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Functional Connectivity of Anterior Insula Predicts Recovery of Patients With Disorders of Consciousness

文献类型：期刊论文

作者Zhang, Li1; Luo, Lunjie2; Zhou, Zhen3; Xu, Kaibin4; Zhang, Lijuan5; Liu, Xiaoyan6,7; Tan, Xufei6,7; Zhang, Jie1; Ye, Xiangming1; Gao, Jian5
刊名FRONTIERS IN NEUROLOGY
出版日期2018-11-30
卷号9页码:10
关键词insula disorders of consciousness resting-state functional magnetic resonance imaging functional connectivity inferior parietal lobule
ISSN号1664-2295
DOI10.3389/fneur.2018.01024
通讯作者Gao, Jian(vanjeff@163.com) ; Luo, Benyan(luobenyan@zju.edu.cn)
英文摘要Background: We hypothesize that the anterior insula is important for maintenance of awareness. Here, we explored the functional connectivity alterations of the anterior insula with changes in the consciousness level or over time in patients with disorders of consciousness (DOC) and determined potential correlation with clinical outcomes. Methods: We examined 20 participants (9 patients with DOC and 11 healthy controls). Each patient underwent resting-state functional magnetic resonance imaging (rs-fMRI) and a standardized Coma Recovery Scale-Revised (CRS-R) assessment on the same day. We categorized the patients according to the prognosis: those who emerged from a minimally conscious state (recovery group, n = 4) and those who remained in the unconscious state (unrecovery group, n = 5). Two rs-fMRI scans were obtained from all patients, and the second scan of patients in the recovery group was obtained after they regained consciousness. We performed seed-based fMRI analysis and selected the left ventral agranular insula (vAI) and dorsal agranular insula (dAI) as the regions of interest. Correlations with CRS-R were determined with the Spearman's correlation coefficient. Results: Compared with healthy controls, the functional connectivity between dAI and gyrus rectus of patients who recovered was significantly increased (p < 0.001, cluster-wise family-wise error rate [EWER] < 0.05). The second rs-fMRI scan of patients who remained with DOC showed a significant decreased functional connectivity between the dAI to contralateral insula, pallidum, bilateral inferior parietal lobule (IPL), precentral gyrus, and middle cingulate cortex (p < 0.001, cluster-wise FWER < 0.05) as well as the functional connectivity between vAI to caudate and cingulum contrast to controls (p < 0.001, cluster-wise FWER < 0.05). Finally, the functional connectivity strength of dAI-temporal pole (Spearman r = 0.491, p < 0.05) and dAI-IPL (Spearman r = 0.579, p < 0.05) were positively correlated with CRS-R scores in all DOC patients. The connectivity of dAl-IPL was also positively correlated with clinical scores in the recovery group (Spearman r = 0.807, p < 0.05). Conclusions: Our findings indicate that the recovery of consciousness is associated with an increased connectivity of the dAI to IPL and temporal pole. This possibly highlights the role of the insula in human consciousness. Moreover, longitudinal variations in dAI-IPL and dAI-temporal pole connectivity may be potential hallmarks in the outcome prediction of DOC patients.
WOS关键词DEFAULT MODE ; NETWORK ; STATE ; LEVEL ; LOBE ; MRI
WOS研究方向Neurosciences & Neurology
语种英语
WOS记录号WOS:000451949700002
出版者FRONTIERS MEDIA SA
源URL[http://ir.ia.ac.cn/handle/173211/25693]  
专题综合信息系统研究中心_脑机融合与认知评估
通讯作者Gao, Jian; Luo, Benyan
作者单位1.Hangzhou Med Coll, Peoples Hosp, Zhejiang Prov Peoples Hosp, Dept Rehabil Med, Hangzhou, Zhejiang, Peoples R China
2.Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Rehabil Med, Hangzhou, Zhejiang, Peoples R China
3.Zhejiang Univ, Coll Comp Sci & Technol, Hangzhou, Zhejiang, Peoples R China
4.Chinese Acad Sci, Brainnetome Ctr, Inst Automat, Beijing, Peoples R China
5.Hangzhou Hosp Zhejiang CAPR, Dept Rehabil, Hangzhou, Zhejiang, Peoples R China
6.Zhejiang Univ, Affiliated Hosp 1, Coll Med, Dept Neurol, Hangzhou, Zhejiang, Peoples R China
7.Zhejiang Univ, Affiliated Hosp 1, Coll Med, Brain Med Ctr, Hangzhou, Zhejiang, Peoples R China
推荐引用方式
GB/T 7714		 Zhang, Li,Luo, Lunjie,Zhou, Zhen,et al. Functional Connectivity of Anterior Insula Predicts Recovery of Patients With Disorders of Consciousness[J]. FRONTIERS IN NEUROLOGY,2018,9:10.
APA Zhang, Li.,Luo, Lunjie.,Zhou, Zhen.,Xu, Kaibin.,Zhang, Lijuan.,...&Luo, Benyan.(2018).Functional Connectivity of Anterior Insula Predicts Recovery of Patients With Disorders of Consciousness.FRONTIERS IN NEUROLOGY,9,10.
MLA Zhang, Li,et al."Functional Connectivity of Anterior Insula Predicts Recovery of Patients With Disorders of Consciousness".FRONTIERS IN NEUROLOGY 9(2018):10.

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