Consciousness is a prismatic and ambiguous concept that still eludes any universal definition. Severe acquired brain injuries resulting in a disorder of con-sciousness(DOC) provide a model from which insights into con...Consciousness is a prismatic and ambiguous concept that still eludes any universal definition. Severe acquired brain injuries resulting in a disorder of con-sciousness(DOC) provide a model from which insights into consciousness can be drawn. A number of recent studies highlight the difficulty in making a diagnosis in patients with DOC based only on behavioral assessments. Here we aim to provide an overview of how neuroimaging techniques can help assess patients with DOC. Such techniques are expected to facilitate a more accurate understanding of brain function in states of unconsciousness and to improve the evaluation of thepatient's cognitive abilities by providing both diagnostic and prognostic indicators.展开更多
1|INTRODUCTION.In most individuals,consciousness waxes and wanes in a circadian(24 h)rhythm in the sleep-wake cycle.However,this cycle can be majorly disturbed in disorders of consciousness(DoC1),to the point where it...1|INTRODUCTION.In most individuals,consciousness waxes and wanes in a circadian(24 h)rhythm in the sleep-wake cycle.However,this cycle can be majorly disturbed in disorders of consciousness(DoC1),to the point where it is unclear between what states an individual may alternate given the absence of full-blown wakefulness or all usual characteristics of sleep.展开更多
Patients with disorders of consciousness suffer from severe impairments in arousal and awareness alongside anomalous brain connections and aberrant neuronal activities.The thalamus,a crucial hub in the brain connectom...Patients with disorders of consciousness suffer from severe impairments in arousal and awareness alongside anomalous brain connections and aberrant neuronal activities.The thalamus,a crucial hub in the brain connectome,has been empirically inferred to maintain consciousness and wakefulness.Here,we investigated thalamic spiking,brain connectivity,consciousness states,and recovery outcomes following deep brain stimulation in 29 patients.Our study reveals that thalamic neuronal activity serves as a marker of consciousness state.Patients diagnosed with vegetative state/unresponsive wakefulness syndrome exhibited less-active neurons,with longer and more variable burst discharges,than those in a minimally conscious state.Furthermore,neuronal profiles in the intralaminar thalamus,the direct stimulation site,predicted whether electrostimulation here improved recovery.Stronger tonic firing was correlated with enhanced thalamocortical connectivity and better recovery outcomes in patients.These findings suggest that thalamic spiking signatures,including singleneuron burst discharge and tonic firing,selectively indicate the representation and alteration of consciousness.展开更多
基金Supported by The European Commissionthe James McDon-nell Foundation+5 种基金the European Space AgencyMind Science Foundationthe French Speaking Community Concerted Research Actionthe Belgian interuniversity attraction polethe Public Utility Foundation"Université Européenne du Travail""Fondazione Europea di Ricerca Biomedica"and the University and University Hospital of Liège
文摘Consciousness is a prismatic and ambiguous concept that still eludes any universal definition. Severe acquired brain injuries resulting in a disorder of con-sciousness(DOC) provide a model from which insights into consciousness can be drawn. A number of recent studies highlight the difficulty in making a diagnosis in patients with DOC based only on behavioral assessments. Here we aim to provide an overview of how neuroimaging techniques can help assess patients with DOC. Such techniques are expected to facilitate a more accurate understanding of brain function in states of unconsciousness and to improve the evaluation of thepatient's cognitive abilities by providing both diagnostic and prognostic indicators.
基金supported by the University and University Hospital of Liegethe BIAL Foundation,the Belgian National Funds for Scientific Research(FRSFNRS)+17 种基金the FNRS PDR project(T.0134.21)the FLAGERA JTC2021 project ModelDXConsciousness(Human Brain Project Partnering Project)FLAG-ERA JTC 2023—HBP—Basic and Applied Research,project BrainActJTC the fund Generetthe King Baudouin Foundationthe Funds Chantal Schaeck Yolandethe Televie Foundationthe European Space Agency(ESA)the Belgian Federal Science Policy Office(BELSPO)in the framework of the PRODEX Programthe Public Utility Foundation“Universite Europeenne du Travail”“Fondazione Europea di Ricerca Biomedica”the Mind Science Foundation,the European Commissionthe Fondation Leon Fredericqthe Mind-Care Foundationthe National Natural Science Foundation of China(Joint Research Project 81471100)the European Foundation of Biomedical Research FERB Onlusthe Horizon 2020 MSCA—Research and Innovation Staff Exchange DoC-Box project(HORIZONMSCA-2022-SE-01-01,101131344)the FWO(1265522N).
文摘1|INTRODUCTION.In most individuals,consciousness waxes and wanes in a circadian(24 h)rhythm in the sleep-wake cycle.However,this cycle can be majorly disturbed in disorders of consciousness(DoC1),to the point where it is unclear between what states an individual may alternate given the absence of full-blown wakefulness or all usual characteristics of sleep.
基金supported by funding fromBeijingNatural Science Foundation grant Z210009National Science and Technology Innovation 2030 Major Projects,STI2030-Major Projects grant 2022ZD0204800+4 种基金National Natural Science Foundation of China grants 32070987 and 31722025Chinese Academy of Sciences Key Program of Frontier Sciences grant QYZDB-SSW-SMC019supported by funding from National Key R&D Program of China grant 2022YFB4700100Strategic Priority Research Program of Chinese Academy of Sciences XDB37030303funded as a chairholder from the Canada Excellence Research Chair in Neuroplasticity,as research director at the Belgian National Fund for Scientific Research,by the European Foundation of Biomedical Research,by the Foundation for Research and Rehabilitation of Neurodegenerative Diseases,and by National Natural Science Foundation of China 81920108023.
文摘Patients with disorders of consciousness suffer from severe impairments in arousal and awareness alongside anomalous brain connections and aberrant neuronal activities.The thalamus,a crucial hub in the brain connectome,has been empirically inferred to maintain consciousness and wakefulness.Here,we investigated thalamic spiking,brain connectivity,consciousness states,and recovery outcomes following deep brain stimulation in 29 patients.Our study reveals that thalamic neuronal activity serves as a marker of consciousness state.Patients diagnosed with vegetative state/unresponsive wakefulness syndrome exhibited less-active neurons,with longer and more variable burst discharges,than those in a minimally conscious state.Furthermore,neuronal profiles in the intralaminar thalamus,the direct stimulation site,predicted whether electrostimulation here improved recovery.Stronger tonic firing was correlated with enhanced thalamocortical connectivity and better recovery outcomes in patients.These findings suggest that thalamic spiking signatures,including singleneuron burst discharge and tonic firing,selectively indicate the representation and alteration of consciousness.
