Assessment of the Potential of Modern Diagnostic Tools in Differentiation of Minimum Conscious State from the Vegetative State

Abstract

Background: The problem of treatment of patients in coma and persistent disturbances of consciousness is difficult and often neglected. Purpose: The study validated the effectiveness of functional magnetic resonance imaging, electroencephalography and isotopic brain perfusion in differentiating vegetative state from minimal conscious state. Methods: The study was performed in a group of 61 patients with persistent disturbances of consciousness. All patients underwent CRS-R differentiation of consciousness and functional magnetic resonance imaging, EEG, and SPECT/CT studies according to a uniform diagnostic protocol. Results: Analysis has shown that functional magnetic resonance imaging is an effective tool for detecting of consciousness. Analysis of the EEG showed that the occurrence of primary alpha rhythm in patients with impaired consciousness coincides with the state of minimal conscious and may indicate a favourable prognosis. Sector analysis of isotopic cerebral perfusion allowed to put forward the thesis that the key role in the maintenance of consciousness plays a medial part of the left parietal lobe. Conclusion: On the basis of these results, diagnostic protocol was developed for patients with disturbances of consciousness.