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BRIEF RESEARCH REPORT article

Front. Neuroimaging
Sec. Brain Imaging Methods
Volume 3 - 2024 | doi: 10.3389/fnimg.2024.1445952

Pre-and Post-Therapy functional MRI Connectivity in Severe Acute Brain Injury with Suppression of Consciousness: A Comparative Analysis to Epilepsy Features

Provisionally accepted
Emilio G. Cediel Emilio G. Cediel 1*Erika A. Duran Erika A. Duran 1Jeffrey Laux Jeffrey Laux 2William Reuther William Reuther 1Olivia Leggio Olivia Leggio 1Belfin Robinson Belfin Robinson 1Varina L. Boerwinkle Varina L. Boerwinkle 1
  • 1 Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
  • 2 North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

The final, formatted version of the article will be published soon.

    Severe acute brain injury (SABI) with suppressed consciousness is a major societal burden, with early prognosis being crucial for life-and-death treatment decisions. Resting-state functional-MRI (rs-fMRI) is promising for prognosis and identifying epileptogenic activity in SABI. While established for SABI prognosis and seizure networks (SzNET) identification in epilepsy, the rs-fMRI use for SzNET detection in SABI is limited. This study compared SzNET and resting state networks (RSN) evolution pre-to-post treatment in SABI and epilepsy, hypothesizing that changes would align with clinical evolution. Therapies included epilepsy surgery for the Epilepsy group and antiseizure medication for the SABI group. Independent component analysis (ICA) was used to identify SzNET and RSNs in all rs-fMRI. High Frequency BOLD (HF-BOLD), an ICA power spectrum-based index, quantified RSN and SzNET changes by patient. Confidence intervals measured HF-BOLD changes pre-to-post therapy. Baseline HF-BOLD and HF-BOLD changes were compared using linear-mix-models and interaction tests. Five SABI and ten Epilepsy patients were included. SzNET were identified in all SABI's pretherapy rs-fMRI. The clinical changes in SABI and epilepsy were consistent with rs-fMRI findings across groups. HF-BOLD reduced in the Epilepsy group RSN post-therapy (-0.78, 95% CI -3.42 to -0.33), but evidence was insufficient to determine a HF-BOLD reduction in SABI patients or SzNET. The HF-BOLD change trend in pre-to-post epilepsy surgery scans paralleled the clinical improvement, suggesting that the power spectrum may quantify degree of abnormality on ICA derived networks. Despite limitations such as small sample sizes, this exploratory study provides valuable insights into network dysfunction in SABI and epilepsy.

    Keywords: Functional Neuroimaging, connectome, Seizures, brain injuries, acute, Coma, Consciousness Disorders, Epilepsy, Antiseizure medication

    Received: 08 Jun 2024; Accepted: 10 Sep 2024.

    Copyright: © 2024 G. Cediel, Duran, Laux, Reuther, Leggio, Robinson and Boerwinkle. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Emilio G. Cediel, Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, 27599, North Carolina, United States

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