An fMRI study on cognitive processing before and after recovery from posttraumatic vegetative state

TRISTÁN BEKINSCHTEIN; JORGE NIKLISON; ADRIÁN OWEN; DANIEL BOR; RAMÓN LEIGUARDA; FACUNDO MANES

University of Antwerp

Conferencia; The Eighth Conference of the Association for the Scientific Study of Consciousness; 2004

Association for the Scientific Study of Consciousness

FMRI was used to investigate changes in brain activity in response to increasing complexity paradigm in a patient before and after recovery from persistent vegetative state. The patient had a head trauma accident remaining 5 months in vegetative state, and two months in minimally conscious state before recover full awareness of the self and the environment. Brain activation patterns from the third month (during the Persistent Vegetative State) and the tenth month (when she was already conscious) after the accident were compared. In both scans there was primary auditory area activation after presentation of simple words, but when recovered the activation was bilateral. A text read by an unknown reader and by the mother showed increasing recruiting of brain areas in both states but while in PVS the activation was focalized to certain areas of the parietal, temporal and frontal lobes and in full conscious state the pattern was much more wide spread across the brain. Thus, despite altered awareness, the auditory cortices can still be activated, although with a different pattern. Speech and association areas have very different pattern activation in PVS and recovered conscious state revealing that lack of integrative processing during PVS can be recovered after a higher level of awareness is attained. Unconscious and conscious processing of complex auditory stimuli are discussed.