{"id":{"repo_id":"uwo","oai_identifier":"oai:uwo.scholaris.ca:20.500.14721/27462"},"canonical_url":"https://search.dev.ndltd.org/etd/uwo/oai:uwo.scholaris.ca:20.500.14721/27462","repository":{"repo_id":"uwo","name":"Western University","base_url":"https://uwo.scholaris.ca/server/oai/request"},"display":{"title":"Functional Magnetic Resonance Imaging as an Assessment Tool in Critically Ill Patients","abstract":"Little is known about whether residual cognitive function occurs in the earliest stages of brain injury. The overarching goal of the work presented in this dissertation was to elucidate the role of functional neuroimaging in assessing brain activity in critically ill patients. The overall objective was addressed in the following four empirical chapters: In Chapter 2, three versions of a hierarchically-designed auditory task were developed and their ability to detect various levels of auditory language processing was assessed in individual healthy participants. The same procedure was then applied in two acutely comatose patients. In Chapter 3, a hierarchical auditory task was employed in a heterogeneous cohort of acutely comatose patients. The results revealed that the level of auditory processing in coma may be predictive of subsequent functional recovery. In Chapter 4, two mental imagery paradigms were utilized to assess covert command-following in coma. The findings demonstrate, for the first time, preserved awareness in an acutely comatose patient. In Chapter 5, functional neuroimaging techniques were used for covert communication with two completely locked-in, critically ill patients. The results suggest that this methodology could be used as an augmentative communication tool to allow patients to be involved in their own medical decision-making. Taken together, the proceeding chapters of this work demonstrate that functional neuroimaging can detect preserved cognitive functions in some acutely comatose patients, which has both diagnostic and prognostic relevance. Moreover, these techniques may be extended even further to be used as a communication tool in critically ill patients.","abstract_html":"Little is known about whether residual cognitive function occurs in the earliest stages of brain injury. The overarching goal of the work presented in this dissertation was to elucidate the role of functional neuroimaging in assessing brain activity in critically ill patients. The overall objective was addressed in the following four empirical chapters: In Chapter 2, three versions of a hierarchically-designed auditory task were developed and their ability to detect various levels of auditory language processing was assessed in individual healthy participants. The same procedure was then applied in two acutely comatose patients. In Chapter 3, a hierarchical auditory task was employed in a heterogeneous cohort of acutely comatose patients. The results revealed that the level of auditory processing in coma may be predictive of subsequent functional recovery. In Chapter 4, two mental imagery paradigms were utilized to assess covert command-following in coma. The findings demonstrate, for the first time, preserved awareness in an acutely comatose patient. In Chapter 5, functional neuroimaging techniques were used for covert communication with two completely locked-in, critically ill patients. The results suggest that this methodology could be used as an augmentative communication tool to allow patients to be involved in their own medical decision-making. Taken together, the proceeding chapters of this work demonstrate that functional neuroimaging can detect preserved cognitive functions in some acutely comatose patients, which has both diagnostic and prognostic relevance. Moreover, these techniques may be extended even further to be used as a communication tool in critically ill patients.","abstract_has_math":false,"creators":["Norton, Loretta"],"institution":"The University of Western Ontario","degree_name":"Ph D","degree_level":null,"degree_discipline":"Neuroscience","degree_department":null,"school":null,"contributors":[],"advisors":["Owen, Adrian M."],"committee_chairs":[],"committee_members":[],"year":2017,"date_issued":"2017-08-22","date_published":"2017-08-22","updated_at":"2026-07-27T21:56:18Z","subjects":["Coma","functional magnetic resonance imaging","prognosis","diagnosis","disorders of consciousness"],"languages":["en_ca"],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/20.500.14721/27462","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Owen, Adrian M."]},{"key":"dc:creator","label":"Author","values":["Norton, Loretta"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2025-07-10T15:30:06Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2025-07-10T15:30:06Z"]},{"key":"dc:date.issued","label":"Date","values":["2017-08-22"]},{"key":"dc:publisher","label":"Institution","values":["The University of Western Ontario"]},{"key":"dc:type","label":"Dc Type","values":["thesis"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Neuroscience"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Ph D"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Coma","functional magnetic resonance imaging","prognosis","diagnosis","disorders of consciousness"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en_ca"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/20.500.14721/27462"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["The thesis cover page in the PDF document includes references to Western University’s previous institutional repository platform, known as Scholarship@Western, and links to that platform (beginning with ir.lib.uwo.ca). In citing or referring to this thesis, use the DOI or handle from this page instead. Sample citation: Author name, \"Thesis title.\" (Year). Western University Open Repository. https://doi.org/10.71858/123456."]},{"key":"dc:description.abstract","label":"Abstract","values":["Little is known about whether residual cognitive function occurs in the earliest stages of brain injury. The overarching goal of the work presented in this dissertation was to elucidate the role of functional neuroimaging in assessing brain activity in critically ill patients. The overall objective was addressed in the following four empirical chapters: In Chapter 2, three versions of a hierarchically-designed auditory task were developed and their ability to detect various levels of auditory language processing was assessed in individual healthy participants. The same procedure was then applied in two acutely comatose patients. In Chapter 3, a hierarchical auditory task was employed in a heterogeneous cohort of acutely comatose patients. The results revealed that the level of auditory processing in coma may be predictive of subsequent functional recovery. In Chapter 4, two mental imagery paradigms were utilized to assess covert command-following in coma. The findings demonstrate, for the first time, preserved awareness in an acutely comatose patient. In Chapter 5, functional neuroimaging techniques were used for covert communication with two completely locked-in, critically ill patients. The results suggest that this methodology could be used as an augmentative communication tool to allow patients to be involved in their own medical decision-making. Taken together, the proceeding chapters of this work demonstrate that functional neuroimaging can detect preserved cognitive functions in some acutely comatose patients, which has both diagnostic and prognostic relevance. Moreover, these techniques may be extended even further to be used as a communication tool in critically ill patients."]},{"key":"dc:title","label":"Title","values":["Functional Magnetic Resonance Imaging as an Assessment Tool in Critically Ill Patients"]}]}],"canonical_facts":{"dc:contributor.advisor":["Owen, Adrian M."],"dc:creator":["Norton, Loretta"],"dc:date.accessioned":["2025-07-10T15:30:06Z"],"dc:date.available":["2025-07-10T15:30:06Z"],"dc:date.issued":["2017-08-22"],"dc:description":["The thesis cover page in the PDF document includes references to Western University’s previous institutional repository platform, known as Scholarship@Western, and links to that platform (beginning with ir.lib.uwo.ca). In citing or referring to this thesis, use the DOI or handle from this page instead. Sample citation: Author name, \"Thesis title.\" (Year). 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In Chapter 4, two mental imagery paradigms were utilized to assess covert command-following in coma. The findings demonstrate, for the first time, preserved awareness in an acutely comatose patient. In Chapter 5, functional neuroimaging techniques were used for covert communication with two completely locked-in, critically ill patients. The results suggest that this methodology could be used as an augmentative communication tool to allow patients to be involved in their own medical decision-making. Taken together, the proceeding chapters of this work demonstrate that functional neuroimaging can detect preserved cognitive functions in some acutely comatose patients, which has both diagnostic and prognostic relevance. 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