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Functional Brain Network Topology Discriminates between Patients with Minimally Conscious State and Unresponsive Wakefulness Syndrome
Open AccessArticle

Neuroimaging Studies on Disorders of Consciousness: A Meta-Analytic Evaluation

1
Department of Humanistic Studies (DISTUM), University of Urbino Carlo Bo, 61029 Urbino, Italy
2
Center of Clinical Developmental Neuropsychology, ASUR Marche, Area Vasta 1 Pesaro, 61122 Pesaro, Italy
3
NeuroMi, Milan Center for Neuroscience, 20126 Milano, Italy
4
Center of Cognitive Neuropsychology, ASTT Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy
5
Brain and Behavioral Science Department, Università degli Studi di Pavia, 27100 Pavia, Italy
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Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20122 Milano, Italy
7
Fondazione Europea di Ricerca Biomedica Onlus, 20063 Milan, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(4), 516; https://doi.org/10.3390/jcm8040516
Received: 18 February 2019 / Revised: 27 March 2019 / Accepted: 10 April 2019 / Published: 16 April 2019
(This article belongs to the Special Issue Brain Networks in Disorders of Consciousness)
Neuroimaging tools could open a window on residual neurofunctional activity in the absence of detectable behavioural responses in patients with disorders of consciousness (DOC). Nevertheless, the literature on this topic is characterised by a large heterogeneity of paradigms and methodological approaches that can undermine the reproducibility of the results. To explicitly test whether task-related functional magnetic resonance imaging (fMRI) can be used to systematically detect neurofunctional differences between different classes of DOC, and whether these differences are related with a specific category of cognitive tasks (either active or passive), we meta-analyzed 22 neuroimaging studies published between 2005 and 2017 using the Activation Likelihood Estimate method. The results showed that: (1) active and passive tasks rely on well-segregated patterns of activations; (2) both unresponsive wakeful syndrome and patients in minimally conscious state activated a large portion of the dorsal-attentional network; (3) shared activations between patients fell mainly in the passive activation map (7492 voxels), while only 48 voxels fell in a subcortical region of the active-map. Our results suggest that DOCs can be described along a continuum—rather than as separated clinical categories—and characterised by a widespread dysfunction of brain networks rather than by the impairment of a well functionally anatomically defined one. View Full-Text
Keywords: fMRI; minimally conscious state; unresponsive wakefulness syndrome; GingerALE fMRI; minimally conscious state; unresponsive wakefulness syndrome; GingerALE
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Berlingeri, M.; Magnani, F.G.; Salvato, G.; Rosanova, M.; Bottini, G. Neuroimaging Studies on Disorders of Consciousness: A Meta-Analytic Evaluation. J. Clin. Med. 2019, 8, 516.

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