A decade ago it was discovered that functional magnetic resonance imaging – fMRI – signals were able to detect cognitive functions in comatose, or even vegetative patients which spurred new research into consciousness.

In patients with severe traumatic brain injury (TBI), the earlier they regain consciousness, the better the recovery; however, the lack of unequivocal methods to determine consciousness limits the ability to predict functional outcomes and create major clinical and ethical decisions for families facing life-altering choices. Even for patients under anesthesia, reliable markers that indicate the presence or absence of consciousness remain elusive.Brain Rehabilitation Concept

Recently, an international team of scientists have reported fMRI-based evidence of distinct patterns of brain activity that could differentiate consciousness from unconsciousness.

In consciousness, brain regions communicate with a rich temperament, showing both positive and negative connections (coherence) that facilitate efficient exchange of information. When unconscious, brain regions do not connect with each another.

In an effort to find these indicators, Athena Demertzi and colleagues recorded fMRI data from 159 subjects scanned at four independent research sites. Participants included healthy individuals, as well as patients diagnosed with unresponsive wakefulness syndrome (UWS), in which they can open their eyes but do not display voluntary movements, and patients in a minimally conscious state (MCS), in which they show additional behaviors potentially indicative of awareness.

Detecting these brain patterns in real time could allow for externally induced therapeutic methods to non-invasively restore consciousness. The researchers note that this detection process also has the potential to greatly facilitate medical decision-making for patients in whom consciousness is impaired.

“We conclude that these patterns of transient brain signal coordination are characteristic of conscious and unconscious brain states, warranting future research concerning their relationship to ongoing conscious content, and the possibility of modifying their prevalence by external perturbations, both in healthy and pathological individuals, as well as across species,” the authors write.

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