Multimodal neuroimaging approaches to disorders of consciousness.

TitleMultimodal neuroimaging approaches to disorders of consciousness.
Publication TypeJournal Article
Year of Publication2006
AuthorsSchiff, Nicholas D.
JournalJ Head Trauma Rehabil
Date Published2006 Sep-Oct
KeywordsArousal, Brain, Brain Injuries, Consciousness Disorders, Diagnostic Imaging, Diffuse Axonal Injury, Humans, Image Processing, Computer-Assisted, Longitudinal Studies, Magnetic Resonance Imaging, Magnetoencephalography, Nerve Net, Persistent Vegetative State, Positron-Emission Tomography, Prognosis, Recovery of Function

Advances in neuroimaging techniques hold significant promise for improving understanding of disorders of consciousness arising from severe brain injuries. We review neuroimaging studies of the vegetative state (VS) and minimally conscious state (MCS), and findings in an unusual case of late emergence from MCS. Multimodal neuroimaging studies using positron emission tomography techniques, functional magnetic resonance imaging, and quantitative electroencephalography and magnetoencephalography quantify variations of residual cerebral activity across these patient populations. The results suggest models to distinguish the pathophysiologic basis of VS and MCS. Less clear are potential brain mechanisms underlying late recovery of communication in rare MCS patients. Diffusion tensor magnetic resonance imaging studies and recent experimental findings suggest that structural remodeling of the brain following severe injury may play a role in late functional recoveries. More generally, relatively long time courses of recovery following severe brain injury emphasize the need to develop markers for identifying patients who may harbor potential for further meaningful recovery. Introduction of neuroimaging into the clinical evaluation process will require developing frameworks for longitudinal assessments of cerebral function. Although limited in number, available studies already provide important insights into underlying brain mechanisms that may help guide development of such assessment strategies.

Alternate JournalJ Head Trauma Rehabil
PubMed ID16983224
Grant ListNS02172 / NS / NINDS NIH HHS / United States
NS43451 / NS / NINDS NIH HHS / United States

Weill Cornell Medicine Consortium for the Advanced Study of Brain Injury 520 East 70th Street New York, NY