RESEARCH ARTICLE


The Role of Neuroimaging Techniques in Establishing Diagnosis, Prognosis and Therapy in Disorders of Consciousness



Olivia Gosseries1, 2, *, Francesca Pistoia3, 4, Vanessa Charland-Verville1, Antonio Carolei3, Simona Sacco3, Steven Laureys1
1 Coma Science Group, GIGA, University of Liege, Liege, Belgium
2 Department of Psychology and Psychiatry, University of Wisconsin, Madison, WI, United-States
3 Department of Biotechnological and Applied Clinical Sciences, Neurological Institute, University of L'Aquila, L'Aquila, Italy
4 Don Carlo Gnocchi ONLUS Foundation, Milan, Italy


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© Gosseries et al.; 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 6001 Research Park Blvd Madison, Wisconsin, United-States; Tel: 00 1 608 957 29 44; E-mail: ogosseries@ulg.ac.be


Abstract

Non-communicative brain damaged patients raise important clinical and scientific issues. Here, we review three major pathological disorders of consciousness: coma, the unresponsive wakefulness syndrome and the minimally conscious state. A number of clinical studies highlight the difficulty in making a correct diagnosis in patients with disorders of consciousness based only on behavioral examinations. The increasing use of neuroimaging techniques allows improving clinical characterization of these patients. Recent neuroimaging studies using positron emission tomography, functional magnetic resonance imaging, electroencephalography and transcranial magnetic stimulation can help assess diagnosis, prognosis, and therapeutic treatment. These techniques, using resting state, passive and active paradigms, also highlight possible dissociations between consciousness and responsiveness, and are facilitating a more accurate understanding of brain function in this challenging population.

Keywords: Coma, EEG, fMRI, minimally conscious state, neuroimaging, PET scan, unresponsive wakefulness syndrome.