Brain Network Disruptions Related to Traumatic Coma
Condition: Traumatic Coma
MeSH terms: Coma; Coma, Post-Head Injury
Study type: Interventional

Summary: 
      To provide a fine-grained description of the brain network dysfunctions induced by severe
      traumatic brain injury (TBI) or anoxic encephalopathy, that are responsible for the acute
      state of unarousable unawareness, named coma, this trial wants to explore the usefulness in
      this setting of a combined neuroimaging approaches encompassing several up-to-date techniques
      as structural MRI, fMRI and positron emission tomography (PET) scan (neuroinflammation
      ligands).
    

Detailed description: 
      So far, the gold standard for neuroprognostication of severe traumatic brain injury (TBI) or
      anoxic encephalopathy is the bedside behavioural evaluation. Nevertheless, the predictive
      value of such an exclusive clinical approach has been consistently reported as limited and
      insufficient in this challenging clinical setting. Recent theoretical and experimental data
      converge towards the idea of the critical implication of long-range brain connection in
      consciousness access and maintain. Nevertheless, previous studies have focused on the
      specific analysis of some targeted connections (regions of interest), and have used
      exclusively a single approach in neuroimaging (structural or functional imaging), with no
      interest in the neuro-inflammatory and neurodegenerative mechanisms likely associated with
      these disconnection phenomena. So, cerebral disconnection characterization at the level of
      the whole brain, at different stages of pathological abolition of consciousness must be made,
      on an anatomical, functional and metabolic scale. This descriptive study represents a first
      step in the identification of relevant multimodal imaging biomarkers. This will then lead to
      a larger study to identify the prognostic impact of these different biomarkers obtained in
      the acute phase of patient management.
    

Intervention name(s): PET examination with radiopharmaceutical drug [18F] DPA-714; MRI examination; Blood samples
Intervention type(s): Radiation; Diagnostic Test; Biological
Intervention description(s): Using a Biograph 6 Truepoint device. Establishment of a venous route. It will be injected 4 MBq / kg of 18F-DPA714 by the venous route with a maximum dose of 280 MBq. The patient will be placed along the orbito-meatal line. Brain acquisition will begin 60 minutes post-injection; MRI device Philips Achieva - 3Tesla. The acquisition of the data will include different sequences (anatomical MRI, diffusion MRI, resting fMRI) and will last a total of one hour (installation and removal of the patient in the machine included).anatomical MRI associated with FLAIR (Fluid Attenuation Inversion Recovery) and diffusion tensor (tractography).; Characterization of the TSPO phenotype (mitochondrial translocase) for tracer affinity
Intervention MeSH terms: Radiopharmaceuticals
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: coma; traumatic brain injury; anoxic encephalopathy; brain connectome; neuroinflammation; prognosis