Title | Multimodal neuroimaging approaches to disorders of consciousness. |
Publication Type | Journal Article |
Year of Publication | 2006 |
Authors | Schiff, Nicholas D. |
Journal | J Head Trauma Rehabil |
Volume | 21 |
Issue | 5 |
Pagination | 388-97 |
Date Published | 2006 Sep-Oct |
ISSN | 0885-9701 |
Keywords | Arousal, 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 |
Abstract | 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 Journal | J Head Trauma Rehabil |
PubMed ID | 16983224 |
Grant List | NS02172 / NS / NINDS NIH HHS / United States NS43451 / NS / NINDS NIH HHS / United States |
Submitted by mam2155 on January 7, 2014 - 10:53am