Article (Scientific journals)
Quantitative rates of brain glucose metabolism distinguish minimally conscious from vegetative state patients
Stender, Johan; Kupers, Ron; Rodell, Anders et al.
2015In Journal of Cerebral Blood Flow and Metabolism, 35 (1), p. 58-65
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Keywords :
brain injury; consciousness; FDG-PET; metabolism; minimally conscious state; vegetative state
Abstract :
[en] 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.
Research center :
GIGA CRC (Cyclotron Research Center) In vivo Imaging-Aging & Memory - ULiège
Disciplines :
Neurology
Author, co-author :
Stender, Johan
Kupers, Ron
Rodell, Anders
Thibaut, Aurore ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Chatelle, Camille ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Bruno, Marie-Aurélie ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Gejl, Michael
Bernard, Claire ;  Université de Liège - ULiège > Département de physique > Département de physique
HUSTINX, Roland  ;  Centre Hospitalier Universitaire de Liège - CHU > Médecine nucléaire et imagerie oncologique
Laureys, Steven  ;  Université de Liège - ULiège > Centre de recherches du cyclotron
Gjedde, Albert
Language :
English
Title :
Quantitative rates of brain glucose metabolism distinguish minimally conscious from vegetative state patients
Publication date :
2015
Journal title :
Journal of Cerebral Blood Flow and Metabolism
ISSN :
0271-678X
eISSN :
1559-7016
Publisher :
SAGE, Thousand Oaks, United States - California
Volume :
35
Issue :
1
Pages :
58-65
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 13 November 2014

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