Reference : Perception of pain in the minimally conscious state with PET activation: an observationa...
Scientific journals : Article
Human health sciences : Neurology
http://hdl.handle.net/2268/25022
Perception of pain in the minimally conscious state with PET activation: an observational study.
English
Boly, Mélanie mailto [Université de Liège - ULg > Département des sciences cliniques > Neurologie >]
Faymonville, Marie-Elisabeth mailto [Université de Liège - ULg > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine) >]
Schnakers, Caroline [Université de Liège - ULg > > Centre de recherches du cyclotron >]
Peigneux, Philippe mailto [Université de Liège - ULg > Département des sciences cognitives > Département des sciences cognitives >]
Lambermont, Bernard mailto [Université de Liège - ULg > > Frais communs médecine >]
Phillips, Christophe mailto [Université de Liège - ULg > > Centre de recherches du cyclotron - Dép. d'électric., électron. et informat. (Inst.Montefiore) >]
Lancellotti, Patrizio mailto [Université de Liège - ULg > > Cardiologie >]
Luxen, André mailto [Université de Liège - ULg > Département de chimie (sciences) > Chimie organique de synthèse - Centre de recherches du cyclotron >]
Lamy, Maurice mailto [Université de Liège - ULg > Département des sciences cliniques > Département des sciences cliniques >]
Moonen, Gustave mailto [Université de Liège - ULg > Département des sciences cliniques > Neurologie - Doyen de la Faculté de Médecine >]
Maquet, Pierre mailto [Université de Liège - ULg > > Centre de recherches du cyclotron - Département des sciences cliniques >]
Laureys, Steven mailto [Université de Liège - ULg > > Centre de recherches du cyclotron - Département des sciences cliniques >]
2008
Lancet Neurology
Elsevier Science
7
11
1013-20
Yes (verified by ORBi)
International
1474-4422
1474-4465
London
United Kingdom
[en] BACKGROUND: Patients in a minimally conscious state (MCS) show restricted self or environment awareness but are unable to communicate consistently and reliably. Therefore, better understanding of cerebral noxious processing in these patients is of clinical, therapeutic, and ethical relevance. METHODS: We studied brain activation induced by bilateral electrical stimulation of the median nerve in five patients in MCS (aged 18-74 years) compared with 15 controls (19-64 years) and 15 patients (19-75 years) in a persistent vegetative state (PVS) with (15)O-radiolabelled water PET. By way of psychophysiological interaction analysis, we also investigated the functional connectivity of the primary somatosensory cortex (S1) in patients and controls. Patients in MCS were scanned 57 (SD 33) days after admission, and patients in PVS 36 (9) days after admission. Stimulation intensities were 8.6 (SD 6.7) mA in patients in MCS, 7.4 (5.9) mA in controls, and 14.2 (8.7) mA in patients in PVS. Significant results were thresholded at p values of less than 0.05 and corrected for multiple comparisons. FINDINGS: In patients in MCS and in controls, noxious stimulation activated the thalamus, S1, and the secondary somatosensory or insular, frontoparietal, and anterior cingulate cortices (known as the pain matrix). No area was less activated in the patients in MCS than in the controls. All areas of the cortical pain matrix showed greater activation in patients in MCS than in those in PVS. Finally, in contrast with patients in PVS, those in MCS had preserved functional connectivity between S1 and a widespread cortical network that includes the frontoparietal associative cortices. INTERPRETATION: Cerebral correlates of pain processing are found in a similar network in controls and patients in MCS but are much more widespread than in patients in PVS. These findings might be objective evidence of a potential pain perception capacity in patients in MCS, which supports the idea that these patients need analgesic treatment.
Centre de Recherches du Cyclotron - CRC
Fonds de la Recherche Scientifique (Communauté française de Belgique) - F.R.S.-FNRS
Researchers ; Professionals
http://hdl.handle.net/2268/25022
also: http://hdl.handle.net/2268/2401 ; http://hdl.handle.net/2268/107597
10.1016/S1474-4422(08)70219-9
http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6X3F-4TKJM58-1-9&_cdi=7297&_user=532038&_orig=search&_coverDate=11%2F30%2F2008&_sk=999929988&view=c&wchp=dGLzVzz-zSkzS&md5=0912058b885c12cf1ddf335e6108f745&ie=/sdarticle.pdf

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