title: Structural brain injury in patients with disorders of consciousness: A voxel-based morphometry study.
abstract: OBJECTIVE
  Disorders of consciousness (DOC; encompassing coma, vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious state minus/plus (MCS-/+)) are associated with structural brain injury. The extent of this damage remains poorly understood and merits a detailed examination using novel analysis techniques. Research design/methods and procedures: This study used voxel-based morphometry (VBM) on structural magnetic resonance imaging scans of 61 patients with DOC to examine grey and white matter injury associated with DOC, time spent in DOC, aetiology and diagnosis.
  
  
  RESULTS
  DOC and time spent in DOC were found to be associated with widespread structural brain injury, although the latter did not correlate strongly with injury in the right cerebral hemisphere. Traumatic, as compared to non-traumatic aetiology, was related to more injury in the brainstem, midbrain, thalamus, hypothalamus, basal forebrain, cerebellum, and posterior corpus callosum. Potential structural differences were found between VS/UWS and MCS and between MCS- and MCS+, but need further examination.
  
  
  CONCLUSIONS
  The findings indicate that both traumatic and non-traumatic DOC are associated with widespread structural brain injury, although differences exist that could lead to aetiology-specific treatment strategies. Furthermore, the high degree of atrophy occurring after initial brain injury prompts the development and use of neuroprotective techniques to potentially increase patients' chances of recovery.
authors.affiliation: a Coma Science Group , Cyclotron Research Center and University Hospital of Liège, University of Liège , Liège , Belgium.
authors.forename: Pieter
authors.initials: P
authors.lastname: Guldenmund
authors.affiliation: b Brain & Mind Institute, Physics & Astronomy Department , Western University , London , Ontario , Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Soddu
authors.affiliation: c Computer Imaging and Medical Applications Laboratory , National University of Colombia , Bogotá , Colombia.|d MoVeRe Group, Cyclotron Research Center , University of Liège , Liège , Belgium.
authors.forename: Katherine
authors.initials: K
authors.lastname: Baquero
authors.affiliation: a Coma Science Group , Cyclotron Research Center and University Hospital of Liège, University of Liège , Liège , Belgium.|e Algology-Palliative Care Department , University Hospital of Liège, University of Liège , Liège , Belgium.
authors.forename: Audrey
authors.initials: A
authors.lastname: Vanhaudenhuyse
authors.affiliation: a Coma Science Group , Cyclotron Research Center and University Hospital of Liège, University of Liège , Liège , Belgium.
authors.forename: Marie-Aurélie
authors.initials: MA
authors.lastname: Bruno
authors.affiliation: a Coma Science Group , Cyclotron Research Center and University Hospital of Liège, University of Liège , Liège , Belgium.
authors.forename: Olivia
authors.initials: O
authors.lastname: Gosseries
authors.affiliation: a Coma Science Group , Cyclotron Research Center and University Hospital of Liège, University of Liège , Liège , Belgium.
authors.forename: Steven
authors.initials: S
authors.lastname: Laureys
authors.affiliation: a Coma Science Group , Cyclotron Research Center and University Hospital of Liège, University of Liège , Liège , Belgium.|f Computer Science Department , Central University of Colombia , Bogotá , Colombia.
authors.forename: Francisco
authors.initials: F
authors.lastname: Gómez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000473:pathology*; D001933:Brain Stem / Q000473:pathology; D003244:Consciousness Disorders / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000000981:diagnostic imaging / Q000473:pathology; D013788:Thalamus / Q000473:pathology
keywords: Vegetative state/unresponsive wakefulness syndrome; minimally conscious state; structural brain injury; voxel-based morphometry