To compare functional connectivity after severe traumatic brain injury (TBI) between a group of post-comatose TBI with restored consciousness and a group of post-comatose TBI with persistant disorder of consciousness at admission in rehabilitation
Recovery of consciousness can be impaired in severe traumatic brain injury (TBI). Prognostic factors are sparse and mostly clinical (mainly the initial Glasgow coma scale GCS) (1). Functional magnetic resonance imaging (fMRI) could allow a better understanding of functional recovery. Graph method has been applied to fMRI signal analysis in disorder of consciousness (DOC) due to post-anoxic encephalopathy. Comatose state was characterized by dramatic change in local connectivity (hub location) without significant change in global connectivity (2). The present study aims at describing functional connectivity in DOC following severe TBI. We will record resting state fMRI in TBI patients in two clinical conditions: conscious state versus DOC state.
Study Type
OBSERVATIONAL
Enrollment
34
One hour brain MRI recording without active task for the patient, no sedation
Grenoble University Hospital
Grenoble, France
cortical functional connectivity
the index is calculated from methodology of the article cited below (2)
Time frame: connectivity index measured on MRI recorded at discharge from intensive care unit (ICU) (30 days post-TBI on average) and compared between the two groups of patients (group "normal level of consciousness" versus group "disorder of consciousness")
consciousness level measured with Coma recovery scale -revised (CRS-R)
Time frame: CRS-R score at discharge from intensive care unit (ICU) (30 days post-TBI on average)
consciousness level measured with Coma recovery scale -revised (CRS-R)
Time frame: day 60 after first MRI
cortical functional connectivity change
Time frame: connectivity index change (measured on MRI done day 60 after first MRI and compared to MRI done on day 0
Slow wave sleep quantification
Electroencephalographic recording on 12 consecutive hours by night
Time frame: EEG at discharge from intensive care unit (ICU) (30 days post-TBI on average)
structural connectivity
fibers density between region of interest by DTI
Time frame: DTI At discharge from intensive care unit (ICU) (30 days post-TBI on average)
structural connectivity
fibers density between region of interest by DTI
Time frame: DTI day 60 after first MRI
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