Tracking the recovery of consciousness from coma
J. Clin. Invest. Steven Laureys, et al. 116:1823 doi:10.1172/JCI29172 [Go to this article.]

Figure 1
PET studies show that in the rare patients who recover consciousness after being in a chronic VS, glucose metabolism is partially restored in discrete cortical regions. (A) The most significant restoration of glucose metabolism occurs in the posteromedial cortices (shown in white on a medial view of a 3D-rendered MRI). The arrows represent the corticocortical and corticothalamocortical functional disconnections observed in vegetative patients. MF, mesiofrontal cortex; P, precuneus; T, thalamus (nonspecific nuclei). (B) Metabolism in this area is significantly impaired during the VS (black) but resumes near-normal activity after recovery of consciousness (REC; gray). Normal resting metabolic rates of glucose as measured in healthy controls are shown for comparison (CON; white). In this issue of the JCI, Voss and coworkers report on their observation of intracortical connectivity changes in the same area of the brain, as assessed by diffusion tensor MRI, in an exceptional patient who emerged after spending 19 years in an MCS (12). This residual cerebral plasticity in chronic disorders of consciousness has been largely overlooked by the medical community and deserves further study to expose its underlying cellular mechanisms. Figure and data adapted with permission from the Journal of Neurology, Neurosurgery, and Psychiatry (22).