Abstract
The clinical evaluation of consciousness in disorder of consciousness (DOC) patients
based on their exhibited behavior is difficult and remains erroneous in many cases.
Recent studies demonstrated different levels of stimulus processing as well as evidence
of some level of awareness in sub-groups of these patients. The aim of the current
study was to examine the plausibility and challenges of implementing a clinical service
for evaluation of consciousness level in DOC patients.
Eleven Patients (ages 11–67) diagnosed as being in vegetative or minimal conscious
states were included. Functional MRI evaluations included auditory, language, voice
familiarity, imagery, and visual tests.
In 9 patients auditory-related activation was found, however only in 5 of the subjects
was differential activation found for language. Six patients exhibited differential
response to their own name. In three patients a response to visual stimuli was identified.
In one patient the auditory and linguistic systems were clearly activated in a hierarchical
pattern, and moreover willful modulation of brain activity was identified in the imagery
test.
We discuss the importance of using a wide battery of tests, the difference between
our clinical cohort and previous publications, as well as the challenges of clinically
implementing this method. Translating novel imaging methods into the clinical evaluation
of DOC patients is essential for better diagnosis and may encourage treatment development.
Keywords
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Article info
Publication history
Published online: September 05, 2013
Accepted:
August 7,
2013
Received:
July 22,
2013
Identification
Copyright
© 2013 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
