Le Cause Maria, Bonanno Lilla, Alagna Antonella, Bonanno Carmen, De Caro Jolanda, Logiudice Anna Lisa, Pollicino Patrizia, Corallo Francesco, De Salvo Simona, Rifici Carmela, Quartarone Angelo, Marino Silvia
IRCCS Centro Neurolesi Bonino Pulejo, 98124 Messina, Italy.
J Clin Med. 2024 Sep 25;13(19):5704. doi: 10.3390/jcm13195704.
This review focuses on the prognostic role of resting-state functional magnetic resonance imaging (fMRI) in disorders of consciousness (DOCs). Several studies were conducted to determine the diagnostic accuracy in DOC patients to identify prognostic markers and to understand the neural correlates of consciousness. A correct diagnosis of consciousness in unresponsive or minimally responsive patients is important for prognostic and therapeutic management. Functional connectivity is considered as an important tool for the formulation of cerebral networks; it takes into account the primary sensorimotor, language, visual and central executive areas, where fMRI studies show damage in brain connectivity in the areas of frontoparietal networks in DOC patients. The integration of neuroimaging or neurophysiological methods could improve our knowledge of the neural correlates of clinical response after an acquired brain injury. The use of MRI is widely reported in the literature in different neurological diseases. In particular, fMRI is the most widely used brain-imaging technique to investigate the neural mechanisms underlying cognition and motor function. We carried out a detailed literature search following the relevant guidelines (PRISMA), where we collected data and results on patients with disorders of consciousness from the studies performed. In this review, 12 studies were selected, which showed the importance of the prognostic role of fMRI for DOCs. Currently there are still few studies on this topic. Future studies using fMRI are to be considered an added value for the prognosis and management of DOCs.
本综述聚焦于静息态功能磁共振成像（fMRI）在意识障碍（DOCs）中的预后作用。开展了多项研究以确定DOC患者的诊断准确性，识别预后标志物并了解意识的神经关联。对无反应或反应微弱患者的意识进行正确诊断对于预后和治疗管理至关重要。功能连接被视为构建脑网络的重要工具；它考虑了主要的感觉运动、语言、视觉和中央执行区域，fMRI研究显示DOC患者额顶叶网络区域的脑连接存在损伤。神经影像学或神经生理学方法的整合可以增进我们对后天性脑损伤后临床反应的神经关联的认识。MRI的应用在不同神经疾病的文献中有广泛报道。特别是，fMRI是用于研究认知和运动功能潜在神经机制的应用最为广泛的脑成像技术。我们按照相关指南（PRISMA）进行了详细的文献检索，收集了所开展研究中关于意识障碍患者的数据和结果。在本综述中，选取了12项研究，这些研究显示了fMRI对DOCs预后作用的重要性。目前关于该主题的研究仍然较少。未来使用fMRI的研究应被视为对DOCs预后和管理的一项附加价值。
