Abstract

The diagnosis and prognosis of patients with severe chronic disorders of consciousness are still challenging issues and a high rate of misdiagnosis is evident. Hence, new tools are needed for an accurate diagnosis, which will also have an impact on the prognosis. In recent years, functional Magnetic Resonance Imaging (fMRI) has been gaining more and more importance when diagnosing this patient group. Especially resting state scans, i.e., an examination when the patient does not perform any task in particular, seems to be promising for these patient groups. After preprocessing the resting state fMRI data with a standard pipeline, we extracted the correlation matrices of 132 regions of interest. The aim was to find the regions of interest which contributed most to the distinction between the different patient groups and healthy controls. We performed feature selection using a genetic algorithm and a support vector machine. Moreover, we show by using only those regions of interest for classification that are most often selected by our algorithm, we get a much better performance of the classifier.

Highlights

  • In the past decades, emergency treatment as well as intensive care treatment have significantly improved, which has led to more patients surviving severe brain damage

  • Our first finding is that the proposed algorithm works well and that it is applicable to patients with severe chronic disorders of consciousness (scDOC)

  • Choosing the approach of using feature selection directly gave us the region of interest (ROI) that are most important for the classification

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Summary

Introduction

Emergency treatment as well as intensive care treatment have significantly improved, which has led to more patients surviving severe brain damage. Many of these patients do not fully recover from their brain damage but remain in some sort of comatose state [1,2]. The main question that arises during treatment is whether the comatose patient is conscious or not because this has an impact on ethical as well as legal questions. We mainly distinguish between two types of severe chronic disorders of consciousness (scDOC), namely unresponsive wakefulness syndrome (UWS; in the past called vegetative state (VS) or apallic syndrome), and minimally consciousness state (MCS) [3,4].

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