Evidence map›Paper›PMID 26561296›Full record

Trial reportNeurology2015

Disruption of posteromedial large-scale neural communication predicts recovery from coma.

Stein Silva, Francesco de Pasquale, Corine Vuillaume, Beatrice Riu, Isabelle Loubinoux, Thomas Geeraerts, Thierry Seguin, Vincent Bounes, Olivier Fourcade, Jean-Francois Demonet and 1 more

Registry-linked trialOpen access · hybridAbstract readClinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03482115 (Whole Brain Connectivity Changes Induced by Traumatic Coma), which is not on this map. Cited by 62 papers.

0numbers the graph read from it
0cells of the map it votes in
62citing papers in PubMed
4.8field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03482115 nacompletednot on this mapstarted 2018, after this paper: background citation

Whole Brain Connectivity Changes Induced by Traumatic Coma: Combined Structural, Functional and Neuroinflammatory Approaches

TypeinterventionalSponsorUniversity Hospital, ToulouseRan2018 to 2022Enrolled59ConditionsTraumatic ComaArmsPET examination with radiopharmaceutical drug [18F] DPA-714, MRI examination, Blood samples
3 · Its place in the literature

Who cites it

62 citing papers in PubMed, 108 citations in OpenAlex.

  1. Article
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  3. Review
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  14. Zoological research · 2024
    Article
  15. Article
  16. Neuroimaging in Disorders of Consciousness and Recovery.Physical medicine and rehabilitation clinics of North America · 2024
    Review
  17. Article
  18. Article
  19. Article
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2 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 2 countries.

Stein SilvaFrom the Critical Care Unit (S.S., B.R.), Critical Care and Anaesthesiology Department (S.S., C.V., B.R., T.G., T.S., O.F.), and SAMU 31 (V.B.), University Teaching Hospital of Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9; INSERM U825 (S.S., C.V., I.L., P.P.), CHU Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France; Department of Radiology (F.d.P.), Santa Lucia Foundation, Rome; ITAB (F.d.P.), Department of Neuroscience Imaging and Clinical Science, G. D'Annunzio University, Chieti, Italy; and Leenaards Memory Center (J.-F.D.), Department of Clinical Neuroscience CHUV and University of Lausanne, Switzerland. silva.s@chu-toulouse.fr.
Francesco de PasqualeFrom the Critical Care Unit (S.S., B.R.), Critical Care and Anaesthesiology Department (S.S., C.V., B.R., T.G., T.S., O.F.), and SAMU 31 (V.B.), University Teaching Hospital of Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9; INSERM U825 (S.S., C.V., I.L., P.P.), CHU Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France; Department of Radiology (F.d.P.), Santa Lucia Foundation, Rome; ITAB (F.d.P.), Department of Neuroscience Imaging and Clinical Science, G. D'Annunzio University, Chieti, Italy; and Leenaards Memory Center (J.-F.D.), Department of Clinical Neuroscience CHUV and University of Lausanne, Switzerland.
Corine VuillaumeFrom the Critical Care Unit (S.S., B.R.), Critical Care and Anaesthesiology Department (S.S., C.V., B.R., T.G., T.S., O.F.), and SAMU 31 (V.B.), University Teaching Hospital of Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9; INSERM U825 (S.S., C.V., I.L., P.P.), CHU Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France; Department of Radiology (F.d.P.), Santa Lucia Foundation, Rome; ITAB (F.d.P.), Department of Neuroscience Imaging and Clinical Science, G. D'Annunzio University, Chieti, Italy; and Leenaards Memory Center (J.-F.D.), Department of Clinical Neuroscience CHUV and University of Lausanne, Switzerland.
Beatrice RiuFrom the Critical Care Unit (S.S., B.R.), Critical Care and Anaesthesiology Department (S.S., C.V., B.R., T.G., T.S., O.F.), and SAMU 31 (V.B.), University Teaching Hospital of Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9; INSERM U825 (S.S., C.V., I.L., P.P.), CHU Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France; Department of Radiology (F.d.P.), Santa Lucia Foundation, Rome; ITAB (F.d.P.), Department of Neuroscience Imaging and Clinical Science, G. D'Annunzio University, Chieti, Italy; and Leenaards Memory Center (J.-F.D.), Department of Clinical Neuroscience CHUV and University of Lausanne, Switzerland.
Isabelle LoubinouxFrom the Critical Care Unit (S.S., B.R.), Critical Care and Anaesthesiology Department (S.S., C.V., B.R., T.G., T.S., O.F.), and SAMU 31 (V.B.), University Teaching Hospital of Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9; INSERM U825 (S.S., C.V., I.L., P.P.), CHU Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France; Department of Radiology (F.d.P.), Santa Lucia Foundation, Rome; ITAB (F.d.P.), Department of Neuroscience Imaging and Clinical Science, G. D'Annunzio University, Chieti, Italy; and Leenaards Memory Center (J.-F.D.), Department of Clinical Neuroscience CHUV and University of Lausanne, Switzerland.
Thomas GeeraertsFrom the Critical Care Unit (S.S., B.R.), Critical Care and Anaesthesiology Department (S.S., C.V., B.R., T.G., T.S., O.F.), and SAMU 31 (V.B.), University Teaching Hospital of Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9; INSERM U825 (S.S., C.V., I.L., P.P.), CHU Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France; Department of Radiology (F.d.P.), Santa Lucia Foundation, Rome; ITAB (F.d.P.), Department of Neuroscience Imaging and Clinical Science, G. D'Annunzio University, Chieti, Italy; and Leenaards Memory Center (J.-F.D.), Department of Clinical Neuroscience CHUV and University of Lausanne, Switzerland.
Thierry SeguinFrom the Critical Care Unit (S.S., B.R.), Critical Care and Anaesthesiology Department (S.S., C.V., B.R., T.G., T.S., O.F.), and SAMU 31 (V.B.), University Teaching Hospital of Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9; INSERM U825 (S.S., C.V., I.L., P.P.), CHU Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France; Department of Radiology (F.d.P.), Santa Lucia Foundation, Rome; ITAB (F.d.P.), Department of Neuroscience Imaging and Clinical Science, G. D'Annunzio University, Chieti, Italy; and Leenaards Memory Center (J.-F.D.), Department of Clinical Neuroscience CHUV and University of Lausanne, Switzerland.
Vincent BounesFrom the Critical Care Unit (S.S., B.R.), Critical Care and Anaesthesiology Department (S.S., C.V., B.R., T.G., T.S., O.F.), and SAMU 31 (V.B.), University Teaching Hospital of Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9; INSERM U825 (S.S., C.V., I.L., P.P.), CHU Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France; Department of Radiology (F.d.P.), Santa Lucia Foundation, Rome; ITAB (F.d.P.), Department of Neuroscience Imaging and Clinical Science, G. D'Annunzio University, Chieti, Italy; and Leenaards Memory Center (J.-F.D.), Department of Clinical Neuroscience CHUV and University of Lausanne, Switzerland.
Olivier FourcadeFrom the Critical Care Unit (S.S., B.R.), Critical Care and Anaesthesiology Department (S.S., C.V., B.R., T.G., T.S., O.F.), and SAMU 31 (V.B.), University Teaching Hospital of Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9; INSERM U825 (S.S., C.V., I.L., P.P.), CHU Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France; Department of Radiology (F.d.P.), Santa Lucia Foundation, Rome; ITAB (F.d.P.), Department of Neuroscience Imaging and Clinical Science, G. D'Annunzio University, Chieti, Italy; and Leenaards Memory Center (J.-F.D.), Department of Clinical Neuroscience CHUV and University of Lausanne, Switzerland.
Jean-Francois DemonetFrom the Critical Care Unit (S.S., B.R.), Critical Care and Anaesthesiology Department (S.S., C.V., B.R., T.G., T.S., O.F.), and SAMU 31 (V.B.), University Teaching Hospital of Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9; INSERM U825 (S.S., C.V., I.L., P.P.), CHU Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France; Department of Radiology (F.d.P.), Santa Lucia Foundation, Rome; ITAB (F.d.P.), Department of Neuroscience Imaging and Clinical Science, G. D'Annunzio University, Chieti, Italy; and Leenaards Memory Center (J.-F.D.), Department of Clinical Neuroscience CHUV and University of Lausanne, Switzerland.
Patrice PéranFrom the Critical Care Unit (S.S., B.R.), Critical Care and Anaesthesiology Department (S.S., C.V., B.R., T.G., T.S., O.F.), and SAMU 31 (V.B.), University Teaching Hospital of Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9; INSERM U825 (S.S., C.V., I.L., P.P.), CHU Purpan, Place du Dr Baylac, F-31059 Toulouse Cedex 9, France; Department of Radiology (F.d.P.), Santa Lucia Foundation, Rome; ITAB (F.d.P.), Department of Neuroscience Imaging and Clinical Science, G. D'Annunzio University, Chieti, Italy; and Leenaards Memory Center (J.-F.D.), Department of Clinical Neuroscience CHUV and University of Lausanne, Switzerland.
Inserm · FRFondazione Santa Lucia · ITUniversity of Chieti-Pescara · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveWe hypothesize that the major consciousness deficit observed in coma is due to the breakdown of long-range neuronal communication supported by precuneus and posterior cingulate cortex (PCC), and that prognosis depends on a specific connectivity pattern in these networks.

methodsWe compared 27 prospectively recruited comatose patients who had severe brain injury (Glasgow Coma Scale score <8; 14 traumatic and 13 anoxic cases) with 14 age-matched healthy participants. Standardized clinical assessment and fMRI were performed on average 4 ± 2 days after withdrawal of sedation. Analysis of resting-state fMRI connectivity involved a hypothesis-driven, region of interest-based strategy. We assessed patient outcome after 3 months using the Coma Recovery Scale-Revised (CRS-R).

resultsPatients who were comatose showed a significant disruption of functional connectivity of brain areas spontaneously synchronized with PCC, globally notwithstanding etiology. The functional connectivity strength between PCC and medial prefrontal cortex (mPFC) was significantly different between comatose patients who went on to recover and those who eventually scored an unfavorable outcome 3 months after brain injury (Kruskal-Wallis test, p < 0.001; linear regression between CRS-R and PCC-mPFC activity coupling at rest, Spearman ρ = 0.93, p < 0.003).

conclusionIn both etiology groups (traumatic and anoxic), changes in the connectivity of PCC-centered, spontaneously synchronized, large-scale networks account for the loss of external and internal self-centered awareness observed during coma. Sparing of functional connectivity between PCC and mPFC may predict patient outcome, and further studies are needed to substantiate this potential prognosis biomarker.

Indexed as

AdultAgedBrain InjuriesComaConsciousnessFemaleGlasgow Coma ScaleGyrus CinguliHumansMagnetic Resonance ImagingMaleMiddle AgedNerve NetParietal LobePredictive Value of TestsRecovery of Function

Identifiers

PMID26561296
PMCPMC4676759
OpenAlexW2215205717

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.