White=matter connectivity changes and late recovery of communication after severe brain injury

Local changes in network structure contribute to late communication recovery after severe brain injury

Daniel J. Thengone, Henning U. Voss, Esteban A. Fridman, and Nicholas D. Schiff

Sci.Transl. Med. 8, 368re5 (2016)


Recovery of brain function after severe brain injury can evolve over a range of time scales. Very late recovery of communication has been reported in patients with severe brain injury, but the mechanisms that underpin such recovery are unclear. Here, we longitudinally studied a single subject, who had suffered severe multifocal structural ischemic brain injury. This patient remained behaviorally unresponsive for 21 months until the identification of an intermittent communication channel using vertical movement of the left eye. After this discovery, we tracked the subject for 2 years and 9 months using both quantitative behavioral assessments and multiple independent imaging measurements of brain structure and function to gain insight into the underlying biological mechanisms of late functional recovery of communication after brain injury.

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