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Functional Brain Network Topology Discriminates between Patients with Minimally Conscious State and Unresponsive Wakefulness Syndrome
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Neuroimaging Studies on Disorders of Consciousness: A Meta-Analytic Evaluation

Department of Humanistic Studies (DISTUM), University of Urbino Carlo Bo, 61029 Urbino, Italy
Center of Clinical Developmental Neuropsychology, ASUR Marche, Area Vasta 1 Pesaro, 61122 Pesaro, Italy
NeuroMi, Milan Center for Neuroscience, 20126 Milano, Italy
Center of Cognitive Neuropsychology, ASTT Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy
Brain and Behavioral Science Department, Università degli Studi di Pavia, 27100 Pavia, Italy
Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, 20122 Milano, Italy
Fondazione Europea di Ricerca Biomedica Onlus, 20063 Milan, Italy
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(4), 516;
Received: 18 February 2019 / Revised: 27 March 2019 / Accepted: 10 April 2019 / Published: 16 April 2019
(This article belongs to the Special Issue Brain Networks in Disorders of Consciousness)
PDF [886 KB, uploaded 16 April 2019]


Neuroimaging tools could open a window on residual neurofunctional activity in the absence of detectable behavioural responses in patients with disorders of consciousness (DOC). Nevertheless, the literature on this topic is characterised by a large heterogeneity of paradigms and methodological approaches that can undermine the reproducibility of the results. To explicitly test whether task-related functional magnetic resonance imaging (fMRI) can be used to systematically detect neurofunctional differences between different classes of DOC, and whether these differences are related with a specific category of cognitive tasks (either active or passive), we meta-analyzed 22 neuroimaging studies published between 2005 and 2017 using the Activation Likelihood Estimate method. The results showed that: (1) active and passive tasks rely on well-segregated patterns of activations; (2) both unresponsive wakeful syndrome and patients in minimally conscious state activated a large portion of the dorsal-attentional network; (3) shared activations between patients fell mainly in the passive activation map (7492 voxels), while only 48 voxels fell in a subcortical region of the active-map. Our results suggest that DOCs can be described along a continuum—rather than as separated clinical categories—and characterised by a widespread dysfunction of brain networks rather than by the impairment of a well functionally anatomically defined one. View Full-Text
Keywords: fMRI; minimally conscious state; unresponsive wakefulness syndrome; GingerALE fMRI; minimally conscious state; unresponsive wakefulness syndrome; GingerALE

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Berlingeri, M.; Magnani, F.G.; Salvato, G.; Rosanova, M.; Bottini, G. Neuroimaging Studies on Disorders of Consciousness: A Meta-Analytic Evaluation. J. Clin. Med. 2019, 8, 516.

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