Selective emotional processing and its use as a marker for brain plasticity in patients with chronic disorders of consciousness

Disorders of consciousness (DOC), which include the Vegetative and Minimally Conscious States (VS and MSC), are severe disorders of consciousness following extensive brain injury, defined as states of preserved wakefulness but with either absent (VS) or severely impaired (MCS) behavioral evidence of awareness of self and the environment.

 

Consequently, research using functional neuroimaging, which can assess brain function without relying solely on behavioral output, has emerged as especially suited for these patients. Such recent studies have demonstrated evidence for covert awareness in patients by recording specific brain activations during a cognitive task. However, the possible existence of incommunicable subjective experiences of self and emotion in DOC patients remains largely unexplored.

 

Moreover, the possibility to extrapolate pertinent prognostic indicators using such methods remains to be established.

In this study we aim to probe whether DOC patients are able to selectively process specific visual cues, and whether there is differential processing of visual cues that carry seminal subjective emotional meaning. For this we used the emotive impact of personally familiar faces. For differential processing we intended to probe for patient's ability to perform top-down volitional modulation of brain processes, processing information that is both category-specific and emotional. To this aim we apply a familiar face imagery task.

 

In the final part of this study I wish to explore whether DOC patients are able to learn new information - as learning is the neural surrogate of brain plasticity. To achieve this we will employ a novel visual learning paradigm.

Dr. Sharon's current work combines research into what builds the subjective experience of the self in health and disease. He is especially interested in the neurobiology of pain and methods that can rapidly change this aversive experience in a noninvasive, brain-focused and patient-tailored manner. To that aim he combines advanced functional brain imaging, pharmacotherapy and noninvasive brain stimulation and modulation techniques in healthy individuals and in patients.

Dr. Sharon leads the #Consciousness & Psychopharmacolog research team at the Sagol Brain Institute.

DR. HAGGAI SHARON (MD)