Prognostic and Diagnostic Value of Clinical Examination and fMRI in theEvaluation of Patients in a Vegetative State

Introduction: Primary focus of research in psychology, neuropsychology and neuroscience within the past few decades understands what consciousness means biologically and psychologically for information present in it that is on determining the neural and psychological correlates of consciousness. This retrospective study evaluated the correlation between clinical examination and neuroradiological imaging in patients with disorder of consciousness (DOC), for predicting the likely outcome of one's current standing. Materials and methods: Six patients (4 men and 2 female) suffered of DOC post-coma, outcome of severe acquired brain injuries were examined in acute phase with brain (scan) CAT (computerized axial tomography) and/ or fMRI (functional magnetic resonance imaging). After, they were evaluated with electroencephalogram and fMRI. Repeated clinical assessments were conducted with neurological examination and rating scales such as Glasgow Coma Scale (GCS) and Disability Rating Scale (DRS) at the beginning (T1), middle (T2) and end (T3) of hospitalization. 2/6 patients died. Discussion: Clinical evaluation performed with rating scales of consciousness and disability degree, showed in all patients an increase of absolute value of GCS and a reduction of DRS. We obtained most interesting observations concerning the relationship between the prognosis and patient characteristics with functional MRI. Conclusion: Although the few numbers of patients and the limits of methodological problems, our study, in accordance with previous evidence from the literature, may confirm the central role of nature of brain injuries as the prediction marker for the and fMRI direct visualization of the areas of cortical activation.