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Brain imaging provides window into consciousness
Date:2/24/2011

NEW YORK (Feb. 25, 2011) -- Using a sophisticated imaging test to probe for higher-level cognitive functioning in severely brain-injured patients provides a window into consciousness -- but the view it presents is one that is blurred in fascinating ways, say researchers at Weill Cornell Medical College in the Feb. 25 online edition of the journal Brain.

In a novel study of six patients ranging in their function from minimally conscious state to the locked-in syndrome (normal cognitive function with severe motor impairment), the researchers looked at how the brains of these patients respond to a set of commands and questions while being scanned with functional magnetic resonance imaging (fMRI).

They found there was a wide, and largely unpredictable, variation in the ability of patients to respond to a simple command (such as "imagine swimming -- now stop") and then using that same command to answer simple yes/no or multiple-choice questions. This variation was apparent when compared with their ability to interact at the bedside using voice or gesture.

Some patients unable to communicate by gestures or voice were unable to do the mental tests, while others unable to communicate by gestures or voice were intermittently able to answer the researchers' questions using mental imagery. And, intriguingly, some patients with the ability to communicate through gestures or voice were unable to do the mental tasks.

The researchers say these findings suggest that no exam yet exists that can accurately assess the higher-level functioning that may be, and certainly seems to be, occurring in a number of severely brain-injured patients -- but that progress is being made.

"We have to abandon the idea that we can rely on a bedside exam in our assessment of some severe brain injuries. These results demonstrate that patients who show very limited responses at the bedside may have higher cognitive function revealed through fMRI," s
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Contact: Andrew Klein
ank2017@med.cornell.edu
212-821-0560
New York- Presbyterian Hospital/Weill Cornell Medical Center/Weill Cornell Medical College
Source:Eurekalert

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