Invited Review

Neuroradiology

, Volume 52, Issue 1, pp 15-24

Neuroimaging after coma

  • Luaba TshibandaAffiliated withComa Science Group, Cyclotron Research Center, University and University Hospital of LiègeDepartment of Neuroradiology, University Hospital of Liège
  • , Audrey VanhaudenhuyseAffiliated withComa Science Group, Cyclotron Research Center, University and University Hospital of Liège
  • , Mélanie BolyAffiliated withComa Science Group, Cyclotron Research Center, University and University Hospital of LiègeDepartment of Neuroradiology, University Hospital of LiègeDepartment of Neurology, University Hospital of Liège
  • , Andrea SodduAffiliated withComa Science Group, Cyclotron Research Center, University and University Hospital of Liège
  • , Marie-Aurelie BrunoAffiliated withComa Science Group, Cyclotron Research Center, University and University Hospital of Liège
  • , Gustave MoonenAffiliated withDepartment of Neurology, University Hospital of Liège
  • , Steven LaureysAffiliated withComa Science Group, Cyclotron Research Center, University and University Hospital of LiègeDepartment of Neuroradiology, University Hospital of LiègeDepartment of Neurology, University Hospital of Liège Email author 
  • , Quentin NoirhommeAffiliated withComa Science Group, Cyclotron Research Center, University and University Hospital of Liège

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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.

Keywords

Vegetative state Diffusion tensor imaging MR spectroscopy Functional MRI Consciousness