title: Dissociations between behavioural and functional magnetic resonance imaging-based evaluations of cognitive function after brain injury.
abstract: Functional neuroimaging methods hold promise for the identification of cognitive function and communication capacity in some severely brain-injured patients who may not retain sufficient motor function to demonstrate their abilities. We studied seven severely brain-injured patients and a control group of 14 subjects using a novel hierarchical functional magnetic resonance imaging assessment utilizing mental imagery responses. Whereas the control group showed consistent and accurate (for communication) blood-oxygen-level-dependent responses without exception, the brain-injured subjects showed a wide variation in the correlation of blood-oxygen-level-dependent responses and overt behavioural responses. Specifically, the brain-injured subjects dissociated bedside and functional magnetic resonance imaging-based command following and communication capabilities. These observations reveal significant challenges in developing validated functional magnetic resonance imaging-based methods for clinical use and raise interesting questions about underlying brain function assayed using these methods in brain-injured subjects.
authors.affiliation: Department of Neuroscience, Weill Cornell Graduate School of Medical Sciences, 1300 York Avenue, NY 10021, USA.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Bardin
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Fins
authors.forename: Douglas I
authors.initials: DI
authors.lastname: Katz
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hersh
authors.forename: Linda A
authors.initials: LA
authors.lastname: Heier
authors.forename: Karsten
authors.initials: K
authors.lastname: Tabelow
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Dyke
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Ballon
authors.forename: Nicholas D
authors.initials: ND
authors.lastname: Schiff
authors.forename: Henning U
authors.initials: HU
authors.lastname: Voss
mesh_terms: D000328:Adult; D001921:Brain / Q000098:blood supply* / Q000473:pathology; D001930:Brain Injuries / Q000150:complications*; D001931:Brain Mapping; D002755:Choice Behavior / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology* / Q000473:pathology*; D003142:Communication; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D055815:Young Adult
chemical_list: D010100:Oxygen