Global glucose metabolism rate as diagnostic marker for disorder of consciousness of patients: quantitative FDG-PET study
ObjectiveThis study was to employ 18F-flurodeoxyglucose (FDG-PET) to evaluate the resting-state brain glucose metabolism in a sample of 46 patients diagnosed with disorders of consciousness (DoC). The aim was to identify objective quantitative metabolic indicators and predictors that could potential...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1425271/full |
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| author | Dongsheng Liu Dongsheng Liu Dongsheng Liu Nan Wang Nan Wang Nan Wang Ming Song Ming Song Ming Song Xiaoke Chai Xiaoke Chai Qiheng He Tianqing Cao Dawei Kong Zhuhuan Song Guangming Zhang Lei Liu Xiaosong Wang Guoqiang Chen Shaoya Yin Shaoya Yin Shaoya Yin Yi Yang Yi Yang Yi Yang Yi Yang Yi Yang Yi Yang Yi Yang Yi Yang Jizong Zhao Jizong Zhao |
| author_facet | Dongsheng Liu Dongsheng Liu Dongsheng Liu Nan Wang Nan Wang Nan Wang Ming Song Ming Song Ming Song Xiaoke Chai Xiaoke Chai Qiheng He Tianqing Cao Dawei Kong Zhuhuan Song Guangming Zhang Lei Liu Xiaosong Wang Guoqiang Chen Shaoya Yin Shaoya Yin Shaoya Yin Yi Yang Yi Yang Yi Yang Yi Yang Yi Yang Yi Yang Yi Yang Yi Yang Jizong Zhao Jizong Zhao |
| author_sort | Dongsheng Liu |
| collection | DOAJ |
| description | ObjectiveThis study was to employ 18F-flurodeoxyglucose (FDG-PET) to evaluate the resting-state brain glucose metabolism in a sample of 46 patients diagnosed with disorders of consciousness (DoC). The aim was to identify objective quantitative metabolic indicators and predictors that could potentially indicate the level of awareness in these patients.MethodsA cohort of 46 patients underwent Coma Recovery Scale-Revised (CRS-R) assessments in order to distinguish between the minimally conscious state (MCS) and the unresponsive wakefulness syndrome (UWS). Additionally, resting-state FDG-PET data were acquired from both the patient group and a control group consisting of 10 healthy individuals. The FDG-PET data underwent reorientation, spatial normalization to a stereotaxic space, and smoothing. The normalization procedure utilized a customized template following the methodology outlined by Phillips et al. Mean cortical metabolism of the overall sample was utilized for distinguishing between UWS and MCS, as well as for predicting the outcome at a 1-year follow-up through the application of receiver operating characteristic (ROC) analysis.ResultsWe used Global Glucose Metabolism as the Diagnostic Marker. A one-way ANOVA revealed that there was a statistically significant difference in cortical metabolic index between two groups (F(2, 53) = 7.26, p < 0.001). Multiple comparisons found that the mean of cortical metabolic index was significantly different between MCS (M = 4.19, SD = 0.64) and UWS group (M = 2.74, SD = 0.94,p < 0.001). Also, the mean of cortical metabolic index was significantly different between MCS and healthy group (M = 7.88, SD = 0.80,p < 0.001). Using the above diagnostic criterion, the diagnostic accuracy yielded an area under the curve (AUC) of 0.89 across the pooled cohort (95%CI 0.79–0.99). There was an 85% correct classification between MCS and UWS, with 88% sensitivity and 81% specificity for MCS. The best classification rate in the derivation cohort was achieved at a metabolic index of 3.32 (41% of the mean cortical metabolic index in healthy controls).ConclusionOur findings demonstrate that conscious awareness requires a minimum of 41% of normal cortical activity, as indicated by metabolic rates. |
| format | Article |
| id | doaj-art-8dfa6f7b33064f5280d971decb1255d5 |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-8dfa6f7b33064f5280d971decb1255d52025-01-03T06:47:28ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011510.3389/fneur.2024.14252711425271Global glucose metabolism rate as diagnostic marker for disorder of consciousness of patients: quantitative FDG-PET studyDongsheng Liu0Dongsheng Liu1Dongsheng Liu2Nan Wang3Nan Wang4Nan Wang5Ming Song6Ming Song7Ming Song8Xiaoke Chai9Xiaoke Chai10Qiheng He11Tianqing Cao12Dawei Kong13Zhuhuan Song14Guangming Zhang15Lei Liu16Xiaosong Wang17Guoqiang Chen18Shaoya Yin19Shaoya Yin20Shaoya Yin21Yi Yang22Yi Yang23Yi Yang24Yi Yang25Yi Yang26Yi Yang27Yi Yang28Yi Yang29Jizong Zhao30Jizong Zhao31Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, ChinaDepartment of Neurosurgery, Aviation General Hospital, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaNational Laboratory of Pattern Recognition, Institute of Automation, The Chinese Academy of Sciences, Beijing, ChinaBrainnetome Center, Institute of Automation, The Chinese Academy of Sciences, Beijing, ChinaUniversity of the Chinese Academy of Sciences, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Aviation General Hospital, Beijing, ChinaDepartment of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, ChinaDepartment of Neurosurgery, Aviation General Hospital, Beijing, ChinaDepartment of Neurosurgery, Aviation General Hospital, Beijing, ChinaDepartment of Neurosurgery, Aviation General Hospital, Beijing, ChinaDepartment of Neurosurgery, Aviation General Hospital, Beijing, ChinaClinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, ChinaDepartment of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China0Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Neurosurgical Institute, Tianjin Huanhu Hospital, Tianjin, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, China1Brain-Computer Interface Transitional Research Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China2China National Center for Neurological Disorders, Beijing, China3National Research Center for Rehabilitation Technical Aids, Beijing, China4Chinese Institute for Brain Research Beijing, Beijing, China5Beijing Institute of Brain Disorders, Beijing, China6Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United KingdomDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaChina National Clinical Research Center for Neurological Diseases, Beijing, ChinaObjectiveThis study was to employ 18F-flurodeoxyglucose (FDG-PET) to evaluate the resting-state brain glucose metabolism in a sample of 46 patients diagnosed with disorders of consciousness (DoC). The aim was to identify objective quantitative metabolic indicators and predictors that could potentially indicate the level of awareness in these patients.MethodsA cohort of 46 patients underwent Coma Recovery Scale-Revised (CRS-R) assessments in order to distinguish between the minimally conscious state (MCS) and the unresponsive wakefulness syndrome (UWS). Additionally, resting-state FDG-PET data were acquired from both the patient group and a control group consisting of 10 healthy individuals. The FDG-PET data underwent reorientation, spatial normalization to a stereotaxic space, and smoothing. The normalization procedure utilized a customized template following the methodology outlined by Phillips et al. Mean cortical metabolism of the overall sample was utilized for distinguishing between UWS and MCS, as well as for predicting the outcome at a 1-year follow-up through the application of receiver operating characteristic (ROC) analysis.ResultsWe used Global Glucose Metabolism as the Diagnostic Marker. A one-way ANOVA revealed that there was a statistically significant difference in cortical metabolic index between two groups (F(2, 53) = 7.26, p < 0.001). Multiple comparisons found that the mean of cortical metabolic index was significantly different between MCS (M = 4.19, SD = 0.64) and UWS group (M = 2.74, SD = 0.94,p < 0.001). Also, the mean of cortical metabolic index was significantly different between MCS and healthy group (M = 7.88, SD = 0.80,p < 0.001). Using the above diagnostic criterion, the diagnostic accuracy yielded an area under the curve (AUC) of 0.89 across the pooled cohort (95%CI 0.79–0.99). There was an 85% correct classification between MCS and UWS, with 88% sensitivity and 81% specificity for MCS. The best classification rate in the derivation cohort was achieved at a metabolic index of 3.32 (41% of the mean cortical metabolic index in healthy controls).ConclusionOur findings demonstrate that conscious awareness requires a minimum of 41% of normal cortical activity, as indicated by metabolic rates.https://www.frontiersin.org/articles/10.3389/fneur.2024.1425271/fullFDG-PETdisorders of consciousnessglobal glucose metabolism ratediagnostic markerCRS-R |
| spellingShingle | Dongsheng Liu Dongsheng Liu Dongsheng Liu Nan Wang Nan Wang Nan Wang Ming Song Ming Song Ming Song Xiaoke Chai Xiaoke Chai Qiheng He Tianqing Cao Dawei Kong Zhuhuan Song Guangming Zhang Lei Liu Xiaosong Wang Guoqiang Chen Shaoya Yin Shaoya Yin Shaoya Yin Yi Yang Yi Yang Yi Yang Yi Yang Yi Yang Yi Yang Yi Yang Yi Yang Jizong Zhao Jizong Zhao Global glucose metabolism rate as diagnostic marker for disorder of consciousness of patients: quantitative FDG-PET study Frontiers in Neurology FDG-PET disorders of consciousness global glucose metabolism rate diagnostic marker CRS-R |
| title | Global glucose metabolism rate as diagnostic marker for disorder of consciousness of patients: quantitative FDG-PET study |
| title_full | Global glucose metabolism rate as diagnostic marker for disorder of consciousness of patients: quantitative FDG-PET study |
| title_fullStr | Global glucose metabolism rate as diagnostic marker for disorder of consciousness of patients: quantitative FDG-PET study |
| title_full_unstemmed | Global glucose metabolism rate as diagnostic marker for disorder of consciousness of patients: quantitative FDG-PET study |
| title_short | Global glucose metabolism rate as diagnostic marker for disorder of consciousness of patients: quantitative FDG-PET study |
| title_sort | global glucose metabolism rate as diagnostic marker for disorder of consciousness of patients quantitative fdg pet study |
| topic | FDG-PET disorders of consciousness global glucose metabolism rate diagnostic marker CRS-R |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1425271/full |
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