Functional MRI for Acute Covert Consciousness: Emerging Data and Implementation Case Series

Author:

Boerwinkle Varina L.1,Gillette Kirsten1,Rubinos Clio A.2,Broman-Fulks Jordan1,Aseem Fazila2,DeHoff Grace K.2,Arhin Martin1ORCID,Cediel Emilio1,Strohm Tamara2

Affiliation:

1. Division of Child Neurology, University of North Carolina School of Medicine, Chapel Hill, North Carolina

2. Division of Neurocritical Care, University of North Carolina School of Medicine, Chapel Hill, North Carolina

Abstract

AbstractAlthough research studies have begun to demonstrate relationships between disorders of consciousness and brain network biomarkers, there are limited data on the practical aspects of obtaining such network biomarkers to potentially guide care. As the state of knowledge continues to evolve, guidelines from professional societies such as the American and European Academies of Neurology and many experts have advocated that the risk–benefit ratio for the assessment of network biomarkers has begun to favor their application toward potentially detecting covert consciousness. Given the lack of detailed operationalization guidance and the context of the ethical implications, herein we offer a roadmap based on local institutional experience with the implementation of functional MRI in the neonatal, pediatric, and adult intensive care units of our local government-supported health system. We provide a case-based demonstrative approach intended to review the current literature and to assist with the initiation of such services at other facilities.

Publisher

Georg Thieme Verlag KG

Subject

Neurology (clinical),Neurology

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