Peripheral Inflammation and Brain Structural Alterations in Patients With Disorders of Consciousness.

Study Overview
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Brief Summary
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Evidence suggests that inflammatory processes are key elements in the secondary effects of severe traumatic brain injury (TBI). The present study was designed to examine whether the peripheral inflammatory markers and brain structural alterations be associated with clinical measures and primary outcome following severe TBI. We hypothesized that peripheral inflammatory markers might be correlated with voxel-based GM volumes in patients with disorder of consciousness.

Detailed Description
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Background: Systemic inflammation, neurocognitive impairments, and morphologic brain changes are associated with outcome in patients with disorder of consciousness. Objective: The aim of this study is to assess the value of peripheral inflammatory markers and brain structural alterations in the chronic phase after severe traumatic brain injury. Methods: Serum levels of Interleukin (IL)-1β, IL-4, IL-6, IL-10, IL-13 and TNF-α were investigated in patients with chronic disorder of consciousness and healthy volunteers. Correlations were carried out between GM, WM, and CSF volumes and inflammatory cytokines levels. In addition, the Coma Recovery Scale-Revised (CRS-R) score was used to quantify the severity, and long-term recovery clinical outcome at 12 month was determined according to Glasgow Outcome Scale (GOS).

Official Title
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Peripheral Inflammation and Brain Structural Alterations in Patients With Disorders of Consciousness.

Conditions
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Disorder of Consciousness

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients ages 14 to 65 years old; Patients had a history of sTBI; Patients had awakened from a coma (indicating preserved sleep-wake cycles), including vegetative state and minimally consciousness state; Patients stay unconscious for more than 1 month. Exclusion Criteria: Patients with acute infectious diseases or liver dysfunction; Patients with serious diseases such as cardiac or pulmonary problems.

Ages Eligible for Study
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Minimum Age: 14 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Inflammatory cytokines | Serum levels of Interleukin (IL)-1β, IL-4, IL-6, IL-10, IL-13 and TNF-α were investigated in patients with chronic disorder of consciousness and healthy volunteers. | Six months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Gray matter volume | The study uses voxel-based morphometry (VBM) to measure changes of gray matter volume in patients with chronic disorder of consciousness and healthy volunteers. | Six months | 
| Coma Recovery Scale-Revised(CRS-R) | Coma Recovery Scale-Revised (CRS-R) score was used to quantify the severity, which consists of 23 hierarchically arranged items that comprise six subscales addressing auditory, visual, motor, oromotor/verbal, communication, and arousal processes. The lowest item on each subscale represents reflexive activity, whereas the highest items represent cognitively mediated behaviors. | 30 minutes before blood collection | 
| Glasgow Outcome Scale (GOS) | A GOS value of <3 was considered as a bad recovery, while a GOS value of ≥3 was considered as a good recovery. | In one year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Inflammatory markers, Magnetic resonance imaging, disorder of consciousness