Brain Network Characteristics in Patients With Disorders of Consciousness

Study Overview
=================
Brief Summary
-----------------
Simultaneous measurement of the three modalities, functional magnetic resonance imaging (fMRI), positron emission tomography (PET) and electroencephalography (EEG) was proven to be feasible and advantageous in evaluating brain structural and functional (via fMRI), metabolic (via PET) and electrophysiological (via EEG) signatures simultaneously under the same conditions. Investigators use trimodal PET-fMRI-EEG imaging to explore the characteristics of brain network damage in patients with disorders of consciousness(DOC), assess the trajectory of consciousness recovery in a prospective observational cohort study.

Official Title
-----------------
Assessing Brain Network Characteristics in Patients With Disorders of Consciousness by Simultaneous Trimodal Positron Emission Tomography-Functional Magnetic Resonance Imaging-Electroencephalograph（PET-fMRI-EEG）Imaging

Conditions
-----------------
Disorders of Consciousness

Intervention / Treatment
-----------------
* Other: PET-fMRI-EEG


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Coma, VS/UWS, MCS and EMCS according to diagnostic criteria Age ≥18 years Written informed consent obtained Exclusion Criteria: Patients with contraindications to PET, MRI, EEG examinations or inability to complete PET-fMRI-EEG examinations (presence of ferromagnetic metal implants or hyperthermia) Hyperglycemia that is difficult to correct Patients with long-term use of corticosteroids Patients with coexisting severe systemic disease and limited life expectancy

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| coma<br> | Other: PET-fMRI-EEG<br>* Participants perform PET, fMRI, and EEG simultaneously using a MRI compatible EEG cap<br>|
| VS/UWS<br> | Other: PET-fMRI-EEG<br>* Participants perform PET, fMRI, and EEG simultaneously using a MRI compatible EEG cap<br>|
| MCS<br> | Other: PET-fMRI-EEG<br>* Participants perform PET, fMRI, and EEG simultaneously using a MRI compatible EEG cap<br>|
| EMCS<br> | Other: PET-fMRI-EEG<br>* Participants perform PET, fMRI, and EEG simultaneously using a MRI compatible EEG cap<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| CRS-R total score | The coma recovery scale-revised(CRS-R) total score is used to measure level of consciousness of disorder in enrolled patients. CRS-R consists of six subscales addressing auditory, visual, motor, verbal, communication, and arousal functions.The lowest item on each subscale represents reflexive activity and the highest item represents cognitively mediated behavior. Maximum scores of each subscale are summed to obtain the total score (from 0 to 23).The score for each subscale is based on the presence or absence of a specific behavioral response to a sensory stimulus (higher scores are better). | Patients in coma after 3 weeks enrolled | 
| GOSE score | Glasgow Outcome Scale-Extended(GOSE) score is used to measure the functional limitations of participants. GOSE is a 1-8 point scale (1 = Death, 2 = Vegetative State, 3 = Lower Severe Disability, 4 = Upper Severe Disability, 5 = Lower Moderate Disability, 6 = Upper Moderate Disability, 7 = Lower Good Recovery, and 8 = Upper Good Recovery). Patients with higher scores are more independent. | Patients are followed up for 6 months after enrolled | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
PET-fMRI-EEG, brain network, coma, Vegetative state(VS), Unresponsive wakefulness syndrome (UWS), Minimally conscious state(MCS), Emerged from minimally conscious state(EMCS)