Quantitative rates of brain glucose metabolism distinguish minimally conscious from vegetative state patients

Stender, Johan, Kupers, Ron, Rodell, Anders, Thibaut, Aurore, Chatelle, Camille, Bruno, Marie-Aurelie, Gejl, Michael, Bernard, Claire, Hustinx, Roland, Laureys, Steven and Gjedde, Albert (2015) Quantitative rates of brain glucose metabolism distinguish minimally conscious from vegetative state patients. Journal of Cerebral Blood Flow and Metabolism, 35 1: 58-65. doi:10.1038/jcbfm.2014.169

Author Stender, Johan
Kupers, Ron
Rodell, Anders
Thibaut, Aurore
Chatelle, Camille
Bruno, Marie-Aurelie
Gejl, Michael
Bernard, Claire
Hustinx, Roland
Laureys, Steven
Gjedde, Albert
Title Quantitative rates of brain glucose metabolism distinguish minimally conscious from vegetative state patients
Journal name Journal of Cerebral Blood Flow and Metabolism   Check publisher's open access policy
ISSN 1559-7016
Publication date 2015-01-10
Year available 2014
Sub-type Article (original research)
DOI 10.1038/jcbfm.2014.169
Open Access Status
Volume 35
Issue 1
Start page 58
End page 65
Total pages 8
Place of publication New York, NY United States
Publisher Nature Publishing Group
Collection year 2015
Language eng
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.
Keyword Brain injury
Minimally conscious state
Vegetative state
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online ahead of print 8 Oct 2014

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
Centre for Advanced Imaging Publications
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