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Fernández-Espejo and colleagues investigate the differential neural substrates of overt and covert motor behavior and assess the structural integrity of the underlying networks in behaviorally nonresponsive patients. They used dynamic causal modeling of functional magnetic resonance imaging to compare voluntary motor imagery and motor execution. Their results suggest a possible biomarker for the absence of intentional movement in covertly aware patients (ie, specific damage to motor thalamocortical fibers), highlight the importance of the thalamus for the execution of intentional movements, and may provide a target for restorative therapies in behaviorally nonresponsive patients. Editorial perspective is provided by Nicholas D. Schiff, MD.
Highlights. JAMA Neurol. 2015;72(12):1391. doi:10.1001/jamaneurol.2014.2881
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