Neuroimaging in Disorders of Consciousness and Recovery

Neuroimaging in DoC has provided a wealth of information in the last decades. With the advancement of neuroimaging technologies, the initial identification of brain regions injured in DoC has evolved to the characterization of complex structural and functional brain networks. Multimodal neuroimaging combining structural and functional techniques will likely be integral in the ongoing optimization of diagnosis and prognostication in DoC. Findings in longitudinal neuroimaging studies suggest the potential for quantifiable structural and functional recovery. Updated research has demonstrated that the natural history of DoC is less pessimistic than once believed, and recovery in the chronic phase does occur.113 Neuroimaging biomarkers provide a complement to clinical bedside assessments and may be valuable to track longitudinally, particularly in patients with prolonged unconsciousness. Elucidating the structural and functional changes that occur over time after acquired brain injury will likely have significant implications both in deepening our understanding of the natural history of DoC and in optimizing the long-term management of this patient population.