Structural changes in brains of patients with disorders of consciousness treated with deep brain stimulation

Abstract Disorders of consciousness (DOC) are one of the major consequences after anoxic or traumatic brain injury. So far, several studies have described the regaining of consciousness in DOC patients using deep brain stimulation (DBS). However, these studies often lack detailed data on the structu...

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Autores principales:	Marina Raguž, Nina Predrijevac, Domagoj Dlaka, Darko Orešković, Ante Rotim, Dominik Romić, Fadi Almahariq, Petar Marčinković, Vedran Deletis, Ivica Kostović, Darko Chudy
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/88a75e2eecd249728c1a011e7aa9fcd7
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spelling	oai:doaj.org-article:88a75e2eecd249728c1a011e7aa9fcd72021-12-02T14:28:17ZStructural changes in brains of patients with disorders of consciousness treated with deep brain stimulation10.1038/s41598-021-83873-y2045-2322https://doaj.org/article/88a75e2eecd249728c1a011e7aa9fcd72021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-83873-yhttps://doaj.org/toc/2045-2322Abstract Disorders of consciousness (DOC) are one of the major consequences after anoxic or traumatic brain injury. So far, several studies have described the regaining of consciousness in DOC patients using deep brain stimulation (DBS). However, these studies often lack detailed data on the structural and functional cerebral changes after such treatment. The aim of this study was to conduct a volumetric analysis of specific cortical and subcortical structures to determine the impact of DBS after functional recovery of DOC patients. Five DOC patients underwent unilateral DBS electrode implantation into the centromedian parafascicular complex of the thalamic intralaminar nuclei. Consciousness recovery was confirmed using the Rappaport Disability Rating and the Coma/Near Coma scale. Brain MRI volumetric measurements were done prior to the procedure, then approximately a year after, and finally 7 years after the implementation of the electrode. The volumetric analysis included changes in regional cortical volumes and thickness, as well as in subcortical structures. Limbic cortices (parahippocampal and cingulate gyrus) and paralimbic cortices (insula) regions showed a significant volume increase and presented a trend of regional cortical thickness increase 1 and 7 years after DBS. The volumes of related subcortical structures, namely the caudate, the hippocampus as well as the amygdala, were significantly increased 1 and 7 years after DBS, while the putamen and nucleus accumbens presented with volume increase. Volume increase after DBS could be a result of direct DBS effects, or a result of functional recovery. Our findings are in accordance with the results of very few human studies connecting DBS and brain volume increase. Which mechanisms are behind the observed brain changes and whether structural changes are caused by consciousness recovery or DBS in patients with DOC is still a matter of debate.Marina RagužNina PredrijevacDomagoj DlakaDarko OreškovićAnte RotimDominik RomićFadi AlmahariqPetar MarčinkovićVedran DeletisIvica KostovićDarko ChudyNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Marina Raguž Nina Predrijevac Domagoj Dlaka Darko Orešković Ante Rotim Dominik Romić Fadi Almahariq Petar Marčinković Vedran Deletis Ivica Kostović Darko Chudy Structural changes in brains of patients with disorders of consciousness treated with deep brain stimulation
description	Abstract Disorders of consciousness (DOC) are one of the major consequences after anoxic or traumatic brain injury. So far, several studies have described the regaining of consciousness in DOC patients using deep brain stimulation (DBS). However, these studies often lack detailed data on the structural and functional cerebral changes after such treatment. The aim of this study was to conduct a volumetric analysis of specific cortical and subcortical structures to determine the impact of DBS after functional recovery of DOC patients. Five DOC patients underwent unilateral DBS electrode implantation into the centromedian parafascicular complex of the thalamic intralaminar nuclei. Consciousness recovery was confirmed using the Rappaport Disability Rating and the Coma/Near Coma scale. Brain MRI volumetric measurements were done prior to the procedure, then approximately a year after, and finally 7 years after the implementation of the electrode. The volumetric analysis included changes in regional cortical volumes and thickness, as well as in subcortical structures. Limbic cortices (parahippocampal and cingulate gyrus) and paralimbic cortices (insula) regions showed a significant volume increase and presented a trend of regional cortical thickness increase 1 and 7 years after DBS. The volumes of related subcortical structures, namely the caudate, the hippocampus as well as the amygdala, were significantly increased 1 and 7 years after DBS, while the putamen and nucleus accumbens presented with volume increase. Volume increase after DBS could be a result of direct DBS effects, or a result of functional recovery. Our findings are in accordance with the results of very few human studies connecting DBS and brain volume increase. Which mechanisms are behind the observed brain changes and whether structural changes are caused by consciousness recovery or DBS in patients with DOC is still a matter of debate.
format	article
author	Marina Raguž Nina Predrijevac Domagoj Dlaka Darko Orešković Ante Rotim Dominik Romić Fadi Almahariq Petar Marčinković Vedran Deletis Ivica Kostović Darko Chudy
author_facet	Marina Raguž Nina Predrijevac Domagoj Dlaka Darko Orešković Ante Rotim Dominik Romić Fadi Almahariq Petar Marčinković Vedran Deletis Ivica Kostović Darko Chudy
author_sort	Marina Raguž
title	Structural changes in brains of patients with disorders of consciousness treated with deep brain stimulation
title_short	Structural changes in brains of patients with disorders of consciousness treated with deep brain stimulation
title_full	Structural changes in brains of patients with disorders of consciousness treated with deep brain stimulation
title_fullStr	Structural changes in brains of patients with disorders of consciousness treated with deep brain stimulation
title_full_unstemmed	Structural changes in brains of patients with disorders of consciousness treated with deep brain stimulation
title_sort	structural changes in brains of patients with disorders of consciousness treated with deep brain stimulation
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/88a75e2eecd249728c1a011e7aa9fcd7
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Structural changes in brains of patients with disorders of consciousness treated with deep brain stimulation

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