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Quantitative Rates of Brain Glucose Metabolism Distinguish Minimally Conscious from Vegetative State Patients

Overview of attention for article published in Cerebrovascular and Brain Metabolism Reviews, October 2014
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Title
Quantitative Rates of Brain Glucose Metabolism Distinguish Minimally Conscious from Vegetative State Patients
Published in
Cerebrovascular and Brain Metabolism Reviews, October 2014
DOI 10.1038/jcbfm.2014.169
Pubmed ID
Authors

Johan Stender, Ron Kupers, Anders Rodell, Aurore Thibaut, Camille Chatelle, Marie-Aurélie Bruno, Michael Gejl, Claire Bernard, Roland Hustinx, Steven Laureys, Albert Gjedde

Abstract

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.

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Geographical breakdown

Country Count As %
United States 2 1%
Czechia 1 <1%
France 1 <1%
Canada 1 <1%
Unknown 134 96%

Demographic breakdown

Readers by professional status Count As %
Researcher 29 21%
Student > Ph. D. Student 25 18%
Student > Master 20 14%
Student > Doctoral Student 11 8%
Professor 6 4%
Other 18 13%
Unknown 30 22%
Readers by discipline Count As %
Neuroscience 38 27%
Medicine and Dentistry 24 17%
Psychology 12 9%
Agricultural and Biological Sciences 12 9%
Engineering 6 4%
Other 8 6%
Unknown 39 28%