IMG-73. Functional connectivity alterations in disorders of consciousness: a systematic review and exploratory coordinate-based meta-analysis
Bibliographic record
Abstract
Abstract PURPOSE Disorders of consciousness (DoC), including coma, unresponsive wakefulness syndrome (UWS), and minimally conscious state (MCS), present significant diagnostic and prognostic challenges due to limited behavioral responsiveness and clinical uncertainty. Functional MRI (fMRI) has been used in research settings to assess residual brain function. This systematic review aimed to summarize connectivity-based fMRI findings in DoC and identify commonly affected networks using an exploratory coordinate-based meta-analysis. METHODS Medline/PubMed, Embase, and Web of Science were searched for studies reporting functional connectivity changes in DoC using fMRI. Extracted peak Montreal Neurological Institute (MNI) coordinates were matched to the Yeo-17 network atlas. A coordinate-based meta-analysis was conducted using Seed-based d Mapping with Permutation of Subject Images (SDM-PSI). Study quality and evidence level were evaluated using adapted NIH and Oxford Centre for Evidence-Based Medicine (OCEBM) criteria. RESULTS Seventy-nine studies (2,521 DoC patients; 1,251 controls) met inclusion. Diagnoses included MCS (n=826), UWS (n=366), VS (n=317), coma (n=383), eMCS (n=25), LIS (n=16), and others. Resting-state fMRI was used in 59.5% of studies and task-based in 41.8%. Most were cross-sectional (58.2%) or prospective cohorts (40.5%); one was a randomized trial. Based on NIH/OCEBM criteria, 35.4% of studies were high quality, and 63.3% fair quality. Seven rs-fMRI studies (n=155) were eligible for meta-analysis, contributing 128 peak coordinates. Alterations localized most frequently to the default mode (29.7%), frontoparietal (18.8%), and somatomotor (10.2%) networks. SDM-PSI identified significant clusters in the medial prefrontal cortex (SDM-Z = −4.604; p < 0.001), superior temporal gyrus (SDM-Z = −3.544; p = 0.011), and inferior parietal lobule (SDM-Z = −3.259; p = 0.032). Between-study heterogeneity was low (I² = 1.7%–10.0%). CONCLUSIONS Altered connectivity within the default mode and frontoparietal networks is frequently reported in DoC. While preliminary findings suggest clinical relevance, further standardized, longitudinal studies are needed to clarify the role of fMRI in DoC evaluation.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.021 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.027 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".