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In this pilot study, we investigated whether regional brain glucose metabolism assessed by <jats:sup>18<\/jats:sup>F\u2010fluorodeoxyglucose positron emission tomography (FDG\u2010PET) at rest could predict voluntary movement in severe TBI patients, particularly those with sufficient upper limb capacity to use communication devices. We visually and verbally instructed patients to clasp or open their hands. After video capture, three independent rehabilitation therapists determined whether the patients' movements were voluntary or involuntary. The results were compared with the standardized uptake value in the primary motor cortex, referring to the Penfield's homunculus, by resting state by FDG\u2010PET imaged 1\u00a0year prior. Results showed that glucose uptake in the left (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0015) and right (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.0121) proximal limb of the primary motor cortex, based on Penfield's homunculus on cerebral cartography, may reflect contralateral voluntary movement. Receiver operating characteristic curve analysis showed that a mean cutoff standardized uptake value of 5.47\u2009\u00b1\u20090.08 provided the best sensitivity and specificity for differentiating between voluntary and involuntary movements in each area. FDG\u2010PET may be a useful and robust biomarker for predicting long\u2010term recovery of motor function in severe TBI patients with disorders of consciousness.<\/jats:p>","DOI":"10.1002\/hbm.26270","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T17:50:17Z","timestamp":1678989017000},"page":"3158-3167","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Prediction of voluntary movements of the upper extremities by resting state\u2010brain regional glucose metabolism in patients with chronic severe brain injury: A pilot study"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3528-3229","authenticated-orcid":false,"given":"Tomohiro","family":"Yamaki","sequence":"first","affiliation":[{"name":"Division of Neurosurgery, Rehabilitation Center for Traumatic Apallics Chiba National Agency for Automotive Safety and Victims' Aid  3\u201030\u20101 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