Mapping fMRI research in disorders of consciousness: a bibliometric study

To systematically map the evolution, academic network structure, and emergent research fronts of functional magnetic resonance imaging (fMRI) applications in prolonged disorders of consciousness (pDoC) through bibliometric analysis, with narrative contextualization of recent clinical trials.

Bibliometric analysis was performed exclusively on the Web of Science Core Collection (WOSCC) database. A total of 418 articles and reviews (2009-September 2025) were analyzed using CiteSpace 6.3. R1 to visualize publication trends, country/institutional collaborations, journal co-citation networks, and keyword evolution. Separately, PubMed was searched (2009-September 2025) identifying recent clinical trials and therapeutic interventions; these 18 studies underwent narrative synthesis to supplement bibliometric findings with clinical context. No bibliometric analysis was performed on PubMed data.

A total of 418 publications from 39 countries or regions were identified in the field of fMRI for pDoC diagnosis. The United States contributed the highest number of publications (144), followed by China (99) and Belgium (1). Steven Laureys, Owen Adrian M, and Edlow Brian L were identified as the core scholars in this field. Co-citation analysis of journals revealed that NeuroImage was the most frequently cited journal for diagnosis-related research. Keyword clustering analysis identified core clusters directly related to diagnosis, including the Minimally Conscious State (MCS), resting-state functional magnetic resonance imaging (rs-fMRI), and scales.

Research on fMRI for pDoC diagnosis from 2009 to 2025 has formed an academic network centered around the United States, China, and Belgium. Key research hotspots include the development of rs-fMRI diagnostic techniques, the identification of Cognitive-Motor Dissociation (CMD) and covert consciousness, and the screening of diagnostic biomarkers for pDoC subtyping. Future research should focus on multimodal approaches, such as parallel acquisition of fMRI-EEG-EMG, to establish closed-loop "consciousness-motor" biomarkers and conduct individualized intervention studies.