Rare Diseases Symptoms Automatic Extraction
Home
A random Abstract
Our Project
Our Team
Diagnostic precision of PET imaging and functional MRI in disorders of consciousness: a clinical validation study.
[locked-in syndrome]
Bedside
clinical
examinations
can
have
high
rates
of
misdiagnosis
of
unresponsive
wakefulness
syndrome
(
vegetative
state
)
or
minimally
conscious
state
.
The
diagnostic
and
prognostic
usefulness
of
neuroimaging-based
approaches
has
not
been
established
in
a
clinical
setting
.
We
did
a
validation
study
of
two
neuroimaging-based
diagnostic
methods
:
PET
imaging
and
functional
MRI
(
fMRI
)
.
For
this
clinical
validation
study
,
we
included
patients
referred
to
the
University
Hospital
of
Li
ège
,
Belgium
,
between
January
,
2008
,
and
June
,
2012
,
who
were
diagnosed
by
our
unit
with
unresponsive
wakefulness
syndrome
,
locked-
in
syndrome
,
or
minimally
conscious
state
with
traumatic
or
non-traumatic
causes
.
We
did
repeated
standardised
clinical
assessments
with
the
Coma
Recovery
Scale-
Revised
(
CRS-R
)
,
cerebral
(
18
)
F-
fluorodeoxyglucose
(
FDG
)
PET
,
and
fMRI
during
mental
activation
tasks
.
We
calculated
the
diagnostic
accuracy
of
both
imaging
methods
with
CRS-R
diagnosis
as
reference
.
We
assessed
outcome
after
12
months
with
the
Glasgow
Outcome
Scale-
Extended
.
We
included
41
patients
with
unresponsive
wakefulness
syndrome
,
four
with
locked-
in
syndrome
,
and
81
in
a
minimally
conscious
state
(
48
=
traumatic
,
78
=
non-traumatic
;
110
=
chronic
,
16
=
subacute
)
.
(
18
)
F-FDG
PET
had
high
sensitivity
for
identification
of
patients
in
a
minimally
conscious
state
(
93
%
,
95
%
CI
85
-
98
)
and
high
congruence
(
85
%
,
77
-
90
)
with
behavioural
CRS-R
scores
.
The
active
fMRI
method
was
less
sensitive
at
diagnosis
of
a
minimally
conscious
state
(
45
%
,
30
-
61
)
and
had
lower
overall
congruence
with
behavioural
scores
(
63
%
,
51
-
73
)
than
PET
imaging
.
(
18
)
F-FDG
PET
correctly
predicted
outcome
in
75
of
102
patients
(
74
%
,
64
-
81
)
,
and
fMRI
in
36
of
65
patients
(
56
%
,
43
-
67
)
.
13
of
41
(
32
%
)
of
the
behaviourally
unresponsive
patients
(
ie
,
diagnosed
as
unresponsive
with
CRS-R
)
showed
brain
activity
compatible
with
(
minimal
)
consciousness
(
ie
,
activity
associated
with
consciousness
,
but
diminished
compared
with
fully
conscious
individuals
)
on
at
least
one
neuroimaging
test
;
69
%
of
these
(
9
of
13
)
patients
subsequently
recovered
consciousness
.
Cerebral
(
18
)
F-FDG
PET
could
be
used
to
complement
bedside
examinations
and
predict
long
-term
recovery
of
patients
with
unresponsive
wakefulness
syndrome
.
Active
fMRI
might
also
be
useful
for
differential
diagnosis
,
but
seems
to
be
less
accurate
.
The
Belgian
National
Funds
for
Scientific
Research
(
FNRS
)
,
Fonds
Léon
Fredericq
,
the
European
Commission
,
the
James
McDonnell
Foundation
,
the
Mind
Science
Foundation
,
the
French
Speaking
Community
Concerted
Research
Action
,
the
University
of
Copenhagen
,
and
the
University
of
Li
ège
.
Diseases
Validation
Diseases presenting
"consciousness"
symptom
locked-in syndrome
You can validate or delete this automatically detected symptom
Validate the Symptom
Delete the Symptom