Betty Wutzl: “The role of fMRI in the diagnosis and prognosis of patients with severe chronic disorders of consciousness”

December 8, 2017  Friday Lunch Seminar
12:15 〜 13:00

CiNet 1F Conference Room

“The role of fMRI in the diagnosis and prognosis of patients with severe chronic disorders of consciousness”

Betty Wutzl

Osaka University

Host PI : Kenji Leibnitz 


Diagnosis and prognosis of patients with severe chronic disorders of consciousness (scDOC) is still a problem and up to know there are no reliable diagnostic tools. Hence a rate of 43% of misdiagnosis was described. Neuroimaging methods, especially fMRI, seem to give additional information of the state of consciousness but specific and reliable paradigms have to be developed and tested. Patients with scDOC undergo fMRI in the Christian Doppler Clinic in Salzburg (where I worked 2 years). We test different paradigms starting from simple ones like vibration over language understanding to imagination. Patients who cannot or do not want to lie still for the duration of the scanning are anaesthetised using Sevoflurane and Fentanyl. FMRI is performed with a clinical routine 3-Tesla MR (Siemens Magnetom Tim Trio, Erlangen, Germany). First results of the vibration paradigm show a correlation between the results and remission of the patient. The vibration paradigm can also be performed under anaesthesia i.e. reasonable results were found. Moreover a study including 27 scDOC patients showed that language paradigms are essential and led to the change of diagnosis in 16 patients. Most frequent language activity could be seen within the occipital lobes whereas rare activity was detected within the inferior frontal region. In order to avoid misdiagnosis in scDOC patients we propose a special diagnostic battery of fMRI paradigms which at least should contain language paradigms to minimize diagnostic errors. Moreover we also recommend to include different imagination paradigms as well as testing the proprioceptive nervous system e.g. by vibration.

About CiNet’s Friday Lunch Seminars:
The Friday Lunch Seminar is CiNet’s main regular meeting series, held every week at 12:15 in the beautiful main lecture theatre on the ground floor at CiNet. The talks are typically 40mins long and orientated towards an inter-disciplinary audience. They are informal, social, and most people bring their own lunch to eat during the talk. They are open to anyone who is feeling curious and wants to come, regardless of where you work.