White matter connectometry in patients with disorders of consciousness revealed by 7-Tesla magnetic resonance imaging

White matter disruption plays an important role in disorders of consciousness (DOC). The aim of this study was to analyze the connectometry between DOC patients and healthy controls and to explore the relationship between diffusion connectometry and levels of consciousness. Fourteen patients with DOC and 13 sex- and age-matched controls were included in this study. The participants underwent diffusion magnetic resonance imaging (MRI) and T1-weighted structural MRI at 7 Tesla. Diffusion MRI connectometry was performed to investigate the differences between groups, and to subsequently study the correlation between Coma Recovery Scale-Revised (CRS-R) indexes and white matter integrity. In DOC patients, the quantitative anisotropy (QA) was significantly reduced in deep white matter tracts, whereas significantly higher QA values were found in the bilateral cerebellum compared with healthy controls. Moreover, the QA values in many tracts within the right hemisphere were higher in patients in a minimally conscious state compared to those in vegetative state/unresponsive wakefulness syndrome, which was reflected by the correlation between diffusion connectometry and CRS-R indexes. These results indicate that the cerebellum may play an important role in DOC, and the lateralization of the cerebral hemisphere in affected patients may suggest neural compensation.

Automated summary

This study reveals the importance of white matter disruption in disorders of consciousness. Through diffusion magnetic resonance imaging, differences in connectometry between DOC patients and healthy controls were identified. Furthermore, the study suggests that the cerebellum may play a significant role in DOC and the lateralization of the cerebral hemisphere in affected patients may indicate neural compensation.