Article 3: Willful modulation of brain activity in disorders of consciousness.

Question 1

Default Mode Network

Answer 1

Brain’s default network is a set of regions more active during passive tasks than tasks demanding focused external attention.

Question 2

2 main goals in the clinical assessment of patients in a vegetative or minimally conscious state.

Answer 2

• First goal: Determine whether patient has the capacity for a purposeful response to stimulation, however inconsistent. Such a capacity distinguishes minimally conscious patients from those in a vegetative state.
• Second goal: Harness and nurture any available response, through intervention, into a form of reproducible communication.

Question 3

Aim of article 3’s study

Answer 3

• What proportion of this group of patients could also reliably and repeatedly modulate their fMRI responses, reflecting preserved awareness.
• Develop and validate a method that would allow the patients to functionally communicate yes-or-no responses by modulating their own brain activity, without training.

Question 4

Tasks of article 3

Answer 4

Imagery task: Participants were asked to perform two imagery tasks: play tennis or walking around the house. Durable responses show these are true periods of imagination.
Communication task: Before each of these imaging sessions, participants were asked a yes or no question and instructed to respond during the imaging session by using one type of mental imagery (motor or spatial imagery) for yes and the other for no

Question 5

Results article 3 (VS and MCS)

Answer 5

• Only 5 out of 54 patients can do the imagining task. Their results matched close to healthy participants.
• 49 out of 54 patients showed no significant fMRI changes during the imagery tasks.
• One of the patients who was able to do the imagery task was asked questions to test whether or not communication was possible via yes or no questions.

Question 6

Discussion article 3

Answer 6

• The task is not very sensitive, this can be due to many non-relevant factors related to consciousness (attention, memory, language)
• The task is very specific, a positive effect can be safely considered as reflecting the presence of consciousness.