Dysfunctional connectivity as a neurophysiologic mechanism of disorders of consciousness: a systematic review

Frontiers in Neuroscience

Neuroscience

Vedran Deletis¹  Marina Raguž²  Darko Chudy³  Gabriela Plosnić⁴ 

[1] Albert Einstein College of Medicine, New York, NY, United States;Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia;School of Medicine, Catholic University of Croatia, Zagreb, Croatia;Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia;School of Medicine, University of Zagreb, Zagreb, Croatia;Department of Pediatrics, University Hospital Centre Zagreb, Zagreb, Croatia;

关键词: disorders of consciousness;    functional connectivity;    disconnection syndrome;    fMRI;    EEG;    neuromodulation;   

DOI  :  10.3389/fnins.2023.1166187

 received in 2023-02-14, accepted in 2023-07-05,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionDisorders of consciousness (DOC) has been an object of numbers of research regarding the diagnosis, treatment and prognosis in last few decades. We believe that the DOC could be considered as a disconnection syndrome, although the exact mechanisms are not entirely understood. Moreover, different conceptual frameworks highly influence results interpretation. The aim of this systematic review is to assess the current knowledge regarding neurophysiological mechanisms of DOC and to establish possible influence on future clinical implications and usage.MethodsWe have conducted a systematic review according to PRISMA guidelines through PubMed and Cochrane databases, with studies being selected for inclusion via a set inclusion and exclusion criteria.ResultsEighty-nine studies were included in this systematic review according to the selected criteria. This includes case studies, randomized controlled trials, controlled clinical trials, and observational studies with no control arms. The total number of DOC patients encompassed in the studies cited in this review is 1,533.ConclusionConnectomics and network neuroscience offer quantitative frameworks for analysing dynamic brain connectivity. Functional MRI studies show evidence of abnormal connectivity patterns and whole-brain topological reorganization, primarily affecting sensory-related resting state networks (RSNs), confirmed by EEG studies. As previously described, DOC patients are identified by diminished global information processing, i.e., network integration and increased local information processing, i.e., network segregation. Further studies using effective connectivity measurement tools instead of functional connectivity as well as the standardization of the study process are needed.

【 授权许可】

Unknown   
Copyright © 2023 Plosnić, Raguž, Deletis and Chudy.