Brain network motif topography may predict emergence from disorders of consciousness: a case series

Abstract

Neuroimaging methods have improved the accuracy of diagnosis in patients with disorders of consciousness (DOC), but novel, clinically translatable methods for prognosticating this population are still needed. In this case series, we explored the association between topographic and global brain network properties and prognosis in patients with DOC. We recorded high-density electroencephalograms in three patients with acute or chronic DOC, two of whom also underwent an anesthetic protocol. In these two cases, we compared functional network motifs, network hubs and power topography (i.e. topographic network properties), as well as relative power and graph theoretical measures (i.e. global network properties), at baseline, during exposure to anesthesia and after recovery from anesthesia. We also compared these properties to a group of healthy, conscious controls. At baseline, the topographic distribution of nodes participating in alpha motifs resembled conscious controls in patients who later recovered consciousness and high relative power in the delta band was associated with a negative outcome. Strikingly, the reorganization of network motifs, network hubs and power topography under anesthesia followed by their return to a baseline patterns upon recovery from anesthesia, was associated with recovery of consciousness. Our findings suggest that topographic network properties measured at the single-electrode level might provide more prognostic information than global network properties that are averaged across the brain network. In addition, we propose that the brain network’s capacity to reorganize in response to a perturbation is a precursor to the recovery of consciousness in DOC patients.

Stimulus type shapes the topology of cellular functional networks in mouse visual cortex

“…Similar to anatomically-defined structural motifs which form fundamental building blocks of neural circuits 1 , 67 , 68 , functional motifs, which are defined by correlated neural activities, represent elementary information processing components of a functional network 69 . Although extensive over-representation of certain network motifs such as feedforward loop is found mostly in anatomical networks 1 , 52 , 67 , 70 , functional motifs (especially triplets) also have been discovered to reflect the level of consciousness 71 , 72 , accurately predict neural activity 73 , encode global topological information 74 , and exhibit coupling with anatomical connections 75 .…”

Disrupted multi-scale topological organization of directed functional brain networks in patients with disorders of consciousness

“…Previous studies have found reduced white matter fibre connections 10 and functional connections 71 between several regions within the DMN in DOC patients. A recent case study 72 showed that motif configurations within the DMN can predict the clinical recovery of DOC patients. We inferred that the three-node connection patterns within and between the DMN might be essential to the maintenance of conscious activity.…”

Appeared inexplicable disorders of consciousness after general anesthesia tracheal tube drawing in endoscopic tympanoplasty

“…The key points for improving the prognosis were early diagnosis and prompt therapy, consequently, the patient was diagnosed as having hypoactive DOC based on CRS‐R and MBT (Pignat JM et al, 2016). At present, there are advanced diagnostic techniques for DOC, for example, the brain network motif topography, functional MRI (fMRI), and processed EEG (pEEG) (Nadin D, et al, 2020; Bernat J L. 2009). It is worth mentioning that transcranial magnetic stimulation‐ electroencephalogram (TMS‐EEG) has been preliminarily applied to discriminant consciousness under various physiological (sleep), pharmacological (anesthesia), pathological (coma, vegetative state, etc.)…”