Document Detail


Functional imaging reveals movement preparatory activity in the vegetative state.
MedLine Citation:
PMID:  21441977     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
The vegetative state (VS) is characterized by the absence of awareness of self or the environment and preserved autonomic functions. The diagnosis relies critically on the lack of consistent signs of purposeful behavior in response to external stimulation. Yet, given that patients with disorders of consciousness often exhibit fragmented movement patterns, voluntary actions may go unnoticed. Here we designed a simple motor paradigm that could potentially detect signs of purposeful behavior in VS patients with mild to severe brain damage by examining the neural correlates of motor preparation in response to verbal commands. Twenty-four patients who met the diagnostic criteria for VS were recruited for this study. Eleven of these patients showing preserved auditory evoked potentials underwent functional magnetic resonance imaging (fMRI) to test for basic speech processing. Five of these patients, who showed word related activity, were included in a second fMRI study aimed at detecting functional changes in premotor cortex elicited by specific verbal instructions to move either their left or their right hand. Despite the lack of overt muscle activity, two patients out of five activated the dorsal premotor cortex contralateral to the instructed hand, consistent with movement preparation. Our results may reflect residual voluntary processing in these two patients. We believe that the identification of positive results with fMRI using this simple task, may complement the clinical assessment by helping attain a more precise diagnosis in patients with disorders of consciousness.
Authors:
Tristan Andres Bekinschtein; Facundo Francisco Manes; Mirta Villarreal; Adrian Mark Owen; Valeria Della-Maggiore
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Publication Detail:
Type:  Journal Article     Date:  2011-01-27
Journal Detail:
Title:  Frontiers in human neuroscience     Volume:  5     ISSN:  1662-5161     ISO Abbreviation:  Front Hum Neurosci     Publication Date:  2011  
Date Detail:
Created Date:  2011-03-28     Completed Date:  2011-07-14     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  101477954     Medline TA:  Front Hum Neurosci     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  5     Citation Subset:  -    
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Descriptor/Qualifier:
Grant Support
ID/Acronym/Agency:
MC_U105559847//Medical Research Council
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