Multimodal neuroimaging in patients with disorders of consciousness showing “functional hemispherectomy”

• Published in: Progress in Brain Research Vol. 193; pp. 323 - 333
• Main Authors: Bruno, M.A., Fernández-Espejo, D., Lehembre, R., Tshibanda, L., Vanhaudenhuyse, A., Gosseries, O., Lommers, E., Napolitani, M., Noirhomme, Q., Boly, M., Papa, M., Owen, A., Maquet, P., Laureys, S., Soddu, A.
• Format: Book Chapter Journal Article Web Resource
• Language: English
• Published: Netherlands Elsevier Science & Technology 2011; Elsevier
• Subjects: Adolescent; Brain - pathology; Brain - physiopathology; Brain Injuries - pathology; Brain Injuries - physiopathology; coma; consciousness; Consciousness - physiology; Consciousness Disorders - pathology; Consciousness Disorders - physiopathology; Diagnostic Imaging - methods; Diffusion Tensor Imaging; EEG; Electroencephalography; fMRI; Hemispherectomy; Human health sciences; Humans; Magnetic Resonance Imaging; Male; minimally conscious state; Neuroimaging - methods; Neurologie; Neurology; Neuropsychological Tests; Persistent Vegetative State - pathology; Persistent Vegetative State - physiopathology; PET; Positron-Emission Tomography; Sciences de la santé humaine; traumatic brain injury; vegetative state; Young Adult; fMRI; consciousness; EEG; traumatic brain injury; coma; PET; vegetative state; minimally conscious state
• ISBN: 9780444538390; 0444538399
• ISSN: 0079-6123; 1875-7855; 1875-7855
• DOI: 10.1016/B978-0-444-53839-0.00021-1

Beside behavioral assessment of patients with disorders of consciousness, neuroimaging modalities may offer objective paraclinical markers important for diagnosis and prognosis. They provide information on the structural location and extent of brain lesions (e.g., morphometric MRI and diffusion tensor imaging (DTI-MRI) assessing structural connectivity) but also their functional impact (e.g., metabolic FDG-PET, hemodynamic fMRI, and EEG measurements obtained in “resting state” conditions). We here illustrate the role of multimodal imaging in severe brain injury, presenting a patient in unresponsive wakefulness syndrome (UWS; i.e., vegetative state, VS) and in a “fluctuating” minimally conscious state (MCS). In both cases, resting state FDG-PET, fMRI, and EEG showed a functionally preserved right hemisphere, while DTI showed underlying differences in structural connectivity highlighting the complementarities of these neuroimaging methods in the study of disorders of consciousness.