Potential applications of concurrent transcranial magnetic stimulation and functional magnetic resonance imaging in acquired brain injury and disorders of consciousness

Background: Diagnostic assessment, prognosis and treatment monitoring in patients with disorders of consciousness (DoC) rest largely on behaviorally-based procedures. This approach can lead to misdiagnosis, inaccurate outcome prediction and inappropriate judgements regarding the effectiveness of treatment interventions. Concurrent transcranial magnetic stimulation (TMS) and functional magnetic resonance imaging (fMRI) may provide a biological measure of conscious awareness, aid clinicians in clinical decision-making and provide a treatment alternative for DoC. Study: This paper reviews the use of TMS and fMRI in the assessment of patients with DoC and suggests potential applications for concurrent use of these procedures.