Volume 87, Issue 12, Supplement , Pages 67-76, December 2006
Functional Neuroimaging Applications for Assessment and Rehabilitation Planning in Patients With Disorders of Consciousness
Abstract
Giacino JT, Hirsch J, Schiff N, Laureys S. Functional neuroimaging applications for assessment and rehabilitation planning in patients with disorders of consciousness.
Objective
To describe the theoretic framework, design, and potential clinical applications of functional neuroimaging protocols in patients with disorders of consciousness.
Data Sources
Recent published literature and authors’ own work.
Study Selection
Studies using functional neuroimaging techniques to investigate cognitive processing in patients diagnosed with vegetative and minimally conscious state.
Data Extraction
Not applicable.
Data Synthesis
Positron-emission tomography activation studies suggest that the vegetative state represents a global disconnection syndrome in which higher order association cortices are functionally disconnected from primary cortical areas. In contrast, patterns of activation in functional magnetic resonance imaging studies of patients in the minimally conscious state show preservation of large-scale cortical networks associated with language and visual processing.
Conclusions
Novel applications of functional neuroimaging in patients with disorders of consciousness may aid in differential diagnosis, prognostic assessment and identification of pathophysiologic mechanisms. Improvements in patient characterization may, in turn, provide new opportunities for restoration of function through interventional neuromodulation.
Key Words: Magnetic resonance imaging, functional, Minimally conscious state, Persistent vegetative state, Rehabilitation
Supported in part by the National Institute on Disability and Rehabilitation Research (grant no. H133A031713-04), National Cancer Institute Cancer Center Support, Charles A. Dana Fund, National Institute of Neurological Disorders and Stroke (grant no. R21 NS43451), the University Hospital of Liège, Belgium, and the Mind Science Foundation.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated. Laureys is Research Associate at the Belgian National Funds for Scientific Research.
PII: S0003-9993(06)01262-7
doi:10.1016/j.apmr.2006.07.272
© 2006 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Volume 87, Issue 12, Supplement , Pages 67-76, December 2006
