TY - JOUR
T1 - Preservation of Language Processing and Auditory Performance in Patients With Disorders of Consciousness
T2 - A Multimodal Assessment
AU - Ferraro, Stefania
AU - Nigri, Anna
AU - D'Incerti, Ludovico
AU - Rosazza, Cristina
AU - Sattin, Davide
AU - Rossi Sebastiano, Davide
AU - Visani, Elisa
AU - Duran, Dunja
AU - Marotta, Giorgio
AU - Demichelis, Greta
AU - Catricala', Eleonora
AU - Kotz, Sonja
AU - Verga, Laura
AU - Leonardi, Matilde
AU - Cappa, Stefano
AU - Bruzzone, Maria Grazia
N1 - Funding Information:
Funding. This study was funded by Regione Lombardia (IX/000407-05/08/2010 to ML).
Publisher Copyright:
© Copyright © 2020 Ferraro, Nigri, D'Incerti, Rosazza, Sattin, Rossi Sebastiano, Visani, Duran, Marotta, Demichelis, Catricala', Kotz, Verga, Leonardi, Cappa and Bruzzone.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/12/21
Y1 - 2020/12/21
N2 - The impact of language impairment on the clinical assessment of patients suffering from disorders of consciousness (DOC) is unknown or underestimated and may mask the presence of conscious behavior. In a group of DOC patients (n = 11; time post-injury range: 5–252 months), we investigated the main neural functional and structural underpinnings of linguistic processing, and their relationship with the behavioral measures of the auditory function using the Coma Recovery Scale-Revised (CRS-R). We assessed the integrity of the brainstem auditory pathways, of the left superior temporal gyrus and arcuate fasciculus, the neural activity elicited by passive listening of an auditory language task, and the mean hemispheric glucose metabolism. Our results support the hypothesis of a relationship between the level of preservation of the investigated structures/functions and the CRS-R auditory subscale scores. Moreover, our findings indicate that patients in minimally conscious state minus (MCS−): (1) when presenting the auditory startle (at the CRS-R auditory subscale) might be aphasic in the receptive domain, being severely impaired in the core language structures/functions; (2) when presenting the localization to sound might retain language processing, being almost intact or intact in the core language structures/functions. Despite the small group of investigated patients, our findings provide a grounding of the clinical measures of the CRS-R auditory subscale in the integrity of the underlying auditory structures/functions. Future studies are needed to confirm our results that might have important consequences for the clinical practice.
AB - The impact of language impairment on the clinical assessment of patients suffering from disorders of consciousness (DOC) is unknown or underestimated and may mask the presence of conscious behavior. In a group of DOC patients (n = 11; time post-injury range: 5–252 months), we investigated the main neural functional and structural underpinnings of linguistic processing, and their relationship with the behavioral measures of the auditory function using the Coma Recovery Scale-Revised (CRS-R). We assessed the integrity of the brainstem auditory pathways, of the left superior temporal gyrus and arcuate fasciculus, the neural activity elicited by passive listening of an auditory language task, and the mean hemispheric glucose metabolism. Our results support the hypothesis of a relationship between the level of preservation of the investigated structures/functions and the CRS-R auditory subscale scores. Moreover, our findings indicate that patients in minimally conscious state minus (MCS−): (1) when presenting the auditory startle (at the CRS-R auditory subscale) might be aphasic in the receptive domain, being severely impaired in the core language structures/functions; (2) when presenting the localization to sound might retain language processing, being almost intact or intact in the core language structures/functions. Despite the small group of investigated patients, our findings provide a grounding of the clinical measures of the CRS-R auditory subscale in the integrity of the underlying auditory structures/functions. Future studies are needed to confirm our results that might have important consequences for the clinical practice.
KW - brainstem auditory evoked potentials
KW - disorders of consciousness
KW - language processing
KW - magnetic resonance imaging
KW - positron emission tomography
UR - http://www.scopus.com/inward/record.url?scp=85098752614&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85098752614&partnerID=8YFLogxK
U2 - 10.3389/fneur.2020.526465
DO - 10.3389/fneur.2020.526465
M3 - Article
AN - SCOPUS:85098752614
VL - 11
JO - Frontiers in Neurology
JF - Frontiers in Neurology
SN - 1664-2295
M1 - 526465
ER -