Neuroimaging after coma.
Following coma, some patients will recover wakefulness without signs of consciousness (only showing reflex movements, i.e., the vegetative state) or may show non-reflex movements but remain without functional communication (i.e., the minimally conscious state). Currently, there remains a high rate of misdiagnosis of the vegetative state (Schnakers et. al. BMC Neurol, 9:35, 8) and the clinical and electrophysiological markers of outcome from the vegetative and minimally conscious states remain unsatisfactory. This should incite clinicians to use multimodal assessment to detect objective signs of consciousness and validate para-clinical prognostic markers in these challenging patients. This review will focus on advanced magnetic resonance imaging (MRI) techniques such as magnetic resonance spectroscopy, diffusion tensor imaging, and functional MRI (fMRI studies in both "activation" and "resting state" conditions) that were recently introduced in the assessment of patients with chronic disorders of consciousness.
Tshibanda
Luaba
L
Coma Science Group, Cyclotron Research Center, University and University Hospital of Liège, Sart-Tilman, B30 Liège, Belgium.
Vanhaudenhuyse
Audrey
A
Boly
Mélanie
M
Soddu
Andrea
A
Bruno
Marie-Aurelie
MA
Moonen
Gustave
G
Laureys
Steven
S
Noirhomme
Quentin
Q
D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D003128:Coma / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D003243:Consciousness / Q000502:physiology*; D003244:Consciousness Disorders / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D009434:Neural Pathways / Q000473:pathology / Q000503:physiopathology