Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Consciousness in Neurocritical Care Cohort Study Using fMRI and EEG (CONNECT-ME): Protocol for a Longitudinal Prospective Study and a Tertiary Clinical Care Service

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Measuring Neurobehavioral Disabilities Among Severe Brain Injury Survivors: Reports of Survivors and Proxies in the Chronic Phase

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Effect of Intermittent versus Continuous Light Exposure on Pupillary Light Response, As Evaluated by Pupillometry

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Influence of Strategic Cortical Infarctions on Pupillary Function

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Long-Term Return to Work After Acquired Brain Injury in Young Danish Adults: A Nation-Wide Registry-Based Cohort Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Optimization of preprocessing strategies in Positron Emission Tomography (PET) neuroimaging: A [11C]DASB PET study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Acute endovascular reperfusion treatment in patients with ischaemic stroke and large-vessel occlusion (Denmark 2011–2017)

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Correction: Psychedelic effects of psilocybin correlate with serotonin 2A receptor occupancy and plasma psilocin levels

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Psychedelic effects of psilocybin correlate with serotonin 2A receptor occupancy and plasma psilocin levels

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

Aims and Objectives: To facilitate individualized assessment of unresponsive patients in the intensive care unit for signs of preserved consciousness after acute brain injury. Background: Physicians and neuroscientists are increasingly recognizing a disturbing dilemma: Brain-injured patients who appear entirely unresponsive at the bedside may show signs of covert consciousness when examined by functional MRI (fMRI) or electroencephalography (EEG). According to a recent meta-analysis, roughly 15% of behaviorally unresponsive brain-injured patients can participate in mental tasks by modifying their brain activity during EEG- or fMRI-based paradigms, suggesting that they are conscious and misdiagnosed. This has major ethical and practical implications, including prognosis, treatment, resource allocation, and end-of-life decisions. However, EEG- or fMRI-based paradigms have so far typically been tested in chronic brain injury. Hence, as a novel approach, CONNECT-ME will import the full range of consciousness paradigms into neurocritical care. Methods: We will assess intensive care patients with acute brain injury for preserved consciousness by serial and multimodal evaluation using active, passive and resting state fMRI and EEG paradigms, as well as state-of-the-art clinical techniques including pupillometry and sophisticated clinical rating scales such as the Coma Recovery Scale-Revised. In addition, we are establishing a biobank (blood, cerebrospinal fluid and brain tissue, where available) to facilitate future genomic and microbiomic research to search for signatures of consciousness recovery. Discussion: We anticipate that this multimodal approach will add vital clinical information, including detection of preserved consciousness in patients previously thought of as unconscious, and improved (i.e., personalized) prognostication of individual patients. Our aim is two-fold: We wish to establish a cutting-edge tertiary care clinical service for unresponsive patients in the intensive care unit and lay the foundation for a fruitful multidisciplinary research environment for the study of consciousness in acute brain injury. Of note, CONNECT-ME will not only enhance our understanding of consciousness disorders in acute brain injury but it will also raise awareness for these patients who, for obvious reasons, have lacked a voice so far. Trial registration: The study is registered with clinicaltrials.org (ClinicalTrials.gov Identifier: NCT02644265).

Original languageEnglish
JournalFrontiers in Neurology
Volume9
Pages (from-to)1012
ISSN1664-2295
DOIs
Publication statusPublished - 2018

ID: 56304610