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.
Coma Science Group, Cyclotron Research Center, University and University Hospital of Liège, Sart-Tilman, B30 Liège, Belgium.
Luaba
L
Tshibanda
Audrey
A
Vanhaudenhuyse
Mélanie
M
Boly
Andrea
A
Soddu
Marie-Aurelie
MA
Bruno
Gustave
G
Moonen
Steven
S
Laureys
Quentin
Q
Noirhomme
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