Structural and functional connectivity of ascending reticular activating system in a patient with impaired consciousness after a cardiac arrest. A case report

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dc.contributor.authorParra Morales, Alejandra M.
dc.contributor.authorRudas, Jorge
dc.contributor.authorVargas, Jorge A.
dc.contributor.authorGómez, Francisco
dc.contributor.authorEnciso Olivera, César O.
dc.contributor.authorTrujillo Rodríguez, Diana
dc.contributor.authorMartínez, Darwin
dc.contributor.authorHernández, José
dc.contributor.authorOrdóñez Rubiano, Edgar G.
dc.contributor.authorMarín Muñoz, Jorge H.
dc.date.accessioned2022-02-21T15:02:38Z
dc.date.available2022-02-21T15:02:38Z
dc.date.issued2019-04-17
dc.description.abstractAbstract Rationale: Diffusion tensor imaging (DTI), diffusion tensor tractography (DTT), as well as resting-state-functional magnetic resonance imaging (rsfMRI) are promising methods for assessing patients with disorders of consciousness (DOCs). Patient concerns: This work describes the main findings using DTI, DTT, and rsfMRI in a patient with a DOC secondary to an anoxic encephalopathy who had a fatal outcome. She was an 85-year-old woman who presented a cardiac arrest and underwent cardiopulmonary resuscitation for 20 minutes then returning to spontaneous circulation. After sedation withdrawal, 2 days after the event, she remained with a Glasgow Coma Scale score of 3/15 and with an absence of brainstem reflexes. Diagnoses: DOC secondary to an anoxic encephalopathy after cardiovascular resuscitation. Interventions: A complete brain MRI scan was performed 72 hours after the initial event, including DTI, DTT, and rsfMRI. DTT demonstrated disruption of both ventral and dorsal tegmental tracts bilaterally. DTI showed a reduction of fractional anisotropic level in the mesencephalic nuclei. Moreover, changes in the number of fiber tracts were not evidenced in any portions of the ascending reticular activating system (ARAS). Finally, an increase in the anticorrelated and correlated association among the nuclei in the ARAS and the cortex was evidenced. Outcomes: Patient deceased. Lessons: Neuroimaging demonstrated low FA values in the ARAS, destruction of dorsal and ventral tegmental tracts, as well as hyper-connective (highly correlated or anti-correlated) association among ARAS and cortical nuclei compared with 3 healthy control subjects. Abbreviations: AAN = Arousal Network Atlas, ADC = apparent diffusion coefficient, ARAS = ascending reticular activating system, BOLD = blood-oxygen-level dependent imaging, DIPY = Diffusion Imaging in Python, DOC = disorder of consciousness, DTI = diffusion tensor imaging, DTT = diffusion tensor tractography, DWI = diffusion weighted imaging, FA = fractional anisotropy, FC = functional connectivity, FSL = FMRIB Software Library, ODF = orientation distribution function, ROI = region of interest, rsfMRI = resting-state functional magnetic resonance imaging, TBI = traumatic brain injury.eng
dc.format.extent6 p.spa
dc.format.mimetypeapplication/pdfspa
dc.identifier.urihttps://repositorio.fucsalud.edu.co/handle/001/1989
dc.language.isoengspa
dc.publisherWolters Kluwer Health, Inc.spa
dc.publisher.placeEstados Unidosspa
dc.relation.citationendpagee15625spa
dc.relation.citationissue19spa
dc.relation.citationstartpagee15620spa
dc.relation.citationvolume98spa
dc.relation.ispartofMedicine e-ISSN: 0025-7974 Vol.98 N° 19 (2019)
dc.relation.ispartofjournalMedicinespa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.coarhttp://purl.org/coar/access_right/c_abf2spa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)spa
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/spa
dc.sourcehttps://journals.lww.com/md-journal/Fulltext/2019/05100/Structural_and_functional_connectivity_of.110.aspx
dc.subject.decsImagen de difusión tensora
dc.subject.decsAgitación psicomotora
dc.subject.decsZona reticular
dc.subject.decsConciencia
dc.subject.decsImagen por resonancia magnética
dc.subject.proposalAscending reticular activating systemeng
dc.subject.proposalConsciousnesseng
dc.subject.proposalDiffusion tensor imagingeng
dc.subject.proposalArousaleng
dc.subject.proposalfMRIeng
dc.subject.proposalTractographyeng
dc.titleStructural and functional connectivity of ascending reticular activating system in a patient with impaired consciousness after a cardiac arrest. A case reporteng
dc.typeArtículo de revistaspa
dc.type.coarhttp://purl.org/coar/resource_type/c_6501spa
dc.type.coarversionhttp://purl.org/coar/version/c_970fb48d4fbd8a85spa
dc.type.contentTextspa
dc.type.driverinfo:eu-repo/semantics/articlespa
dc.type.redcolhttps://purl.org/redcol/resource_type/WPspa
dc.type.versioninfo:eu-repo/semantics/publishedVersionspa

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