On the difficulty to communicate with fMRI-based protocols used to identify covert awareness.

摘要: Abstract Assessment of awareness in patients with disorders consciousness such as a vegetative state (unresponsive wakefulness syndrome, UWS) and minimally conscious (MCS) remains difficult, high rate misdiagnosis (around 40%). While UWS have no awareness, MCS partial preservation awareness. To improve the assessment these patients, recent functional neuroimaging protocols been developed. However, does complexity realizing interpreting magnetic resonance imaging (fMRI) investigation protocols, which are currently carried out by only few specialist teams, permit generalizable use clinical routine? In this study, 32 healthy volunteers, definition perfectly able to efficiently communicate, performed protocol proposed Monti et al. 2010. Four methods (comprising method al., mean squared error-based method, correlation-based support vector machine-based method) were tested for correctly accurately communication task. Firstly, different instructions localizer tasks had effect on activations. Secondly, 25% participants (8/32) did not provide expected patterns activations during fMRI (four each imagery task). necessarily prevent classification from guessing answers Conversely, may fail detect correct even though activated brain areas. None four produced 100% detection phases. The obtained best results an error 4.2%. study demonstrate that fMRI-based paradigms be robust enough reliably all aware patients. There is still need develop new statistical analytical before considering their generalization routine.