Functional brain network discrepancies in disorders of consciousness: A brain connectivity analysis

Resting-state functional magnetic resonance imaging provides insight into brain function in patients with consciousness disorders. We investigated the variability in functional brain networks in consciousness disorders with different etiologies and identified potential correlations with recovery. In this single-center prospective observational study, we included seven patients with traumatic brain injury, seven with cerebrovascular accidents, and a healthy control group of eight participants with intraspinal space-occupying lesions. All participants underwent resting-state functional magnetic resonance imaging and were assessed using the Coma Recovery Scale-Revised. Regional homogeneity values were compared across groups to evaluate differences in functional brain activity. Patients with traumatic brain injury demonstrated increased regional homogeneity values in the right fusiform gyrus, left middle cingulum, and right inferior frontal gyrus and reduced values in the left middle temporal gyrus, right supramarginal gyrus, right supplementary motor area, right precentral gyrus, and inferior frontal gyrus. Both groups exhibited higher regional homogeneity values in subcortical nuclei compared with the healthy control group. Patients with traumatic brain injury had reduced regional homogeneity in the paracentral lobule and frontal, temporal, and supramarginal regions compared with patients with cerebrovascular accidents. Preoperative Coma Recovery Scale-Revised scores were positively correlated with regional homogeneity in the hippocampus and negatively correlated with regional homogeneity in the midline temporal region. For 3 months, both groups showed improved consciousness. Regional homogeneity analysis can identify alterations in functional brain activity associated with recovery of consciousness, offering potential neuroimaging biomarkers for clinical assessment and prognosis for consciousness disorders.