Brain connectivity in pathological and pharmacological coma

[en] Recent studies in patients with disorders of consciousness (DOC) tend to support the view that awareness is not related to activity in a single brain region but to thalamo-cortical connectivity in the frontoparietal network. Functional neuroimaging studies have shown preserved albeit disconnected low-level cortical activation in response to external stimulation in patients in a “vegetative state” or unresponsive wakefulness syndrome. While activation of these “primary” sensory cortices does not necessarily reflect conscious awareness, activation in higher-order associative cortices in minimally conscious state patients seems to herald some residual perceptual awareness. PET studies have identified a metabolic dysfunction in a widespread frontoparietal “global neuronal workspace” in DOC patients including the midline default mode network (“intrinsic” system) and the lateral frontoparietal cortices or “extrinsic system.” Recent studies have investigated the relation of awareness to the functional connectivity within intrinsic and extrinsic networks, and with the thalami in both pathological and pharmacological coma. In brain damaged patients, connectivity in all default network areas was found to be non-linearly correlated with the degree of clinical consciousness impairment, ranging from healthy controls and locked-in syndrome to minimally conscious, vegetative, coma, and brain dead patients. Anesthesia-induced loss of consciousness was also shown to correlate with a global decrease in cortico-cortical and thalamo-cortical connectivity in both intrinsic and extrinsic networks, but not in auditory, or visual networks. In anesthesia, unconsciousness was also associated with a loss of cross-modal interactions between networks. These results suggest that conscious awareness critically depends on the functional integrity of thalamo-cortical and cortico-cortical frontoparietal connectivity within and between “intrinsic” and “extrinsic” brain networks.

Research center :

Coma Science Group
GIGA CRC (Cyclotron Research Center) In vivo Imaging-Aging & Memory - ULiège

Disciplines :

Neurology

Author, co-author :

Noirhomme, Quentin ; Université de Liège - ULiège > Centre de recherches du cyclotron

Soddu, Andrea ; Université de Liège - ULiège > Centre de recherches du cyclotron

Lehembre, Remy ; Université de Liège - ULiège > Centre de recherches du cyclotron

Vanhaudenhuyse, Audrey ; Université de Liège - ULiège > Centre de recherches du cyclotron

Boveroux, Pierre ; Université de Liège - ULiège > Anesthésie et réanimation

Boly, Mélanie ; Université de Liège - ULiège > Département des sciences cliniques > Neurologie

Laureys, Steven ; Université de Liège - ULiège > Centre de recherches du cyclotron - Département des sciences cliniques

Language :

English

Title :

Brain connectivity in pathological and pharmacological coma

Publication date :

20 December 2010

Journal title :

Frontiers in Systems Neuroscience

eISSN :

1662-5137

Publisher :

Frontiers Media S.A., Switzerland

Volume :

Pages :

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 06 February 2011

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