RESEARCH ARTICLE


Editorial: The Role of Neuroimaging in the Diagnosis, Prognosis and Management of Disorders of Consciousness and Locked-in Syndrome



Francesca Pistoia*, 1, 2, Antonio Carolei1
1 Neurological Institute, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
2 Don Carlo Gnocchi ONLUS Foundation Milan, Italy


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© Pistoia and Carolei; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Neurological Institute, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila - Italy; E-mail: francesca.pistoia@univaq.it


Abstract

Disorders of consciousness and locked-in syndrome are two completely different neurological conditions which share unresponsiveness or minimal responsiveness at an observable behavioral level. The key element of disorders of consciousness is the loss of self- and environmental awareness, while the main feature of locked-in syndrome is extreme motor entrapment despite preserved awareness. In both cases accurate diagnosis may come late and patients are at risk of being wrongly diagnosed and missing out on appropriate rehabilitative opportunities. Clinical assessment alone often does not suffice in establishing the correct diagnosis and prognosis. The contribution of advanced neuroimaging techniques is essential in order to properly recognize patients’ conditions and formulate a tailored rehabilitative approach. Neuroimaging findings are also crucial in identifying the neuropathological substrate of the disorders: they contribute to elucidating the dynamics of cortical-subcortical networks in disorders of consciousness and the neural correlates of recently reported non-motor symptoms in locked-in syndrome.