How should functional imaging of patients with disorders of consciousness contribute to their clinical rehabilitation needs?
- 1 December 2006
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Neurology
- Vol. 19 (6), 520-527
- https://doi.org/10.1097/wco.0b013e3280106ba9
Abstract
Purpose of review We discuss the problems of evidence-based neurorehabilitation in disorders of consciousness, and recent functional neuroimaging data obtained in the vegetative state and minimally conscious state. Recent findings Published data are insufficient to make recommendations for or against any of the neurorehabilitative treatments in vegetative state and minimally conscious state patients. Electrophysiological and functional imaging studies have been shown to be useful in measuring residual brain function in noncommunicative brain-damaged patients. Despite the fact that such studies could in principle allow an objective quantification of the putative cerebral effect of rehabilitative treatment in the vegetative state and minimally conscious state, they have so far not been used in this context. Summary Without controlled studies and careful patient selection criteria it will not be possible to evaluate the potential of therapeutic interventions in disorders of consciousness. There also is a need to elucidate the neurophysiological effects of such treatments. Integration of multimodal neuroimaging techniques should eventually improve our ability to disentangle differences in outcome on the basis of underlying mechanisms and better guide our therapeutic options in the challenging patient populations encountered following severe acute brain damage.Keywords
This publication has 57 references indexed in Scilit:
- Tracking the recovery of consciousness from comaJCI Insight, 2006
- Possible axonal regrowth in late recovery from the minimally conscious stateJCI Insight, 2006
- Information processing in severe disorders of consciousness: Vegetative state and minimally conscious stateClinical Neurophysiology, 2005
- Outcome after severe brain damage, what makes the difference?Brain Injury, 2005
- Neurometabolic coupling in the vegetative and minimally conscious states: preliminary findingsJournal of Neurology, Neurosurgery & Psychiatry, 2005
- Effect of posture on levels of arousal and awareness in vegetative and minimally conscious state patients: a preliminary investigationJournal of Neurology, Neurosurgery & Psychiatry, 2005
- A Device for the Detection of Cognitive Brain Functions in Completely Paralyzed or Unresponsive PatientsIEEE Transactions on Biomedical Engineering, 2005
- The vegetative state: guidance on diagnosis and managementClinical Medicine, 2003
- Constructing an ethical stereotaxy for severe brain injury: balancing risks, benefits and accessNature Reviews Neuroscience, 2003
- Medical Aspects of the Persistent Vegetative StateNew England Journal of Medicine, 1994