Functional Ultrasound Imaging of Auditory Responses in Comatose Patients

Abstract

Bedside monitoring of brain function in severely brain-injured patients remains a critical clinical challenge. We demonstrate the translational potential of functional ultrasound (fUS) imaging for this purpose. In two comatose patients (Glasgow Coma Scale less than or equal to 8) with cranial windows post-decompressive craniectomy, we used a 7.8 MHz transducer optimized for cortical depths of 1.5-4 cm to perform real-time fUS during auditory stimulation. We observed task-related increases in regional cerebral blood flow (rCBF) in relevant brain regions (P < 10^-3, t-test), which correlated with subsequent neurological recovery at nine-month follow-up. These findings establish fUS as a sensitive and portable tool for bedside brain function assessment, offering potential for improved prognostication, treatment guidance, and development of targeted rehabilitative strategies.