Providing families with an accurate prognosis about neurological recovery is particularly challenging for patients with COVID-19, because so little is known about how the brain is affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or associated inflammation and clotting disorders. “Initially, our goal in the intensive care unit was to support patients through the critical illness of COVID-19,” said lead author David Fischer, MD, neurocritical care fellow at Mass General. “However, we found that a subset of patients, after surviving the critical illness, were not waking up as expected. As neurologists, we were asked by many families whether their loved ones would regain consciousness—a critical question given that decisions about life support often hinged on the answer—but we were uncertain. We used functional MRI to try to provide a more comprehensive assessment of brain function.”
The application of functional MRI to critically ill patients with disorders of consciousness is the culmination of decades of work to develop this technology and ultimately translate it to clinical care. Co-author Bruce Rosen, MD, PhD, director of the Athinoula A. Martinos Center for Biomedical Imaging at Mass General, and one of the developers of functional MRI in the early 1990s, explained that “we have to be cautious when interpreting results from a single patient, but this study provides proof of principle that clinicians may be able to use advanced imaging techniques like functional MRI to get a clearer picture of a patient’s brain function, and hence the potential for recovery.”
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This work was supported by the James S. McDonnell Foundation COVID-19 Recovery of Consciousness Consortium.
About Massachusetts General Hospital
Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Institute conducts the largest hospital-based research program in the nation, with an annual research budget of more than $1 billion and comprises more than 8,500 researchers working across more than 30 institutes, centers and departments. In August 2019 Mass General was once again named #2 in the nation by U.S. News & World Report in its list of "America’s Best Hospitals."Back to HCB News