Treatable brain network biomarkers in children in coma using task and resting-state functional MRI: a case series Article Swipe
Varina L. Boerwinkle
,
Bethany L. Sussman
,
Jordan Broman-Fulks
,
Emilio G. Cediel
,
Kirsten Gillette
,
William Reuther
,
Mark S. Scher
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3389/fneur.2023.1227195
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3389/fneur.2023.1227195
The withdrawal of life-sustaining therapies is frequently considered for pediatric patients with severe acute brain injuries who are admitted to the intensive care unit. However, it is worth noting that some children with a resultant poor neurological status may ultimately survive and achieve a positive neurological outcome. Evidence suggests that adults with hidden consciousness may have a more favorable prognosis compared to those without it. Currently, no treatable network disorders have been identified in cases of severe acute brain injury, aside from seizures detectable through an electroencephalogram (EEG) and neurostimulation via amantadine. In this report, we present three cases in which multimodal brain network evaluation played a helpful role in patient care. This evaluation encompassed various assessments such as continuous video EEG, visual-evoked potentials, somatosensory-evoked potentials, auditory brainstem-evoked responses, resting-state functional MRI (rs-fMRI), and passive-based and command-based task-based fMRI. It is worth noting that the latter three evaluations are unique as they have not yet been established as part of the standard care protocol for assessing acute brain injuries in children with suppressed consciousness. The first patient underwent serial fMRIs after experiencing a coma induced by trauma. Subsequently, the patient displayed improvement following the administration of antiseizure medication to address abnormal signals. In the second case, a multimodal brain network evaluation uncovered covert consciousness, a previously undetected condition in a pediatric patient with acute brain injury. In both patients, this discovery potentially influenced decisions concerning the withdrawal of life support. Finally, the third patient serves as a comparative control case, demonstrating the absence of detectable networks. Notably, this patient underwent the first fMRI prior to experiencing brain death as a pediatric patient. Consequently, this case series illustrates the clinical feasibility of employing multimodal brain network evaluation in pediatric patients. This approach holds potential for clinical interventions and may significantly enhance prognostic capabilities beyond what can be achieved through standard testing methods alone.
Related Topics
Concepts
Minimally conscious state
Coma (optics)
Persistent vegetative state
Medicine
Electroencephalography
Brain activity and meditation
Resting state fMRI
Neurostimulation
Consciousness Disorders
Psychology
Consciousness
Physical medicine and rehabilitation
Neuroscience
Psychiatry
Internal medicine
Optics
Stimulation
Physics
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3389/fneur.2023.1227195
- OA Status
- gold
- Cited By
- 7
- References
- 64
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4385720034
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4385720034Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3389/fneur.2023.1227195Digital Object Identifier
- Title
-
Treatable brain network biomarkers in children in coma using task and resting-state functional MRI: a case seriesWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
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2023Year of publication
- Publication date
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2023-08-10Full publication date if available
- Authors
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Varina L. Boerwinkle, Bethany L. Sussman, Jordan Broman-Fulks, Emilio G. Cediel, Kirsten Gillette, William Reuther, Mark S. ScherList of authors in order
- Landing page
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https://doi.org/10.3389/fneur.2023.1227195Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.3389/fneur.2023.1227195Direct OA link when available
- Concepts
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Minimally conscious state, Coma (optics), Persistent vegetative state, Medicine, Electroencephalography, Brain activity and meditation, Resting state fMRI, Neurostimulation, Consciousness Disorders, Psychology, Consciousness, Physical medicine and rehabilitation, Neuroscience, Psychiatry, Internal medicine, Optics, Stimulation, PhysicsTop concepts (fields/topics) attached by OpenAlex
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7Total citation count in OpenAlex
- Citations by year (recent)
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2025: 1, 2024: 4, 2023: 2Per-year citation counts (last 5 years)
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64Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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