Reference : Visual fixation in the vegetative state: an observational case series PET study.
Scientific journals : Article
Human health sciences : Neurology
http://hdl.handle.net/2268/83853
Visual fixation in the vegetative state: an observational case series PET study.
English
Bruno, Marie-Aurélie mailto [Université de Liège - ULg > > Centre de recherches du cyclotron > Coma Science Group > >]
Vanhaudenhuyse, Audrey mailto [Université de Liège - ULg > Coma Science Group > Centre de recherches du cyclotron > > >]
Schnakers, Caroline mailto [Université de Liège - ULg > Coma Science Group > Centre de recherches du cyclotron > > >]
Boly, Mélanie mailto [Université de Liège - ULg > Département des sciences cliniques > Neurologie >]
Gosseries, Olivia [Université de Liège - ULg > Coma Science Group > Centre de recherches du cyclotron > > >]
Demertzi, Athina [Université de Liège - ULg > > Centre de recherches du cyclotron >]
Majerus, Steve [Université de Liège - ULg > Département des sciences cognitives > Psychopathologie cognitive >]
Moonen, Gustave [Centre Hospitalier Universitaire de Liège - CHU > > Neurologie Sart Tilman >]
Hustinx, Roland mailto [Centre Hospitalier Universitaire de Liège - CHU > > Médecine nucléaire >]
Laureys, Steven mailto [Université de Liège - ULg > Coma Science Group > Centre de recherches du cyclotron - Département des sciences cliniques > > >]
2010
BMC Neurology
BioMed Central
10
35
Yes (verified by ORBi)
International
1471-2377
[en] Adult ; Anoxia/complications ; Brain/metabolism/radionuclide imaging ; Brain Diseases/etiology/metabolism/radionuclide imaging ; Brain Mapping ; Case-Control Studies ; Chronic Disease ; Consciousness ; Female ; Fixation, Ocular ; Follow-Up Studies ; Glucose/metabolism ; Humans ; Male ; Middle Aged ; Neurologic Examination ; Persistent Vegetative State/etiology/metabolism/radionuclide imaging ; Positron-Emission Tomography ; Recovery of Function ; Time Factors
[en] BACKGROUND: Assessment of visual fixation is commonly used in the clinical examination of patients with disorders of consciousness. However, different international guidelines seem to disagree whether fixation is compatible with the diagnosis of the vegetative state (i.e., represents "automatic" subcortical processing) or is a sufficient sign of consciousness and higher order cortical processing. METHODS: We here studied cerebral metabolism in ten patients with chronic post-anoxic encephalopathy and 39 age-matched healthy controls. Five patients were in a vegetative state (without fixation) and five presented visual fixation but otherwise showed all criteria typical of the vegetative state. Patients were matched for age, etiology and time since insult and were followed by repeated Coma Recovery Scale-Revised (CRS-R) assessments for at least 1 year. Sustained visual fixation was considered as present when the eyes refixated a moving target for more than 2 seconds as defined by CRS-R criteria. RESULTS: Patients without fixation showed metabolic dysfunction in a widespread fronto-parietal cortical network (with only sparing of the brainstem and cerebellum) which was not different from the brain function seen in patients with visual fixation. Cortico-cortical functional connectivity with visual cortex showed no difference between both patient groups. Recovery rates did not differ between patients without or with fixation (none of the patients showed good outcome). CONCLUSIONS: Our findings suggest that sustained visual fixation in (non-traumatic) disorders of consciousness does not necessarily reflect consciousness and higher order cortical brain function.
Centre de Recherches du Cyclotron - CRC
Fonds de la Recherche Scientifique (Communauté française de Belgique) - F.R.S.-FNRS ; James S. McDonnell Foundation ; Mind Science Foundation ; European Commission (Mindbridge, DISCOS, DECODER & COST) ; Concerted Research Action ; DISCOS Marie-Curie Actions
http://hdl.handle.net/2268/83853
10.1186/1471-2377-10-35

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