Residual cerebral activity and behavioural fragments can remain in the persistently vegetative brain

This report identifies evidence of partially functional cerebral regions in catastrophically injured brains. To study five patients in a persistent vegetative state (PVS) with different behavioural features, we employed [(18)F]fluorodeoxyglucose-positron emission tomography (FDG-PET), MRI and magnet...

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Bibliographic Details
Published in:Brain (London, England : 1878) England : 1878), 2002-06, Vol.125 (Pt 6), p.1210-1234
Main Authors: SCHIFF, Nicholas D, RIBARY, Urs, PLUM, Fred, RODRIGUEZ MORENO, Diana, BEATTIE, Bradley, KRONBERG, Eugene, BLASBERG, Ronald, GIACINO, Joseph, MCCAGG, Caroline, FINS, Joseph J, LLINAS, Rodolfo
Format: Article
Language:English
Subjects:
Adult
Akinetic Mutism - metabolism
Akinetic Mutism - physiopathology
Behavior - physiology
Biological and medical sciences
Brain Injuries - physiopathology
Cerebral Cortex - physiopathology
Chronic Disease
Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes
Female
Humans
Magnetic Resonance Imaging
Magnetoencephalography
Male
Medical sciences
Middle Aged
Nervous system (semeiology, syndromes)
Neurology
Persistent Vegetative State - metabolism
Persistent Vegetative State - physiopathology
Tomography, Emission-Computed
Unconsciousness - metabolism
Unconsciousness - physiopathology
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Summary:This report identifies evidence of partially functional cerebral regions in catastrophically injured brains. To study five patients in a persistent vegetative state (PVS) with different behavioural features, we employed [(18)F]fluorodeoxyglucose-positron emission tomography (FDG-PET), MRI and magnetoencephalographic (MEG) responses to sensory stimulation. Each patient's brain expressed a unique metabolic pattern. In three of the five patients, co-registered PET/MRI correlate islands of relatively preserved brain metabolism with isolated fragments of behaviour. Two patients had suffered anoxic injuries and demonstrated marked decreases in overall cerebral metabolism to 30-40% of normal. Two other patients with non-anoxic, multifocal brain injuries demonstrated several isolated brain regions with relatively higher metabolic rates, that ranged up to 50-80% of normal. Nevertheless, their global metabolic rates remained
ISSN:0006-8950
1460-2156
DOI:10.1093/brain/awf131