A network approach to assessing cognition in disorders of consciousness
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To the Editor: Rodriguez Moreno et al.1 assessed putative cognitive capacity by fMRI in patients with no noticeable evidence of awareness on bedside examination. We agree that sensory and motor system impairment in persistent vegetative state (PVS) and minimally conscious state (MCS) may hamper clinical diagnosis. However, imaging studies in these cases may show some level of awareness unnoticed by conventional behavioral response methods.2
Command-following paradigms can provide interesting results yet there are intrinsic drawbacks.1 Moreover, PVS and MCS patients usually have marked brain abnormalities, making the identification of remaining brain structures compared to normal brains difficult.2,3
Another possibility is to explore behavioral responses to stimuli with an emotional content. We are investigating if significant differential brain functions and autonomic activations are evident in PVS and MCS patients when hearing their mother's voice. Brain function is assessed using quantitative electric tomography (QEEGt), a technique that …
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