Kazazian Karnig, Norton Loretta, Gofton Teneille E, Debicki Derek, Owen Adrian M
Brain and Mind Institute, Western University, London, ON N6A3K7, Canada.
Graduate Program in Neuroscience, Western University, London, ON N6A3K7, Canada.
Brain Sci. 2020 Sep 3;10(9):604. doi: 10.3390/brainsci10090604.
Differences in the functional integrity of the brain from acute severe brain injury to subsequent recovery of consciousness have not been well documented. Functional magnetic resonance imaging (fMRI) may elucidate this issue as it allows for the objective measurement of brain function both at rest and in response to stimuli. Here, we report the cortical function of a patient with a severe traumatic brain injury (TBI) in a critically ill state and at subsequent functional recovery 9-months post injury. A series of fMRI paradigms were employed to assess sound and speech perception, command following, and resting state connectivity. The patient retained sound perception and speech perception acutely, as indexed by his fMRI responses. Command following was absent acutely, but was present at recovery. Increases in functional connectivity across multiple resting state networks were observed at recovery. We demonstrate the clinical utility of fMRI in assessing cortical function in a patient with severe TBI. We suggest that hallmarks of the recovery of consciousness are associated with neural activity to higher-order cognitive tasks and increased resting state connectivity.
从急性重度脑损伤到随后意识恢复过程中大脑功能完整性的差异尚未得到充分记录。功能磁共振成像（fMRI）或许能阐明这一问题，因为它能够对静息状态下以及对刺激做出反应时的脑功能进行客观测量。在此，我们报告了一名重度创伤性脑损伤（TBI）患者在危重病态下以及受伤9个月后功能恢复时的皮质功能。采用了一系列fMRI范式来评估声音和言语感知、听从指令以及静息状态连接性。通过fMRI反应表明，该患者急性时保留了声音感知和言语感知。急性时无法听从指令，但恢复时可以。恢复时观察到多个静息状态网络的功能连接性增加。我们证明了fMRI在评估重度TBI患者皮质功能方面的临床实用性。我们认为意识恢复的标志与对高阶认知任务的神经活动以及静息状态连接性增加有关。
