Magnetic resonance spectroscopy data in the prognosis of consciousness recovery in patients with vegetative state

Kondrat’eva E.A.

Polenov Neurosurgical Institute, a branch of the Almazov National Medical Research Centre under the Ministry of Health of the Russia 12 Mayakovsky str., Saint Petersburg, Russia, 191014

Diment S.V.

MEDCI, St. Petersburg, Russia

Kondrat’ev S.A.

Polenov Neurosurgical Institute, a branch of the Almazov National Medical Research Centre under the Ministry of Health of the Russia 12 Mayakovsky str., Saint Petersburg, Russia, 191014

Ivanova N.E.

Bukkieva T.A.

Almazov National Medical Research Centre, St. Petersburg, Russia

Efimtsev A.Iu.

Kafedry nervnykh bolezneĭ i rentgenologii i radiologii Voenno-meditsinskoĭ akademii, Sankt-Peterburg

Trufanov G.E.

Almazov National Medical Research Centre, St. Petersburg, Russia

Kondratiev A.N.

Polenov Neurosurgical Institute of thr Ministry of Health of the Russia, 197341, Saint Petersburg, Russia

Laurens S.

Coma Science Group, GIGA-Consciousness, University and University Hospital of Liège, Liège, Belgium

Magnetic resonance spectroscopy data in the prognosis of consciousness recovery in patients with vegetative state

Authors:

Kondrat’eva E.A., Diment S.V., Kondrat’ev S.A., Ivanova N.E., Bukkieva T.A., Efimtsev A.Iu., Trufanov G.E., Kondratiev A.N., Laurens S.

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Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2019;119(10): 7‑14

DOI: 10.17116/jnevro20191191017

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To cite this article:

Kondrat’eva EA, Diment SV, Kondrat’ev SA, et al. . Magnetic resonance spectroscopy data in the prognosis of consciousness recovery in patients with vegetative state. S.S. Korsakov Journal of Neurology and Psychiatry. 2019;119(10):7‑14. (In Russ.)
https://doi.org/10.17116/jnevro20191191017

Подписка 2025-2 (S.S. Korsakov Journal of Neurology and Psychiatry)

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Objective. To study the prognostic value of magnetic resonance spectroscopy (MRS) in patients with vegetative state/unresponsive wakefulness syndrome (VS/UWS). Material and methods. Thirty-four patients with VS/UWS underwent multi-voxel MRS (thalamus, globus pallidus, putamen, internal capsules, fornix, brainstem, temporal and frontal cortex). Subjects were grouped according to etiology: 22 patients with traumatic brain injury (TBI) (group 1) and 12 patients with a hypoxia (group 2). The groups were matched by age and duration of UWS (mean 2, 3 months). The CRS-R was used to identify the first signs of consciousness during hospitalization and 6—12 months later. Outcomes of the patients with TBI were as follows: chronic VS/UWS (n=6), minimally conscious state (MCS) plus (n=9), emergence from MCS (EMCS) (n=7). Outcomes of the patients with hypoxia were: chronic vegetative state (n=10), minimally conscious state (MCS) (n=2). Results. The decrease in the NAA/Cr ratio in thalamus, capsula interna, temporal cortex are correlated with poor outcome in both groups. Higher rates of NAA/Cr in these structures are correlated with further recovery of consciousness. The decrease in the ratio of NAA Cr and NAA/NAA+Cho+Cr in the midbrain is correlated with poor outcome only in UWS with hypoxia. Conclusion. The results suggest that the MRS allows to more accurately predicting the outcome in VS/UWS patients with hypoxic brain damage, as well as in UWS patients with TBI, who have recovered consciousness to the level of EMCS.

Keywords:

MR spectroscopy

vegetative state

minimally conscious state

prognosis of recovery of consciousness

Authors:

Kondrat’eva E.A.

Polenov Neurosurgical Institute, a branch of the Almazov National Medical Research Centre under the Ministry of Health of the Russia 12 Mayakovsky str., Saint Petersburg, Russia, 191014

Diment S.V.

MEDCI, St. Petersburg, Russia

Kondrat’ev S.A.

Polenov Neurosurgical Institute, a branch of the Almazov National Medical Research Centre under the Ministry of Health of the Russia 12 Mayakovsky str., Saint Petersburg, Russia, 191014

Ivanova N.E.

Bukkieva T.A.

Almazov National Medical Research Centre, St. Petersburg, Russia

Efimtsev A.Iu.

Kafedry nervnykh bolezneĭ i rentgenologii i radiologii Voenno-meditsinskoĭ akademii, Sankt-Peterburg

Trufanov G.E.

Almazov National Medical Research Centre, St. Petersburg, Russia

Kondratiev A.N.

Polenov Neurosurgical Institute of thr Ministry of Health of the Russia, 197341, Saint Petersburg, Russia

Laurens S.

Coma Science Group, GIGA-Consciousness, University and University Hospital of Liège, Liège, Belgium

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