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Neuroimaging after coma

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Abstract

Following coma, some patients will recover wakefulness without signs of consciousness (only showing reflex movements, i.e., the vegetative state) or may show non-reflex movements but remain without functional communication (i.e., the minimally conscious state). Currently, there remains a high rate of misdiagnosis of the vegetative state (Schnakers et. al. BMC Neurol, 9:35, 8) and the clinical and electrophysiological markers of outcome from the vegetative and minimally conscious states remain unsatisfactory. This should incite clinicians to use multimodal assessment to detect objective signs of consciousness and validate para-clinical prognostic markers in these challenging patients. This review will focus on advanced magnetic resonance imaging (MRI) techniques such as magnetic resonance spectroscopy, diffusion tensor imaging, and functional MRI (fMRI studies in both “activation” and “resting state” conditions) that were recently introduced in the assessment of patients with chronic disorders of consciousness.

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Acknowledgments

This research was supported by the Fonds de la Recherche Scientifique (FRS), European Commission (DISCOS, Mindbridge, DECODER & CATIA), Concerted Research Action (ARC-06/11-340), McDonnell Foundation, Mind Science Foundation. The authors thank the technicians of the Department of Neuroradiology of the Centre Hospitalier Universitaire, Liege, for their active participation in the MRI studies in comatose patients.

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We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Coma Science Group, Cyclotron Research Center, University and University Hospital of Liège, Sart-Tilman, B30, Liège, Belgium

    Luaba Tshibanda, Audrey Vanhaudenhuyse, Mélanie Boly, Andrea Soddu, Marie-Aurelie Bruno, Steven Laureys & Quentin Noirhomme

  2. Department of Neuroradiology, University Hospital of Liège, Sart-Tilman, Liège, Belgium

    Luaba Tshibanda, Mélanie Boly & Steven Laureys

  3. Department of Neurology, University Hospital of Liège, Sart-Tilman, Liège, Belgium

    Mélanie Boly, Gustave Moonen & Steven Laureys

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  1. Luaba Tshibanda
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  2. Audrey Vanhaudenhuyse
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  3. Mélanie Boly
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Correspondence to Steven Laureys.

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Thibanda and Vanhaudenhuyse contributed equally to this paper.

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Tshibanda, L., Vanhaudenhuyse, A., Boly, M. et al. Neuroimaging after coma. Neuroradiology 52, 15–24 (2010). https://doi.org/10.1007/s00234-009-0614-8

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