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Coma patient in recovery

Predicting the chance of recovery from a coma with a brain scan

A new study, carried out by INSERM U825, one of the French national research institutes in Toulouse, and published in the journal Neurology, has suggested that brain scans can be used to predict the possibility of recovery from a coma.

By using functional magnetic resonance imaging (fMRI) researchers have been able to study the posterior cingulate cortex region of the brain. Until now, few studies have concentrated on this particular area of the brain which is believed to play a part in consciousness  as it’s been hard to image. However, neurologists do know that when this area of the brain is disrupted, through either trauma to the head or a heart attack, it’s unlikely that the patient will recover or ever regain consciousness.

During the study, brain scans of 27 comatose patients were compared with those of 14 healthy people. This showed that the brains of those in a coma exhibited significant disruption in the posterior cingulate cortex region of the brain and the connections leading to it. However, following the recovery of four of the coma patients, it was seen that they still had brain activity between the posterior cingulate cortex and the medial prefrontal cortex, at a similar level to those of healthy people.

Finding suggest that by using MRI scans of the posterior cingulate cortex, medical staff will have a clearer indication of whether a patient is likely to wake up or enter a vegetative state

These findings suggest that by using MRI scans of the posterior cingulate cortex, medical staff will have a clearer indication of whether a patient is likely to wake up, or whether they are more likely to enter a vegetative state. This would lead to better personalised treatments for people with brain injuries. However, the recovery would very much depend on the extent of the damage to the connections to the posterior cingulate cortex.

While the results of the study are extremely encouraging, lead author Dr. Stein Silva stated that further research is needed using larger numbers to confirm their findings. The findings from this particular study were limited due to the small number of people involved, and it is possible that the fMRI results could be different depending on the point at which the scan was performed. The research team are now planning to perform earlier and repeated scans to see how these affect their current results.

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