in patients with disorders of consciousness (DOC). The perturbational complexity index (PCI ... [more ▼]

Background Previous studies have separately reported impaired functional, structural, and effective connectivity in patients with disorders of consciousness (DOC). The perturbational complexity index (PCI) is a transcranial magnetic stimulation (TMS) derived marker of effective connectivity. The global fractional anisotropy (FA) is a marker of structural integrity. Little is known about how these parameters are related to each other. Objective We aimed at testing the relationship between structural integrity and effective connectivity. Methods We assessed 23 patients with severe brain injury more than 4 weeks post-onset, leading to DOC or locked-in syndrome, and 14 healthy subjects. We calculated PCI using repeated single pulse TMS coupled with high-density electroencephalography, and used it as a surrogate of effective connectivity. Structural integrity was measured using the global FA, derived from diffusion weighted imaging. We used linear regression modelling to test our hypothesis, and computed the correlation between PCI and FA in different groups. Results Global FA could predict 74% of PCI variance in the whole sample and 56% in the patients' group. No other predictors (age, gender, time since onset, behavioural score) improved the models. FA and PCI were correlated in the whole population (r = 0.86, p < 0.0001), the patients, and the healthy subjects subgroups. Conclusion We here demonstrated that effective connectivity correlates with structural integrity in brain-injured patients. Increased structural damage level decreases effective connectivity, which could prevent the emergence of consciousness. [less ▲]

Detailed reference viewed: 36 (2 ULiège)
Full Text
Peer Reviewed
See detailEffects of Transcranial Direct Current Stimulation, Transcranial Pulsed Current Stimulation, and Their Combination on Brain Oscillations in Patients with Chronic Visceral Pain: A Pilot Crossover Randomized Controlled Study.
Thibaut, Aurore ULiege; Russo, Cristina; Hurtado-Puerto, Aura-Maria et al

in Frontiers in Neurology (2017)

Objective: Chronic visceral pain (CVP) syndromes are persistently painful disorders with a remarkable lack of effective treatment options. This study aimed at evaluating the effects of different ... [more ▼]

Objective: Chronic visceral pain (CVP) syndromes are persistently painful disorders with a remarkable lack of effective treatment options. This study aimed at evaluating the effects of different neuromodulation techniques in patients with CVP on cortical activity, through electreocephalography (EEG) and on pain perception, through clinical tests. Design:A pilot crossover randomized controlled study. Settings: Out-patient. Subjects: Adults with CVP (>3 months). Methods: Participants received four interventions in a randomized order: (1) transcranial pulsed current stimulation (tPCS) and active transcranial direct current stimulation (tDCS) combined, (2) tPCS alone, (3) tDCS alone, and (4) sham condition. Resting state quantitative electroencephalography (qEEG) and pain assessments were performed before and after each intervention. Results were compared with a cohort of 47 healthy controls. Results: We enrolled six patients with CVP for a total of 21 visits completed. Compared with healthy participants, patients with CVP showed altered cortical activity characterized by increased power in theta, alpha and beta bands, and a significant reduction in the alpha/beta ratio. Regarding tES, the combination of tDCS with tPCS had no effect on power in any of the bandwidths, nor brain regions. Comparing tPCS with tDCS alone, we found that tPCS induced higher increase in power within the theta and alpha bandwidths. Conclusion: This study confirms that patients with CVP present abnormal EEG-indexed cortical activity compared with healthy controls. Moreover, we showed that combining two types of neurostimulation techniques had no effect, whereas the two interventions, when applied individually, have different neural signatures. [less ▲]

Detailed reference viewed: 22 (0 ULiège)
Full Text
Peer Reviewed
See detailDelayed pain decrease following M1 tDCS in spinal cord injury: A randomized controlled clinical trial.
Thibaut, Aurore ULiege; Carvalho, Sandra; Morse, Leslie R et al

in Neuroscience Letters (2017)

Despite some encouraging findings for the treatment of neuropathic pain in patients with spinal cord injury (SCI), transcranial direct current stimulation (tDCS) directed to the primary motor cortex (M1 ... [more ▼]

Despite some encouraging findings for the treatment of neuropathic pain in patients with spinal cord injury (SCI), transcranial direct current stimulation (tDCS) directed to the primary motor cortex (M1) has faced some mixed results. Prior to translating this technology to clinical care, consistent results and durable effects need to be found. We, therefore, aimed to assess the direct and long-term effects of tDCS on pain following SCI. We performed a two-phase randomized sham-controlled clinical trial where patients received 5days of tDCS followed by a 3-month follow-up period (Phase I); then, Phase II consisted of 10days of tDCS with an 8-week follow-up period. We assessed the level of pain with the Visual Analogue Scale (VAS). Patients' quality of life and life satisfaction were also evaluated. 33 patients were enrolled in Phase I and 9 in Phase II. We observed a treatment effect at 1-week follow-up for Phase I and at 4-week follow-up for Phase II. The overall level of pain was significantly lower for the active group, as compared to sham, in Phase II. Our exploratory study shows that tDCS does seem to be a promising tool to manage pain in patients with SCI and repeated stimulation sessions are needed to induce long-lasting effects. Based on our protocol, it appears that adding a second treatment period could induce long-lasting effects. Clinicaltrials.gov identification number: NCT01599767. [less ▲]

Detailed reference viewed: 18 (0 ULiège)
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 126 (5 ULiège)
Full Text
Peer Reviewed
See detailThe repetition of behavioral assessments in diagnosis of disorders of consciousness.
Wannez, Sarah ULiege; Heine, Lizette ULiege; Thonnard, Marie et al

in Annals of Neurology (2017), 81(6), 883-889

OBJECTIVE: To determine whether repeated examinations using the Coma Recovery Scale-Revised (CRS-R) have an impact on diagnostic accuracy of patients with disorders of consciousness and to provide ... [more ▼]

OBJECTIVE: To determine whether repeated examinations using the Coma Recovery Scale-Revised (CRS-R) have an impact on diagnostic accuracy of patients with disorders of consciousness and to provide guidelines regarding the number of assessments required for obtaining a reliable diagnosis. METHODS: One hundred twenty-three adult patients with chronic disorders of consciousness were referred to our tertiary center. They were assessed at least six times with the CRS-R within a 10-day period. Clinical diagnoses based on one, two, three, four, and five Coma Recovery Scale-Revised assessments were compared with a reference diagnosis (ie, the highest behavioral diagnosis obtained after six evaluations) using nonparametric statistics. Results were considered significant at p < 0.05 corrected for multiple comparisons. RESULTS: The number of assessments had a significant effect on the clinical diagnosis. Up to the fourth examination, the diagnosis was still statistically different from the reference diagnosis based on six CRS-R assessments. Compared to this reference diagnosis, the first evaluation led to 36% of misdiagnoses. INTERPRETATION: The number of CRS-R assessments has an impact on the clinical diagnosis of patients with chronic disorders of consciousness. Up to the fourth examinations, behavioral fluctuations may still impact the diagnostic accuracy. We here suggest performing at least five assessments in each patient with disorders of consciousness within a short time interval (eg, 2 weeks) to reduce misdiagnosis. Ann Neurol 2017;81:883-889 Ann Neurol 2017;81:883-889. [less ▲]

Detailed reference viewed: 16 (2 ULiège)
Full Text
See detailHow Does Spasticity Affect Patients with Disorders of Consciousness?
Martens, Géraldine ULiege; Foidart-Dessalle, Marguerite ULiege; Laureys, Steven ULiege et al

in Schnakers, Caroline; Laureys, Steven (Eds.) Coma and Disorders of Consciousness (2017)

Detailed reference viewed: 24 (4 ULiège)
Full Text
See detailSleep, Coma, Vegetative and Minimally 4 Conscious States
Di Perri, Carol ULiege; Cavaliere, Carlo; Bodart, Olivier ULiege et al

in Sleep Disorders Medicine (2017)

Detailed reference viewed: 19 (3 ULiège)
Full Text
Peer Reviewed
See detailCerebral metabolism before and after external trigeminal nerve stimulation in episodic migraine
MAGIS, Delphine ULiege; D'Ostilio, Kevin ULiege; Thibaut, Aurore ULiege et al

in Cephalalgia : An International Journal of Headache (2017)

Detailed reference viewed: 50 (4 ULiège)
Full Text
Peer Reviewed
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)

Detailed reference viewed: 55 (19 ULiège)
Full Text
Peer Reviewed
See detailFunctional Connectivity Substrates for tDCS Response in Minimally Conscious State Patients
Cavaliere, Carlo ULiege; Aiello, Marco; Di Perri, Carol ULiege 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: 41 (8 ULiège)
Peer Reviewed
See detailFrontoparietal tDCS in Patients with Disorders of Consciousness: Double Blind Randomized Controlled Clinical Trial
Martens, Géraldine ULiege; Thibaut, Aurore ULiege; Martial, Charlotte ULiege et al

Poster (2016, September)

In this randomized double blind sham controlled croess-over study, we aimed to assess the effects of frontoparietal transcranial direct current stimulation (tDCS) on the level of consciousness in patients ... [more ▼]

In this randomized double blind sham controlled croess-over study, we aimed to assess the effects of frontoparietal transcranial direct current stimulation (tDCS) on the level of consciousness in patients with disorders of consciousness. This study was performed on patients in unresponsive wakefulness syndrome (UWS), minimally conscious state (MCS) and emergence of MCS (EMCS). 23 patients (UWS=8, MCS=14, EMCS=1; mean age: 45±12 years; 17 men; interval since insult: 4.5±7 years; 11 traumatic etiologies) underwent two tDCS sessions, either anodal or sham in a randomized order. Frontoparietal areas were stimulated using a current of 1 mA during 20 minutes. Consciousness was assessed by the Coma Recovery Scale-Revised (CRS-R) before and after each stimulation. We did not observe any treatment effect in the whole population (p=0.121) but a significant treatment effect was found for the subgroup of MCS patients (p=0.019) while no significant effect was observed for the UWS patients (p=0.345; Fig. 4). We found a significant difference in the total CRS-R score before and after the real session (p=0.042) with no significant difference for the sham session (p=0.826; Fig. 5). We did not observe any tDCS related side effect (e.g. epilepsy, sign of pain, drowsiness). Our results showed that frontoparietal anodal tDCS is safe and might improve the level of consciousness in half of MCS patients. This noninvasive brain stimulation technique could be useful to improve MCS patients’ rehabilitation. [less ▲]

Detailed reference viewed: 13 (0 ULiège)
Peer Reviewed
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 ▲]

Detailed reference viewed: 134 (33 ULiège)
Peer Reviewed
See detailDisorders of Consciousness
Bodart, Olivier ULiege; Thibaut, Aurore ULiege; Laureys, Steven ULiege et al

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

Detailed reference viewed: 239 (28 ULiège)
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 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 ▲]

Detailed reference viewed: 83 (20 ULiège)