NeuroImage
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Functional MRI (fMRI) can detect blood oxygenation level dependent (BOLD) hemodynamic responses secondary to local neuronal activity. The most commonly used method for detecting fMRI signals is the gradient-echo echo-planar imaging (EPI) technique because of its sensitivity and speed. However, it is known that much of the signal obtained with this approach arises from large veins, with additional contribution from the capillaries and venules. ⋯ This method is based on task-induced changes of the apparent diffusion coefficients (ADC), a signal that we demonstrate is generated in vascular compartments that only partially overlap with those generating the BOLD signal. The approach allows both the ADC-based maps and the more commonly used BOLD-based maps to be acquired simultaneously. The spatial overlap between these maps can be used to create composite maps that permit improved localization of the underlying neuronal activity patterns by identifying signals generated in those vascular components that are in closest proximity to the active neuronal populations of interest.
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Clinical Trial
Cortical processing of noxious somatosensory stimuli in the persistent vegetative state.
The persistent vegetative state (PVS) is a devastating medical condition characterized by preserved wakefulness contrasting with absent voluntary interaction with the environment. We used positron emission tomography to assess the central processing of noxious somatosensory stimuli in the PVS. Changes in regional cerebral blood flow were measured during high-intensity electrical stimulation of the median nerve compared with rest in 15 nonsedated patients and in 15 healthy controls. ⋯ Moreover, in PVS patients, the activated primary somatosensory cortex was functionally disconnected from secondary somatosensory, bilateral posterior parietal, premotor, polysensory superior temporal, and prefrontal cortices. In conclusion, somatosensory stimulation of PVS patients, at intensities that elicited pain in controls, resulted in increased neuronal activity in primary somatosensory cortex, even if resting brain metabolism was severely impaired. However, this activation of primary cortex seems to be isolated and dissociated from higher-order associative cortices.