Dissociations between behavioural and functional magnetic resonance imaging-based evaluations of cognitive function after brain injury

Brain. 2011 Mar;134(Pt 3):769-82. doi: 10.1093/brain/awr005.


Functional neuroimaging methods hold promise for the identification of cognitive function and communication capacity in some severely brain-injured patients who may not retain sufficient motor function to demonstrate their abilities. We studied seven severely brain-injured patients and a control group of 14 subjects using a novel hierarchical functional magnetic resonance imaging assessment utilizing mental imagery responses. Whereas the control group showed consistent and accurate (for communication) blood-oxygen-level-dependent responses without exception, the brain-injured subjects showed a wide variation in the correlation of blood-oxygen-level-dependent responses and overt behavioural responses. Specifically, the brain-injured subjects dissociated bedside and functional magnetic resonance imaging-based command following and communication capabilities. These observations reveal significant challenges in developing validated functional magnetic resonance imaging-based methods for clinical use and raise interesting questions about underlying brain function assayed using these methods in brain-injured subjects.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain / blood supply*
  • Brain / pathology
  • Brain Injuries / complications*
  • Brain Mapping
  • Choice Behavior / physiology
  • Cognition Disorders / etiology*
  • Cognition Disorders / pathology*
  • Communication
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Oxygen / blood
  • Young Adult


  • Oxygen