Brain Network Disruptions Related to Traumatic Coma

So far, the gold standard for neuroprognostication of severe traumatic brain injury (TBI) or anoxic encephalopathy is the bedside behavioural evaluation. Nevertheless, the predictive value of such an exclusive clinical approach has been consistently reported as limited and insufficient in this challenging clinical setting. Recent theoretical and experimental data converge towards the idea of the critical implication of long-range brain connection in consciousness access and maintain. Nevertheless, previous studies have focused on the specific analysis of some targeted connections (regions of interest), and have used exclusively a single approach in neuroimaging (structural or functional imaging), with no interest in the neuro-inflammatory and neurodegenerative mechanisms likely associated with these disconnection phenomena. So, cerebral disconnection characterization at the level of the whole brain, at different stages of pathological abolition of consciousness must be made, on an anatomical, functional and metabolic scale. This descriptive study represents a first step in the identification of relevant multimodal imaging biomarkers. This will then lead to a larger study to identify the prognostic impact of these different biomarkers obtained in the acute phase of patient management.

Inclusion criteria

for patients:

• Male or female / age between 18 to 75 years.
• Coma of traumatic or anoxic aetiology (GCS < 10).
• Early (< 1 month after TBI) and after the complete withdrawal of sedative agents.
• Written agreement for participation (legal responsible).

Inclusion criteria

for controls:

• Male or female / age between 18 to 75 years, paired with patients (gender and age).
• Written agreement for participation

Exclusion criteria

• Patients without public insurance regime.
• Pregnancy.
• Specific contraindication to the use of MRI (metallic material) or PET (specific allergy related to the ligand).

Exclusion criteria

for controls:

• pharmacological treatments which could interfere with consciousness (left to the judgement of the investigator)