Université de Liège Réseau des Bibliothèques

BICTEL/e - ULg
Serveur institutionnel des thèses de doctorat



Nouvelles thèses
dans BICTEL/e - ULg
  • Berastegui, Pierre - Fatigue-related risk management in the emergency department: identification and evaluation of informal work practices/La gestion du risque associé à la fatigue en médecine d'urgence : identification et évaluation de pratiques informelles
  • Krzemien, Magali - L'impact du raisonnement analogique sur les acquisitions langagières en lien avec la généralisation chez les enfants présentant un trouble développemental du langage
  • Annen, Jitka - Multimodal assessment of patients with disorders of consciousness
Présentation Recherche thèse Dépôt thèse Accès
gestionnaires
 
Page de résumé pour ULgetd-06212019-152634

Auteur : Annen, Jitka
E-mail de l'auteur : Jitka.Annen@uliege.be
URN : ULgetd-06212019-152634
Langue : Anglais/English
Titre : Multimodal assessment of patients with disorders of consciousness
Intitulé du diplôme : Doctorat en sciences biomédicales et pharmaceutiques
Département : Médecine - Département des sciences précliniques
Jury :
Nom : Titre :
BAHRI, Mohamed Ali Membre du jury/Committee Member
DEMERTZI, Athina Membre du jury/Committee Member
GOEBEL, Rainer Membre du jury/Committee Member
GOSSERIES, Olivia Membre du jury/Committee Member
HUSTINX, Roland Membre du jury/Committee Member
KUPERS, Ron Membre du jury/Committee Member
LEDOUX, Didier Membre du jury/Committee Member
PHILLIPS, Christophe Membre du jury/Committee Member
ROGISTER, Bernard Membre du jury/Committee Member
LAUREYS, Steven Promoteur/Director
Mots-clés :
  • disorders of consciousness
  • MRI
  • PET
  • EEG
  • neurophysiology
  • neuroscience
  • neuroimaging
Date de soutenance : 2019-04-23
Type d'accès : Restreint/Intranet
Résumé :

A realistic scenario after coma is that a patient suffers from a disorder of consciousness

(or DOC). This ranges from complete unawareness (UnresponsiveWakefulness

Syndrome) to consistent but fluctuating signs of awareness

(Minimally Conscious State). In these cases, it is crucial to make a correct

diagnosis as it will impact clinical management. This thesis introduces the

background of clinical (Chapter 1) and auxiliary (Chapter 2) assessments of

DOC patients. Four original research projects are presented in this thesis.

In the first study of this thesis (Chapter 3), the brain’s structural changes

in DOC patients were studied. Atrophy was more severe for patients that

were longer in a DOC, mostly so for unconscious patients. Furthermore, regional

white and grey matter volume were found to discriminate different

awareness levels. The wide availability of MRI makes this technique appealing

for diagnostic purposes. The most important grey matter regions

for diagnosis encompass the default mode network. This network is strictly

related to consciousness.

Given the centrality of the default mode network for consciousness, the

subsequent study investigated how glucose metabolism in this network depends

on its white matter structural integrity (Chapter 4). Afunction–structure

relationship was observed in brain-damaged patients for most of the default

mode network regions. The relationship between thalamic glucose uptake

and thalamocortical tracts was stronger in patients who recovered from the

disorder of consciousness, suggesting an important role for the thalamus in

recovery of consciousness.

In the last chapter (Chapter 5) of this thesis simultaneously acquired FDGPET

and high-density EEG were combined to evaluate the diagnostic accuracy

of both techniques, and to study cerebral electro-metabolic coupling. In

the first study we show that the diagnostic accuracy of high-density EEG was

comparable to that of FDG-PET. In the second study we investigate how EEG

and glucose uptake are related to each other at the regional level. Theta activity

has been suggested to originate from the default mode network and

is positively related to glucose uptake in healthy control subjects. Alpha is

important for relaxation and information processing, but also information

suppression, and is negatively related to glucose uptake. These effects are reverted in patients with disorders of consciousness, which could be related

to low default mode network activity and limited information processing.

To conclude, this thesis shows that objective neuroimaging measures,

specifically derived from T1-weighted structural MRI and EEG, are promising

to complement clinical diagnosis. Second, by combining various neuroimaging

techniques we can study the relationship between brain structure

and function which can provide important contributions to neuroscience in

general.

Autre version :
Fichiers :
Nom du fichier Taille Temps de chargement évalué (HH:MI:SS)
Modem 56K ADSL
[Restreint/Intranet] Thesis_Jitka_Version2.pdf 43.50 Mb 01:43:33 00:03:51
Fichiers accessibles par l'Internet [Public/Internet] ou que par l'Intranet [Restreint/Intranet].

Bien que le maximum ait été fait pour que les droits des ayants-droits soient respectés, si un de ceux-ci constatait qu'une oeuvre sur laquelle il a des droits a été utilisée dans BICTEL/e ULg sans son autorisation explicite, il est invité à prendre contact le plus rapidement possible avec la Direction du Réseau des Bibliothèques.


Parcourir BICTEL/e par Auteur|Département | Rechercher dans BICTEL/e


© Réseau des Bibliothèques de l'ULg, Grande traverse, 12 B37 4000 LIEGE