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J Neurol Neurosurg Psychiatry 2004;75:788 doi:10.1136/jnnp.2003.034876
  • Letter

Emotion processing in the minimally conscious state

  1. T Bekinschtein1,
  2. J Niklison1,
  3. L Sigman1,
  4. F Manes1,2,6,
  5. R Leiguarda2,
  6. J Armony3,
  7. A Owen4,
  8. S Carpintiero5,
  9. L Olmos6
  1. 1Cognitive Neurology Section, Institute for Neurological Research (FLENI), Buenos Aires, Argentina
  2. 2Department of Neurology, Institute for Neurological Research (FLENI), Buenos Aires, Argentina
  3. 3Department of Experimental Psychology, McGill University, Montreal, Canada
  4. 4MRC-CBU, Cambridge, UK
  5. 5Functional Neuroimaging Laboratory, Institute for Neurological Research (FLENI), Buenos Aires, Argentina
  6. 6Rehabilitation Institute (FLENI), Buenos Aires, Argentina
  1. Correspondence to:
 Dr F Manes
 Cognitive Neurology Section, Institute for Neurological Research (FLENI), Montañeses 2325 (C1428AQK). Buenos Aires, Argentina; fmanesfleni.org.ar
  • Received 22 December 2003
  • Accepted 13 February 2004
  • Revised 12 February 2004

As a newly described condition distinct from coma or the vegetative state, minimally conscious state (MCS) is characterised by a threshold level of consciousness, and diagnostic criteria have recently been proposed.1 In MCS, cognitively mediated behaviour occurs inconsistently, but is reproducible or sustained enough to be differentiated from reflexive behaviour. It is clinically essential to distinguish this condition from persistent vegetative state (PVS), due to a potentially more favourable outcome.1 So far, whether patients in MCS can process emotion is unknown.

Cortical processing has been described in PVS using auditory and visual functional paradigms with positron emission tomography.2,3 However, to date hardly any functional imaging studies are available in patients in MCS.4 We used fMRI to assess brain activity induced by an emotional stimulus in a patient in MCS.

A 17 year old man was riding his bicycle when he was hit by a train. The accident …

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