ORIGINAL RESEARCH article
Front. Neurosci.
Sec. Brain Imaging Methods
This article is part of the Research TopicMultimodal neuroimaging techniquesView all articles
Multimodal PET/MR Imaging of Prolonged Disorders of Consciousness: A Pilot Feasibility Study
Provisionally accepted
- 1Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital of Sichuan University, Chengdu, China
- 2Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
- 3Department of Rehabilitation Medicine, West China Tianfu Hospital, Sichuan University, Chengdu, China
- 4Chengdu University of Traditional Chinese Medicine, Chengdu, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract Background: Prolonged disorders of consciousness (pDOC), including vegetative/unresponsive wakefulness state (VS/UWS) and minimally conscious state (MCS), pose significant diagnostic and prognostic challenges. Multimodal neuroimaging has emerged as a promising tool to uncover neural biomarkers that reflect residual brain function and guide management. This pilot feasibility study aimed to preliminarily characterize metabolic, functional, and structural brain alterations in pDOC patients using simultaneous positron emission tomography/magnetic resonance (PET/MR) imaging, and to examine their tentative associations with clinical behavioral responsiveness. Methods: Eight pDOC patients and eight matched healthy controls underwent hybrid 18F-FDG PET/MR scanning. Resting-state fMRI, diffusion tensor imaging (DTI), and FDG-PET were processed to assess amplitude of low-frequency fluctuations (ALFF), fractional anisotropy (FA), and glucose metabolism, respectively. Group differences were analyzed, and correlations with Coma Recovery Scale-Revised (CRS-R) scores were evaluated. Multimodal integration was performed across imaging modalities. Results: Compared to controls, pDOC patients exhibited reduced ALFF and FDG uptake in the posterior cingulate cortex (PCC) and anterior cingulate cortex (ACC), with exploratory increased ALFF in the visual cortex inversely correlated with visual responsiveness. Functional connectivity analyses revealed attenuated intra- and inter-network connectivity in the DMN, SN, and DAN. FDG-PET identified metabolic hypofunction in the insula, frontal cortex, and cerebellum, while DTI demonstrated widespread white matter FA reductions. Multimodal correspondence revealed partially overlapping abnormalities in the PCC and occipital regions, highlighting candidate hubs that may be relevant to consciousness level and warrant further validation. Conclusion: Simultaneous FDG-PET/MR was feasible in this pilot pDOC cohort and provided a convergent, multimodal assessment of metabolic–functional–structural alterations. The PCC and occipital visual cortices emerge as key regions linked to consciousness levels. Given the small sample size and cross-sectional design, these findings are preliminary, and warrant validation in larger longitudinal cohorts before clinical translation.
Keywords: functional connectivity, PET/MR imaging, Posterior cingulate cortex, Prolonged Disorders of consciousness, Visual network
Received: 05 Dec 2025; Accepted: 30 Jan 2026.
Copyright: © 2026 Liu, Sun, Lin, Xiong, He, Yang, Su and He. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
MingGang Su
Jing He
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.