| 제목 |
Difference in ARAS between persistent vegetative and MCS following putaminal hemorrhage |
| 소속 |
Yeungnam University Medical Center, Department of Rehabilitation Medicine1 |
| 저자 |
Sung Ho Jang1†, You Sung Seo1†, Jong Bum Kim1*† |
Objectives: We investigated differences in the ascending reticular activating system (ARAS) of persistent vegetative state (PVS) and minimally conscious state (MCS) patients following putaminal hemorrhage (PH).
Methods: We recruited 17 patients with PH, and classified them into PVS (7 patients) and MCS (10 patients) groups. Eight parts of the ARAS were reconstructed: the dorsal lower ARAS, ventral lower ARAS, whole upper ARAS, prefrontal cortex (PFC)-upper ARAS, premotor cortex-upper ARAS, primary motor cortex-upper ARAS, primary somatosensory cortex-upper ARAS, and posterior parietal cortex-upper ARAS. For each ARAS part, diffusion tensor tractography (DTT) parameters (fractional anisotropy [FA] and tract volume [TV]) were estimated.
Results: The FA value did not differ significantly among the eight parts of the ARAS between the PVS and MCS groups (p > 0.05). The TV value of the PFC-upper ARAS was significantly lower in the PVS group than in the MCS group. There were no other significant TV differences in other parts of the ARAS (p < 0.05).
Conclusions: The sole ARAS difference between PVS and MCS patients following PH was a decrement in neural fibers in the PFC-upper ARAS in PVS patients compared to MCS ones. Based on the results, it appears that the prefrontal portion of the upper ARAS is a critical area when discerning between PVS and MCS in patients with PH.
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Results of diffusion tensor tractography (DTT) for the eight parts of the ascending reticular activating system (ARAS) of two representative patients, one in a persistent vegetative state (PVS: 51-year-old male) and the other in a minimally conscious state (MCS: 56-year-old male)
Demographic data of the patients in the persistent vegetative state and minimally conscious state groups
Comparison of diffusion tensor tractography parameters between the persistent vegetative state and minimally conscious state groups
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