Cerebral response to patient's own name in the vegetative and minimally conscious states

Haibo Di, Senming Yu, Xuchu Weng, Steven Laureys, Dan Yu, J.Q. Li, Pengmin Qin, Yihong Zhu, Suzhan Zhang, Yu Chen

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Abstract

BACKGROUND: A challenge in the management of severely brain-damaged patients with altered states of consciousness is the differential diagnosis between the vegetative state (VS) and the minimally conscious state (MCS), especially for the gray zone separating these clinical entities. OBJECTIVE: To evaluate the differences in brain activation in response to presentation of the patient's own name spoken by a familiar voice (SON-FV) in patients with VS and MCS. METHODS: By using fMRI, we prospectively studied residual cerebral activation to SON-FV in seven patients with VS and four with MCS. Behavioral evaluation was performed by means of standardized testing up to 3 months post-fMRI. RESULTS: Two patients with VS failed to show any significant cerebral activation. Three patients with VS showed SON-FV induced activation within the primary auditory cortex. Finally, two patients with VS and all four patients with MCS not only showed activation in primary auditory cortex but also in hierarchically higher order associative temporal areas. These two patients with VS showing the most widespread activation subsequently showed clinical improvement to MCS observed 3 months after their fMRI scan. CONCLUSION: The cerebral responses to patient's own name spoken by a familiar voice as measured by fMRI might be a useful tool to preclinically distinguish minimally conscious state-like cognitive processing in some patients behaviorally classified as vegetative. ©2007AAN Enterprises, Inc.
Original languageEnglish
Pages (from-to)895-899
Number of pages5
JournalNeurology
Volume68
Issue number12
DOIs
Publication statusPublished - 2007
Externally publishedYes

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Keywords

  • adult
  • article
  • auditory cortex
  • auditory stimulation
  • behavior
  • brain function
  • clinical article
  • cognition
  • controlled study
  • female
  • functional magnetic resonance imaging
  • human
  • male
  • minimally conscious state
  • persistent vegetative state
  • priority journal
  • prospective study
  • voice
  • Acoustic Stimulation
  • Adult
  • Auditory Cortex
  • Auditory Perception
  • Awareness
  • Brain Mapping
  • Cerebral Cortex
  • Consciousness
  • Diagnosis, Differential
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Nerve Net
  • Persistent Vegetative State
  • Predictive Value of Tests
  • Prospective Studies

Cite this

Di, H., Yu, S., Weng, X., Laureys, S., Yu, D., Li, J. Q., Qin, P., Zhu, Y., Zhang, S., & Chen, Y. (2007). Cerebral response to patient's own name in the vegetative and minimally conscious states. Neurology, 68(12), 895-899. https://doi.org/10.1212/01.wnl.0000258544.79024.d0