Neuroradiology
-
Following coma, some patients will recover wakefulness without signs of consciousness (only showing reflex movements, i.e., the vegetative state) or may show non-reflex movements but remain without functional communication (i.e., the minimally conscious state). Currently, there remains a high rate of misdiagnosis of the vegetative state (Schnakers et. al. ⋯ This should incite clinicians to use multimodal assessment to detect objective signs of consciousness and validate para-clinical prognostic markers in these challenging patients. This review will focus on advanced magnetic resonance imaging (MRI) techniques such as magnetic resonance spectroscopy, diffusion tensor imaging, and functional MRI (fMRI studies in both "activation" and "resting state" conditions) that were recently introduced in the assessment of patients with chronic disorders of consciousness.
-
Three cingulate motor areas have been described in monkeys, the rostral, dorsal, and ventral cingulate motor areas, and would control limbic-related motor activity. However, little anatomical data are available in human about the functional networks these cingulate areas underlie. Therefore, networks anchored in the rostral and caudal cingulate motor areas (rCMA and cCMA, respectively) were studied in human using functional connectivity during the brain resting state. Since the rCMA and cCMA are located just under the pre-supplementary and supplementary motor areas (pre-SMA and SMA), the pre-SMA- and SMA-centered networks were also studied to ensure that these four circuits were correctly dissociated. ⋯ The human cingulate motor areas constitute an interface between sensorimotor, limbic and executive systems, sharing common cortical, striatal, and thalamic relays with the overlying premotor medial areas.