Can Mental Imagery Functional Magnetic Resonance Imaging Predict Recovery in Patients With Disorders of Consciousness?

Transcranial magnetic stimulation combined with high-density EEG in altered states of consciousness

“…In order to bypass these limitations, neuroscientists have developed different techniques to assess consciousness without relying on motor output. Functional magnetic resonance imaging (fMRI) using mental imagery paradigms can detect consciousness via wilful activation of specific brain areas in some patients with DOC [9][10][11][12]. However, the lack of response should not be interpreted as an absence of consciousness.…”

Assessing consciousness in coma and related states using transcranial magnetic stimulation combined with electroencephalography

“…Despite being unresponsive at the bedside, these patients should be considered conscious and their diagnosis should be replaced. The terms ''functional LIS'' [19], ''functional MCS'' [36] and ''MCS*'' [37] have been recently suggested to define patients who show non-behavioral evidence of consciousness that is only measurable via neuroimaging testing.…”

On the difficulty to communicate with fMRI-based protocols used to identify covert awareness

“…Moreover, stronger signs of awareness were found through active paradigms, i.e. when the patient had to volitionally modulate his or her cerebral activity in response to specific instructions (Owen et al, 2006, Monti et al, 2010, Bardin et al, 2012, Naci and Owen, 2013, Vogel et al, 2013. A well-known example involves UWS or MCS patients who were asked to imagine either pursuing or stopping sedative infusions.…”

“…A well-known example involves UWS or MCS patients who were asked to imagine either pursuing or stopping sedative infusions. It could thus significantly improve the quality of life of patients who may benefit from rehabilitation treatment (Vogel et al, 2013).…”