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Decoding Thoughts in Disorders of Consciousness

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Brain Function and Responsiveness in Disorders of Consciousness

Abstract

Recent developments in functional neuroimaging have provided a number of new tools for assessing patients who clinically appear to be in a vegetative or minimally conscious state. These techniques have been able to reveal awareness and even allow rudimentary communication, in some patients who remain entirely behaviorally nonresponsive. In some centers, these methods are now being employed routinely in the assessment of severely brain-injured patients, mapping patterns of residual function and dysfunction and helping to reduce diagnostic errors in these conditions. The implications of these results extend well beyond the immediate clinical and scientific findings to suggest an urgent need for a reevaluation of the existing diagnostic guidelines for behaviorally nonresponsive patients to include information derived from functional neuroimaging.

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References

  1. Plum F, Posner JB (1982) The diagnosis of stupor and coma. Oxford University Press, Oxford, Uk

    Google Scholar 

  2. Royal College of Physicians (2003) The vegetative state: guidance on diagnosis and management. Clin Med 3(3):249–254

    Article  Google Scholar 

  3. Andrews K, Murphy L, Munday R, Littlewood C (1996) Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit. BMJ 313(7048):13–16

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Childs NL, Mercer WN, Childs HW (1993) Accuracy of diagnosis of persistent vegetative state. Neurology 43(8):1465–1467

    Article  CAS  PubMed  Google Scholar 

  5. Schnakers C, Vanhaudenhuyse A, Giacino J, Ventura M, Boly M, Majerus S et al (2009) Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment. BMC Neurol 9:35. doi:10.1186/1471-2377-9-35

    Article  PubMed Central  PubMed  Google Scholar 

  6. Boly M, Coleman MR, Davis MH, Hampshire A, Bor D, Moonen G et al (2007) When thoughts become action: an fMRI paradigm to study volitional brain activity in non-communicative brain injured patients. Neuroimage 36(3):979–992. doi:10.1016/j.neuroimage.2007.02.047

    Article  CAS  PubMed  Google Scholar 

  7. Cerf M, Thiruvengadam N, Mormann F, Kraskov A, Quiroga RQ, Koch C et al (2010) On-line, voluntary control of human temporal lobe neurons. Nature 467(7319):1104–1108. doi:10.1038/nature09510

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Gallivan JP, McLean DA, Valyear KF, Pettypiece CE, Culham JC (2011) Decoding action intentions from preparatory brain activity in human parieto-frontal networks. J Neurosci 31(26):9599–9610. doi:10.1523/JNEUROSCI.0080-11.2011

    Article  CAS  PubMed  Google Scholar 

  9. Haynes JD, Sakai K, Rees G, Gilbert S, Frith C, Passingham RE (2007) Reading hidden intentions in the human brain. Curr Biol 17(4):323–328. doi:10.1016/j.cub.2006.11.072

    Article  CAS  PubMed  Google Scholar 

  10. Weiskopf N, Mathiak K, Bock SW, Scharnowski F, Veit R, Grodd W et al (2004) Principles of a brain-computer interface (BCI) based on real-time functional magnetic resonance imaging (fMRI). IEEE Trans Biomed Eng 51(6):966–970. doi:10.1109/TBME.2004.827063

    Article  PubMed  Google Scholar 

  11. Sorger B, Dahmen B, Reithler J, Gosseries O, Maudoux A, Laureys S et al (2009) Another kind of ‘'BOLD Response’: answering multiple-choice questions via online decoded single-trial brain signals. Prog Brain Res 177(275–92):275–292. doi:10.1016/S0079-6123(09)17719-1

    Article  PubMed  Google Scholar 

  12. Aguirre GK, Detre JA, Alsop DC, D’Esposito M (1996) The parahippocampus subserves topographical learning in man. Cereb Cortex 6(6):823–829

    Article  CAS  PubMed  Google Scholar 

  13. Owen AM, Coleman MR, Boly M, Davis MH, Laureys S, Jolles D et al (2007) Response to comments on “Detecting awareness in the vegetative state”. Science 315(5816). doi:10.1126/science.1135583

    Google Scholar 

  14. Owen AM, Coleman MR, Boly M, Davis MH, Laureys S, Pickard JD (2006) Detecting awareness in the vegetative state. Science 313(5792):1402

    Article  CAS  PubMed  Google Scholar 

  15. Monti MM, Vanhaudenhuyse A, Coleman MR, Boly M, Pickard JD, Tshibanda L et al (2010) Willful modulation of brain activity in disorders of consciousness. N Engl J Med 362(7):579–589. doi:10.1056/NEJMoa0905370

    Article  CAS  PubMed  Google Scholar 

  16. Fernandez-Espejo D, Owen AM (2013) Detecting awareness after severe brain injury. Nat Rev Neurosci 14(11):801–809. doi:10.1038/nrn3608

    Article  CAS  PubMed  Google Scholar 

  17. Owen AM (2013) Detecting consciousness: a unique role for neuroimaging. Annu Rev Psychol 64:109–133. doi:10.1146/annurev-psych-113011-143729

    Article  PubMed  Google Scholar 

  18. Owen AM, Coleman MR (2008) Functional neuroimaging of the vegetative state. Nat Rev Neurosci 9(3):235–243. doi:10.1038/nrn2330

    Article  CAS  PubMed  Google Scholar 

  19. Hampshire A, Parkin BL, Cusack R, Espejo DF, Allanson J, Kamau E et al (2012) Assessing residual reasoning ability in overtly non-communicative patients using fMRI. Neuroimage Clin 2:174–183. doi:10.1016/j.nicl.2012.11.008

    Article  PubMed Central  PubMed  Google Scholar 

  20. Naci L, Cusack R, Jia VZ, Owen AM (2013) The brain’s silent messenger: using selective attention to decode human thought for brain-based communication. J Neurosci 33(22):9385–9393. doi:10.1523/JNEUROSCI.5577-12.2013

    Article  CAS  PubMed  Google Scholar 

  21. Naci L, Owen AM (2013) Making every word count for nonresponsive patients. JAMA Neurol 70(10):1235–1241. doi:10.1001/jamaneurol.2013.3686

    PubMed  Google Scholar 

  22. Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness A practical scale. Lancet 2(7872):81–84

    Article  CAS  PubMed  Google Scholar 

  23. Giacino JT, Kalmar K, Whyte J (2004) The JFK coma recovery scale-revised: measurement characteristics and diagnostic utility. Arch Phys Med Rehabil 85(12):2020–2029

    Article  PubMed  Google Scholar 

  24. Monti MM, Coleman MR, Owen AM (2009) Executive functions in the absence of behavior: functional imaging of the minimally conscious state. Prog Brain Res 177:249–260. doi:10.1016/S0079-6123(09)17717-8

    Article  PubMed  Google Scholar 

  25. Bidet-Caulet A, Fischer C, Besle J, Aguera PE, Giard MH, Bertrand O (2007) Effects of selective attention on the electrophysiological representation of concurrent sounds in the human auditory cortex. J Neurosci 27(35):9252–9261. doi:10.1523/JNEUROSCI.1402-07.2007

    Article  CAS  PubMed  Google Scholar 

  26. Zeman A (2009) The problem of unreportable awareness. Prog Brain Res 177:1–9. doi:10.1016/S0079-6123(09)17701-4

    Article  PubMed  Google Scholar 

  27. Naci L, Cusack R, Anello M, Owen AM (2014) A common neural code for similar conscious experiences in different individuals. Proc Natl Acad Sci U S A 111(39):14277–14282. doi:10.1073/pnas.1407007111

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Barbey AK, Colom R, Solomon J, Krueger F, Forbes C, Grafman J (2012) An integrative architecture for general intelligence and executive function revealed by lesion mapping. Brain 135(Pt 4):1154–1164. doi:10.1093/brain/aws021

    Article  PubMed Central  PubMed  Google Scholar 

  29. Duncan J (2010) The multiple-demand (MD) system of the primate brain: mental programs for intelligent behaviour. Trends Cogn Sci 14(4):172–179. doi:10.1016/j.tics.2010.01.004

    Article  PubMed  Google Scholar 

  30. Robertson IH, Manly T, Andrade J, Baddeley BT, Yiend J (1997) ‘Oops!’: performance correlates of everyday attentional failures in traumatic brain injured and normal subjects. Neuropsychologia 35(6):747–758

    Article  CAS  PubMed  Google Scholar 

  31. Peterson A, Naci L, Weijer C, Cruse D, Fernández-Espejo D, Graham M et al (2013) Assessing decision-making capacity in the behaviorally nonresponsive patient with residual covert awareness. AJOB Neuroscience 4(4):3–14

    Article  Google Scholar 

  32. Cruse D, Chennu S, Fernandez-Espejo D, Payne WL, Young GB, Owen AM (2012) Detecting awareness in the vegetative state: electroencephalographic evidence for attempted movements to command. PLoS One 7(11), e49933. doi:10.1371/journal.pone.0049933

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  33. Fins JJ, Schiff ND (2006) Shades of gray: new insights into the vegetative state. Hastings Cent Rep 36(6):8

    Article  PubMed  Google Scholar 

  34. Giacino JT, Schnakers C, Rodriguez-Moreno D, Kalmar K, Schiff N, Hirsch J (2009) Behavioral assessment in patients with disorders of consciousness: gold standard or fool’s gold? Prog Brain Res 177:33–48. doi:10.1016/S0079-6123(09)17704-X

    Article  PubMed  Google Scholar 

  35. Laureys S, Schiff ND (2012) Coma and consciousness: paradigms (re)framed by neuroimaging. Neuroimage 61(2):478–491. doi:10.1016/j.neuroimage.2011.12.041

    Article  PubMed  Google Scholar 

  36. Schnakers C, Majerus S, Goldman S, Boly M, Van Eeckhout P, Gay S et al (2008) Cognitive function in the locked-in syndrome. J Neurol 255(3):323–330. doi:10.1007/s00415-008-0544-0

    Article  PubMed  Google Scholar 

  37. Baddeley AD (1968) A 3 min reasoning test based on grammatical transformation. Psychon Sci 10(10):341–342

    Article  Google Scholar 

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Acknowledgments

This work was funded by generous awards to Adrian M. Owen from the Canada Excellence Research Chair (CERC) Program, the Canadian Institutes of Health Research (CIHR), and the Natural Sciences and Engineering Research Council of Canada (NSERC).

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Authors and Affiliations

  1. Department of Psychology, The Brain and Mind Institute, The University of Western Ontario, London, ON, N6A 5B7, Canada

    Adrian M. Owen & Lorina Naci

Authors
  1. Adrian M. Owen
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  2. Lorina Naci
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Corresponding author

Correspondence to Adrian M. Owen .

Editor information

Editors and Affiliations

  1. Dept. of Psychology and Neurosurgery, University of California, L.A., Los Angeles, California, USA

    Martin M. Monti

  2. Dept of Neurosc, Ophthalmol and Genetics, University of Genova, Genova, Italy

    Walter G. Sannita

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Owen, A.M., Naci, L. (2016). Decoding Thoughts in Disorders of Consciousness. In: Monti, M., Sannita, W. (eds) Brain Function and Responsiveness in Disorders of Consciousness. Springer, Cham. https://doi.org/10.1007/978-3-319-21425-2_6

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  • DOI: https://doi.org/10.1007/978-3-319-21425-2_6

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-21424-5

  • Online ISBN: 978-3-319-21425-2

  • eBook Packages: MedicineMedicine (R0)

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