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Technology-based assessment in patients with disorders of consciousness.
[locked-in syndrome]
Introduction
.
A
number
of
studies
highlight
the
difficulty
in
forming
a
diagnosis
for
patients
with
disorders
of
consciousness
when
this
is
established
merely
on
behavioral
assessments
.
Background
.
Positron
emission
tomography
(
PET
)
,
functional
magnetic
resonance
imaging
(
fMRI
)
,
diffusion
tensor
imaging
(
DTI
)
,
and
electroencephalography
combined
with
transcranial
magnetic
stimulation
(
TMS-EEG
)
techniques
are
promoting
the
clinical
characterization
of
this
challenging
population
.
With
such
technology-based
"
objective
"
tools
,
patients
are
also
differentially
able
to
follow
simple
commands
and
in
some
cases
even
communicate
through
modified
brain
activity
.
Consequently
,
the
vegetative
state
and
minimally
conscious
state
have
been
revised
and
new
nosologies
have
been
proposed
,
namely
the
unresponsive
wakefulness
syndrome
,
the
minimally
conscious
state
plus
and
minus
,
and
the
functional
locked-
in
syndrome
.
Aim
.
To
our
mind
,
an
integration
of
different
technical
modalities
is
important
to
gain
a
holistic
vision
of
the
underlying
pathophysiology
of
disorders
of
consciousness
in
general
and
to
promote
single
-patient
medical
management
in
particular
.
