Review
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World J Radiol. Aug 28, 2014; 6(8): 589-597
Published online Aug 28, 2014. doi: 10.4329/wjr.v6.i8.589
Measuring consciousness in coma and related states
Carol Di Perri, Aurore Thibaut, Lizette Heine, Andrea Soddu, Athena Demertzi, Steven Laureys
Carol Di Perri, Neuroradiology, National Neurological Institute C Mondino, 27100 Pavia, Italy
Carol Di Perri, Aurore Thibaut, Lizette Heine, Athena Demertzi, Steven Laureys, Cyclotron Research Center and Neurology Department, Coma Science Group, University of Liège, 4000 Liège, Belgium
Andrea Soddu, Brain and Mind Institute, Physics and Astronomy Department, Western University, London, Ontario, N6A 3K7, Canada
Author contributions: Di Perri C designed and wrote the manuscript; Thibaut A, Heine L, Soddu A and Demertzi A were involved in designing and editing the manuscript; Laureys S supervised the manuscript design and writing; all authors were involved in literature search.
Supported by The European Commission; the James McDonnell Foundation; the European Space Agency; Mind Science Foundation; the French Speaking Community Concerted Research Action; the Belgian interuniversity attraction pole; the Public Utility Foundation “Université Européenne du Travail”; “Fondazione Europea di Ricerca Biomedica” and the University and University Hospital of Liège
Correspondence to: Carol Di Perri, MD, Cyclotron Research Center and Neurology Department, Coma Science Group, University of Liège, Allée du 6 août 8, Sart Tilman B30, 4000 Liège, Belgium. caroldiperri@hotmail.com
Telephone: +32-43-662316 Fax: +32-43-662946
Received: February 28, 2014
Revised: May 9, 2014
Accepted: June 14, 2014
Published online: August 28, 2014
Processing time: 180 Days and 20.3 Hours
Abstract

Consciousness is a prismatic and ambiguous concept that still eludes any universal definition. Severe acquired brain injuries resulting in a disorder of consciousness (DOC) provide a model from which insights into consciousness can be drawn. A number of recent studies highlight the difficulty in making a diagnosis in patients with DOC based only on behavioral assessments. Here we aim to provide an overview of how neuroimaging techniques can help assess patients with DOC. Such techniques are expected to facilitate a more accurate understanding of brain function in states of unconsciousness and to improve the evaluation of the patient’s cognitive abilities by providing both diagnostic and prognostic indicators.

Keywords: Disorders of consciousness; Neuroimaging; Magnetic resonance imaging; Transcranial magnetic stimulation/electroencephalography; Minimally conscious state; Vegetative state/unresponsive wakefulness syndrome

Core tip: In this review we show the main ways neuroimaging techniques contribute to both understanding the neural correlates of consciousness and detecting possible consciousness residual in severly traumatic brain injured patients. In particular, we make reference to the latest research in terms of both improving the diagnosis of patients with disorder of consciousness, and understanding the brain processes underlining consciousness, such as a broad and more complex than previously thought alteration of brain connectivity architecture.