Frontiers in neurology · 2026
Multimodal MRI reveals three-tiered pathological co-alterations in prolonged disorders of consciousness: structural disconnection, network disintegration, and regional hyperconnectivity.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wang Xiyong, Yin Yi, Wang Xianbin, Wu Shuang
Аннотация
BACKGROUND: Clinical diagnosis of prolonged disorders of consciousness (pDoC) relies primarily on behavioral scales, which lack sensitivity to covert cerebral cognitive activity and carry a risk of misdiagnosis. Few studies integrate structural and functional brain abnormalities to explore pDoC. The objective of this study was to employ resting-state functional magnetic resonance imaging (rs-fMRI) with diffusion tensor imaging (DTI) to delineate multimodal neuroimaging abnormalities in pDoC, clarify its neural mechanisms, and identify potential neuroimaging biomarkers.
METHODS: Eighteen patients with pDoC and 20 healthy controls (HCs) underwent rs-fMRI and DTI acquisition. Key metrics included fractional anisotropy (FA), amplitude of low-frequency fluctuations (ALFF), fractional ALFF (fALFF), regional homogeneity (ReHo), and functional connectivity (FC). Correlations between these metrics and Coma Recovery Scale-Revised (CRS-R) scores were analyzed.
RESULTS: Compared with HCs, pDoC patients exhibited reduced FA in the left anterior corona radiata (ACR-L) (p < 0.05), altered ALFF/fALFF/ReHo in prefrontal, cerebellar, and limbic regions, and disrupted FC within higher-order cortical networks. CRS-R scores positively correlated with ACR-L FA and prefrontal ReHo, and negatively correlated with cerebellar and limbic hyperactivity (p < 0.05).
CONCLUSION: Patients with pDoC demonstrate three simultaneous tiers of pathological co-alterations: extensive white matter structural disruption with peak significance in ACR-L; disintegration of higher-order cortical networks; patterns of hyperactivity and hyperconnectivity in the cerebellum, limbic system, and angular gyrus. Our findings provide a framework for understanding the pathophysiological mechanisms underlying consciousness impairment in pDoC. The neuroimaging biomarkers found in this study facilitate objective pDoC assessment and prognostic evaluation.
METHODS: Eighteen patients with pDoC and 20 healthy controls (HCs) underwent rs-fMRI and DTI acquisition. Key metrics included fractional anisotropy (FA), amplitude of low-frequency fluctuations (ALFF), fractional ALFF (fALFF), regional homogeneity (ReHo), and functional connectivity (FC). Correlations between these metrics and Coma Recovery Scale-Revised (CRS-R) scores were analyzed.
RESULTS: Compared with HCs, pDoC patients exhibited reduced FA in the left anterior corona radiata (ACR-L) (p < 0.05), altered ALFF/fALFF/ReHo in prefrontal, cerebellar, and limbic regions, and disrupted FC within higher-order cortical networks. CRS-R scores positively correlated with ACR-L FA and prefrontal ReHo, and negatively correlated with cerebellar and limbic hyperactivity (p < 0.05).
CONCLUSION: Patients with pDoC demonstrate three simultaneous tiers of pathological co-alterations: extensive white matter structural disruption with peak significance in ACR-L; disintegration of higher-order cortical networks; patterns of hyperactivity and hyperconnectivity in the cerebellum, limbic system, and angular gyrus. Our findings provide a framework for understanding the pathophysiological mechanisms underlying consciousness impairment in pDoC. The neuroimaging biomarkers found in this study facilitate objective pDoC assessment and prognostic evaluation.