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Imaging Correlations in Non-communicating Patients

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Clinical Neurophysiology in Disorders of Consciousness

Abstract

The diagnosis and medical management of patients with acute or chronic disorders of consciousness (DOC) are challenging. Motor-independent functional neuroimaging technologies are increasingly employed to study covert cognitive processes in the absence of behavioural reports. Studies with functional magnetic resonance imaging (fMRI) and positron emission tomography (PET) performed in this patient population have utilized active, passive and resting-state paradigms. Active paradigms refer to mental imagery tasks that measure wilful modulation of brain signal in specific brain areas, aiming to detect command-following. Passive paradigms are used to measure brain responses to external sensory stimulation (e.g. auditory, somatosensory and visual). Alternatively, in resting-state paradigms, spontaneous brain function is assessed while subjects receive no external stimulation and are instructed to let their mind wander. Independently from each other, these methods have shown differences between healthy controls and patients, as well as among patients with DOC. However, these techniques cannot yet be used in clinical settings before robust information at the single-subject level will be provided: it is expected that multimodal research will improve the single-patient diagnosis, shed light on the prognostic biomarkers, and eventually promote the medical management of patients with consciousness alterations.

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Notes

  1. 1.

    The unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage (Loeser and Treede 2008).

  2. 2.

    When the patient follows both object-related and non-object-related commands in all eight administered trials (i.e. four trials per command).

  3. 3.

    When the patient shows three clearly discernible responses over the four trials on any one of the object-related or non-object-related commands.

  4. 4.

    Speech in noise was used as a form for distortion by adding a continuous pink-noise background to sentences.

  5. 5.

    Sentences containing at least two ambiguous words, either homonyms or homophones.

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Acknowledgment

Dr Rossetti is supported by the Swiss National Science Foundation [Grant CR32I3_143780].

Author information

Authors and Affiliations

  1. Coma Science Group, Cyclotron Research Center and Neurology Department, University of Liège, Liège, Belgium

    L. Heine, C. Di Perri & Steven Laureys MD, PhD

  2. Physics and Astronomy Department, Brain and Mind Institute, Western University, London, ON, Canada

    A. Soddu

  3. Computer Science Department, Universidad Central de Colombia, Bogotá, Colombia

    F. Gomez

  4. Coma Science Group, Cyclotron Research Center and CHU Neurology Department, University of Liège, Allée du 6 août n° 8, Sart Tilman B30, Liège, 4000, Belgium

    Athena Demertzi PhD

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  1. L. Heine
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  2. C. Di Perri
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  3. A. Soddu
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  4. F. Gomez
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  5. Steven Laureys MD, PhD
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  6. Athena Demertzi PhD
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Correspondence to Athena Demertzi PhD .

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  1. Service de Neurologie CHUV BH-07, Lausanne, Switzerland

    Andrea O. Rossetti

  2. Cyclotron Research Centre Coma Science Group, University of Liège, Liège, Belgium

    Steven Laureys

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Heine, L., Di Perri, C., Soddu, A., Gomez, F., Laureys, S., Demertzi, A. (2015). Imaging Correlations in Non-communicating Patients. In: Rossetti, A., Laureys, S. (eds) Clinical Neurophysiology in Disorders of Consciousness. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1634-0_12

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