Investigating Structure-Function Connectivity in a Patient With Locked-In Syndrome by 7 T Magnetic Resonance Imaging: A Case Report.

Abstract

Functional neuroimaging studies have been conducted to investigate cognitive and behavioral dysfunctions in locked-in syndrome (LIS). This study, we used a multimodal neuroimaging approach to investigate functional and structural connectivity in a LIS patient. A 39-year-old patient who was in a total locked-in state was admitted in our department. The Coma Recovery Scale-Revised score, event-related potential, and ultra-high-field 7 T magnetic resonance imaging (MRI) were used to investigate this patient. White matter connectometry and seed-based resting-state functional connectivity analysis were used to compare the patient with an age-matched, sex-matched healthy control. Diffusion MRI findings indicated that fibers in the brainstem significantly decreased, especially in the cross region of pons, whereas the fibers above the brainstem in the deep brain increased particularly in the posterior cingulate cortex (PCC), the left parietal lobe, and parts of the corpus callosum. Meanwhile, using the PCC as the seed region, the functional connectivity between PCC and left parietal and occipital lobes, right occipital and temporal lobes increased, respectively, especially in the area of left inferior parietal gyrus and the postcentral gyrus, which were in accordance with the most increased fiber density areas observed in diffusion MRI. These results provide tentative evidences to reveal the important role of PCC and corpus callosum in the LIS patient. These findings may be informative to the study of patients with LIS.