Neural correlates of consciousness and related disorders: From phenotypic descriptors of behavioral and relative consciousness to cortico-subcortical circuitry

Lemaire, Jean‐Jacques; Pontier, Bénédicte; Chaix, Rémi; Ouadih, Youssef El; Khalil, T.; Sinardet, D.; Achim, V.; Postelnicu, A.; Coste, Jérôme; Germain, V.; Sarret, Catherine; Sontheimer, Anna

doi:10.1016/j.neuchi.2021.05.003

Cited by 6 publications

(3 citation statements)

References 117 publications

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“…In terms of several major brain networks of the cortex, we observed a significant loss of connectivity of the bilateral posterior cingulate and precuneus with bilateral medial prefrontal lobes in the DMN of HIE group, which is similar to previous findings of functional connectivity [ 39 , 40 , 41 , 42 ] and suggests an important role of the precuneus and posterior cingulate in the maintenance of consciousness. We also observed that there were metabolic negative correlations between posterior cingulate and medial prefrontal, suggesting a potential mutual inhibitory interaction between them.…”

Section: Discussionsupporting

confidence: 89%

Brain Metabolic Connectivity Patterns in Patients with Prolonged Disorder of Consciousness after Hypoxic-Ischemic Injury: A Preliminary Study

Guan

et al. 2022

Brain Sciences

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Understanding the patterns of brain glucose metabolism and connectivity in hypoxic-ischemic encephalopathy (HIE) patients with prolonged disorders of consciousness (DOC) may be of positive significance to the accurate assessment of consciousness and the optimization of neuromodulation strategy. We retrospectively analyzed the brain glucose metabolism pattern and its correlation with clinical Coma Recovery Scale-Revised (CRS-R) score in six HIE patients with prolonged DOC who had undergone 18F-deoxyglucose brain positron emission tomography scanning (FDG-PET). We also compared the differences in global metabolic connectivity patterns and the characteristics of several brain networks between HIE patients and healthy controls (HC). The metabolism of multiple brain regions decreased significantly in HIE patients, and the degree of local metabolic preservation was correlated with CRS-R score. The internal metabolic connectivity of occipital lobe and limbic system in HIE patients decreased, and their metabolic connectivity with frontal lobe, parietal lobe and temporal lobe also decreased. The metabolic connectivity patterns of default mode network, dorsal attention network, salience network, executive control network and subcortex network of HIE also changed compared with HC. The present study suggested that pattern of cerebral glucose metabolism and network connectivity of HIE patients with prolonged DOC were significantly different from those of healthy people.

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Section: Discussionsupporting

confidence: 89%

Brain Metabolic Connectivity Patterns in Patients with Prolonged Disorder of Consciousness after Hypoxic-Ischemic Injury: A Preliminary Study

Guan

et al. 2022

Brain Sciences

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“…It was reported that internal connectivity in DMN was significantly lower in VS/UWS than in MCS ( 39 ). Further study of the transient analysis found that disrupted functional connectivity in the alpha band of the anterior state between PCC and medial prefrontal cortex was accompanied by decreased level of consciousness, while high functional connectivity between the two regions indicated a positive prognosis in the distant future ( 40 , 41 ). Thus, the interconnection of the two key anterior and posterior nodes within the DMN plays a key role in the generation of consciousness.…”

Section: Discussionmentioning

confidence: 99%

Effects of simultaneous transcutaneous auricular vagus nerve stimulation and high-definition transcranial direct current stimulation on disorders of consciousness: a study protocol

Zhuang,

Zhai,

et al. 2023

Front. Neurol.

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BackgroundNon-invasive brain stimulation (NIBS) techniques are now widely used in patients with disorders of consciousness (DOC) for accelerating their recovery of consciousness, especially minimally conscious state (MCS). However, the effectiveness of single NIBS techniques for consciousness rehabilitation needs further improvement. In this regard, we propose to enhance from bottom to top the thalamic–cortical connection by using transcutaneous auricular vagus nerve stimulation (taVNS) and increase from top to bottom cortical-cortical connections using simultaneous high-definition transcranial direct current stimulation (HD-tDCS) to reproduce the network of consciousness.Methods/designThe study will investigate the effect and safety of simultaneous joint stimulation (SJS) of taVNS and HD-tDCS for the recovery of consciousness. We will enroll 84 MCS patients and randomize them into two groups: a single stimulation group (taVNS and HD-tDCS) and a combined stimulation group (SJS and sham stimulation). All patients will undergo a 4-week treatment. The primary outcome will be assessed using the coma recovery scale-revised (CRS-R) at four time points to quantify the effect of treatment: before treatment (T0), after 1 week of treatment (T1), after 2 weeks of treatment (T2), and after 4 weeks of treatment (T3). At the same time, nociception coma scale-revised (NCS-R) and adverse effects (AEs) will be collected to verify the safety of the treatment. The secondary outcome will involve an analysis of electroencephalogram (EEG) microstates to assess the response mechanisms of dynamic brain networks to SJS. Additionally, CRS-R and AEs will continue to be obtained for a 3-month follow-up (T4) after the end of the treatment.DiscussionThis study protocol aims to innovatively develop a full-time and multi-brain region combined neuromodulation paradigm based on the mesocircuit model to steadily promote consciousness recovery by restoring thalamocortical and cortical-cortical interconnections.

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“…The increased eigenvector centrality implies that the neighbors of the thalamus also have a great influence on the whole network. The thalamus is considered to be the switch of consciousness (Lemaire et al, 2022 ). A large number of studies suspect that reduced cortical–thalamocortical functional connectivity is key to the loss of consciousness (Malekmohammadi et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Altered brain functional connectivity in vegetative state and minimally conscious state

Yang

Dai

et al. 2023

Front. Aging Neurosci.

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ObjectivesThe pathological mechanism for a disorder of consciousness (DoC) is still not fully understood. Based on traditional behavioral scales, there is a high rate of misdiagnosis for subtypes of DoC. We aimed to explore whether topological characterization may explain the pathological mechanisms of DoC and be effective in diagnosing the subtypes of DoC.MethodsUsing resting-state functional magnetic resonance imaging data, the weighted brain functional networks for normal control subjects and patients with vegetative state (VS) and minimally conscious state (MCS) were constructed. Global and local network characteristics of each group were analyzed. A support vector machine was employed to identify MCS and VS patients.ResultsThe average connection strength was reduced in DoC patients and roughly equivalent in MCS and VS groups. Global efficiency, local efficiency, and clustering coefficients were reduced, and characteristic path length was increased in DoC patients (p < 0.05). For patients of both groups, global network measures were not significantly different (p > 0.05). Nodal efficiency, nodal local efficiency, and nodal clustering coefficient were reduced in frontoparietal brain areas, limbic structures, and occipital and temporal brain areas (p < 0.05). The comparison of nodal centrality suggested that DoC causes reorganization of the network structure on a large scale, especially the thalamus. Lobal network measures emphasized that the differences between the two groups of patients mainly involved frontoparietal brain areas. The accuracy, sensitivity, and specificity of the classifier for identifying MCS and VS patients were 89.83, 78.95, and 95%, respectively.ConclusionThere is an association between altered network structures and clinical symptoms of DoC. With the help of network metrics, it is feasible to differentiate MCS and VS patients.

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Neural correlates of consciousness and related disorders: From phenotypic descriptors of behavioral and relative consciousness to cortico-subcortical circuitry

Cited by 6 publications

References 117 publications

Brain Metabolic Connectivity Patterns in Patients with Prolonged Disorder of Consciousness after Hypoxic-Ischemic Injury: A Preliminary Study

Brain Metabolic Connectivity Patterns in Patients with Prolonged Disorder of Consciousness after Hypoxic-Ischemic Injury: A Preliminary Study

Effects of simultaneous transcutaneous auricular vagus nerve stimulation and high-definition transcranial direct current stimulation on disorders of consciousness: a study protocol

Altered brain functional connectivity in vegetative state and minimally conscious state

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