Intrinsic Brain Activity Alterations in Disorders of Consciousness: A Parallel Resting-State fMRI Analysis at 7 Tesla

In this study, we aimed to investigate the intrinsic brain activity alterations in patients with disorders of consciousness (DOC) using multidimensional resting-state functional magnetic resonance imaging (rs-fMRI) metrics at ultra-high field (7 T) MRI. We enrolled 10 patients with DOC, including those with vegetative state/unresponsive wakefulness syndrome and minimally conscious state, and 11 healthy controls (HCs). We applied various rs-fMRI metrics ranging from neuronal activity to synchronization and coordination of whole-brain activity, including amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), percent amplitude of fluctuation (PerAF), regional homogeneity (ReHo), and degree centrality (DC). Patients with DOC exhibited distinct brain activity patterns compared to HCs. The bilateral inferior temporal gyri showed enhanced activity across various metrics (right: ALFF, ReHo, DC; left: ALFF, fALFF, ReHo), while the right precuneus showed decreased activity in patients with DOC (ALFF, DC, PerAF), compared to HCs. Although an initial inverse relationship was observed between the left putamen and CRS-R total scores in DOC patients, this association did not survive multiple comparisons correction (Bonferroni-adjusted threshold: p < 0.0019). Our findings provide new insights into the neural mechanisms underlying DOC, highlighting the importance of the right precuneus and the bilateral inferior temporal gyri in consciousness level. These results can inform the development of diagnostic and therapeutic strategies for DOC.