Prognostication of chronic disorders of consciousness using brain functional networks and clinical characteristics

Disorders of consciousness are a heterogeneous mixture of different diseases or injuries. Although some indicators and models have been proposed for prognostication, any single method when used alone carries a high risk of false prediction. This study aimed to develop a multidomain prognostic model that combines resting state functional MRI with three clinical characteristics to predict one year outcomes at the single-subject level. The model discriminated between patients who would later recover consciousness and those who would not with an accuracy of around 90% on three datasets from two medical centers. It was also able to identify the prognostic importance of different predictors, including brain functions and clinical characteristics. To our knowledge, this is the first implementation reported of a multidomain prognostic model based on resting state functional MRI and clinical characteristics in chronic disorders of consciousness. We therefore suggest that this novel prognostic model is accurate, robust, and interpretable.
Comment: Although some prognostic indicators and models have been proposed for disorders of consciousness, each single method when used alone carries risks of false prediction. Song et al. report that a model combining resting state functional MRI with clinical characteristics provided accurate, robust, and interpretable prognostications. 52 pages, 1 table, 7 figures