Connectivite: Functional Connectivity Measurement After Severe Traumatic Brain Injury
Study Details
Study Description
Brief Summary
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
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Detailed Description
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 Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Conscious patients group: TBI patients awoken from comatose state with normal level of consciousness. intervention: fMRI (resting state) and structural (DTI) |
Procedure: MRI: functional (resting state) and structural (DTI)
One hour brain MRI recording without active task for the patient, no sedation
|
| DOC patients group: TBI patients awoken from comatose state with abnormal level of consciousness intervention: fMRI (resting state) and structural (DTI) |
Procedure: MRI: functional (resting state) and structural (DTI)
One hour brain MRI recording without active task for the patient, no sedation
|
Outcome Measures
Primary Outcome Measures
- cortical functional connectivity [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")]
the index is calculated from methodology of the article cited below (2)
Secondary Outcome Measures
- consciousness level measured with Coma recovery scale -revised (CRS-R) [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) [day 60 after first MRI]
- cortical functional connectivity change [connectivity index change (measured on MRI done day 60 after first MRI and compared to MRI done on day 0]
- Slow wave sleep quantification [EEG at discharge from intensive care unit (ICU) (30 days post-TBI on average)]
Electroencephalographic recording on 12 consecutive hours by night
- structural connectivity [DTI At discharge from intensive care unit (ICU) (30 days post-TBI on average)]
fibers density between region of interest by DTI
- structural connectivity [DTI day 60 after first MRI]
fibers density between region of interest by DTI
Eligibility Criteria
Criteria
Inclusion Criteria:
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severe TBI
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no general anesthesia since 7 days
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no neuroleptic nor hypnotic drug since 3 days
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medical criteria fulfilled to be discharged from ICU
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medical insurance
Exclusion Criteria:
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age < 18
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contra indication to MRI
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consent refusal from the family
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neurological trouble before TBI
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patient protected by law
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Grenoble University Hospital | Grenoble | France |
Sponsors and Collaborators
- University Hospital, Grenoble
Investigators
- Principal Investigator: Lydia Oujamaa, MD, University Hospital, Grenoble
Study Documents (Full-Text)
None provided.More Information
Publications
- Achard S, Delon-Martin C, Vértes PE, Renard F, Schenck M, Schneider F, Heinrich C, Kremer S, Bullmore ET. Hubs of brain functional networks are radically reorganized in comatose patients. Proc Natl Acad Sci U S A. 2012 Dec 11;109(50):20608-13. doi: 10.1073/pnas.1208933109. Epub 2012 Nov 26.
- Nakase-Richardson R, Whyte J, Giacino JT, Pavawalla S, Barnett SD, Yablon SA, Sherer M, Kalmar K, Hammond FM, Greenwald B, Horn LJ, Seel R, McCarthy M, Tran J, Walker WC. Longitudinal outcome of patients with disordered consciousness in the NIDRR TBI Model Systems Programs. J Neurotrauma. 2012 Jan 1;29(1):59-65. doi: 10.1089/neu.2011.1829. Epub 2011 Aug 4.
- 2014-A01873-44