Willful modulation of brain activity in disorders of consciousness.

@article{Monti2010WillfulMO,
  title={Willful modulation of brain activity in disorders of consciousness.},
  author={Martin Max Monti and Audrey Vanhaudenhuyse and Martin R. Coleman and M{\'e}lanie Boly and John D. Pickard and Luaba Tshibanda and Adrian M. Owen and Steven Laureys},
  journal={The New England journal of medicine},
  year={2010},
  volume={362 7},
  pages={
          579-89
        }
}
BACKGROUND The differential diagnosis of disorders of consciousness is challenging. The rate of misdiagnosis is approximately 40%, and new methods are required to complement bedside testing, particularly if the patient's capacity to show behavioral signs of awareness is diminished. METHODS At two major referral centers in Cambridge, United Kingdom, and Liege, Belgium, we performed a study involving 54 patients with disorders of consciousness. We used functional magnetic resonance imaging (MRI… 

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References

SHOWING 1-10 OF 48 REFERENCES
Functional neuroimaging of the vegetative state
TLDR
Functional MRI has been used to show that aspects of speech perception, emotional processing, language comprehension and even conscious awareness might be retained in some patients who behaviourally meet all of the criteria that define the vegetative state.
Voluntary brain processing in disorders of consciousness
TLDR
The present results suggest that active evoked-related potentials paradigms may permit detection of voluntary brain function in patients with severe brain damage who present with a disorder of consciousness, even when the patient may present with very limited to questionably any signs of awareness.
Do vegetative patients retain aspects of language comprehension? Evidence from fMRI.
TLDR
A hierarchical functional magnetic resonance imaging (fMRI) auditory processing paradigm is applied to determine the extent of retained language processing in a group of 14 aetiologically heterogeneous patients to provide further evidence that a subset of patients fulfilling the behavioural criteria for the vegetative state retain islands of preserved cognitive function.
Diagnostic accuracy of the vegetative and minimally conscious state: Clinical consensus versus standardized neurobehavioral assessment
TLDR
Standardized neurobehavioral assessment is a more sensitive means of establishing differential diagnosis in patients with disorders of consciousness when compared to diagnoses determined by clinical consensus.
Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit
TLDR
The vegetative state needs considerable skill to diagnose, requiring assessment over a period of time; diagnosis cannot be made from a bedside assessment; accurate diagnosis is possible but requires the skills of a multidisciplinary team experienced in the management of people with complex disabilities.
...
...