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The neural correlates of lexical processing in disorders of consciousness

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Abstract

There is a growing interest in the use of functional imaging to assess brain activity in the absence of behavioural responses in patients with disorders of consciousness (DOC). In the present study, we applied a hierarchical auditory stimulation paradigm to functional magnetic resonance (fMRI) in a group of long-term DOC adult patients. Brain response to pairs of pseudowords, of unrelated words and of semantically related words, i.e. stimuli differing in lexical status (words vs. pseudowords) and semantic relatedness (related vs. unrelated) was assessed. The former contrast was considered to reflect the automatic brain response to the passive presentation of meaningful real words, while the latter aimed to assess the response to meaning relationships. The results of the study indicate that automatic lexical processing can be observed in minimally conscious state (MCS), but also in vegetative state/unresponsive wakefulness syndrome (VS/UWS) patients, as indicated by increase in blood oxygenation level dependent (BOLD) activity in the linguistic networks. DOC patients, for some task conditions, recruited additional areas in comparison to healthy participants. Furthermore this study provides additional evidence of the potential role of fMRI in the assessment of residual cognitive processing in some of these patients, which may not be evident at the clinical level.

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Acknowledgments

The Besta Coma Research Centre (CRC) team, on behalf of which the present publication was submitted, would like to acknowledge its other members: A. Andronache, P. Fazio, D. Caldiroli, F. Ciaraffa, V. Covelli, A. Giovannetti, L. Minati, F. Molteni, M. Pagani, F. Panzica, E.A. Parati, B. Reggiori, C. Rosazza, G. Varotto, J. Vela Gomez, and E. Visani. The study was realized in collaboration with the European Biomedical Research Federation (FERB). The authors are grateful to Prof. Sonja Kotz, Laura Verga, and Pasquale Della Rosa for support and insights during task implementation and to Francesca Epifani for assistance during data acquisition.

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Authors and Affiliations

  1. Neuroradiology Department, Neurological Institute “Carlo Besta”, IRCCS Foundation, Via Celoria 11, 20133, Milan, Italy

    Anna Nigri, Stefania Ferraro, Maria Grazia Bruzzone & Ludovico D’Incerti

  2. School of Advanced Studies IUSS, Pavia, Italy

    Eleonora Catricalà & Stefano F. Cappa

  3. Neurology, Public Health and Disability Unit, Scientific Department, Neurological Institute “Carlo Besta”, IRCCS Foundation, Milan, Italy

    Davide Sattin & Matilde Leonardi

  4. Neurophysiopathology and Epilepsy Centre, Neurological Institute “Carlo Besta”, IRCCS Foundation, Milan, Italy

    Davide Rossi Sebastiano & Silvana Franceschetti

  5. Department of Nuclear Medicine, Ca’ Granda Ospedale Maggiore Policlinico, IRCCS Foundation, Milan, Italy

    Giorgio Marotta & Riccardo Benti

  6. Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy

    Stefano F. Cappa

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  1. Anna Nigri
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  2. Eleonora Catricalà
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Correspondence to Stefania Ferraro.

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Funding

This study was funded by Regione Lombardia (IX/000407-05/08/2010 to M.L.).

Conflict of interest

Author A.N. declares that she has no conflict of interest. Author E.C. declares that she has no conflict of interest. Author S.F. declares that she has no conflict of interest. Author M.G.B. declares that she has no conflict of interest. Author L.D. declares that he has no conflict of interest. Author D.S. declares that he has no conflict of interest. Author D.R.S. declares that he has no conflict of interest. Author S.F. declares that she has no conflict of interest. Author G.M. declares that he has no conflict of interest. Author R.B. declares that he has no conflict of interest. Author M.L. declares that she has no conflict of interest. Author S.F.C. declares that he has no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants or from the legally authorized representative of the patients included in the study.

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Nigri, A., Catricalà, E., Ferraro, S. et al. The neural correlates of lexical processing in disorders of consciousness. Brain Imaging and Behavior 11, 1526–1537 (2017). https://doi.org/10.1007/s11682-016-9613-7

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