Functional networks reemerge during recovery of consciousness after acute severe traumatic brain injury

Model System:

TBI

Reference Type:

Journal article

Accession No.:

J78892

Journal:

Cortex

Year, Volume, Issue, Page(s):

2018 , , ,

Publication Website:

Abstract:

Study analyzed default mode network (DMN) correlations and anticorrelations in patients with acute disorders of consciousness (DoC) caused by severe traumatic brain injury (TBI). Resting-state functional magnetic resonance imaging (rs-fMRI) was performed to measure DMN connectivity in 17 patients admitted to the intensive care unit (ICU) with acute severe TBI and in 16 healthy control subjects. Eight patients returned for follow-up rs-fMRI and behavioral assessment six months post-injury. At each time point, DMN connectivity was analyzed by measuring intra-network correlations (positive correlations between DMN nodes) and inter-network anticorrelations (negative correlations between the DMN and other resting-state networks). All patients were comatose upon arrival to the ICU and had a DoC at the time of acute rs-fMRI: 2 coma, 4 unresponsive wakefulness syndrome, 7 minimally conscious state, and 4 post-traumatic confusional state. While DMN anticorrelations were absent in patients with acute DoC, patients who recovered from coma to a minimally conscious or confusional state while in the ICU showed partially preserved DMN correlations. Patients who remained in coma or unresponsive wakefulness syndrome in the ICU showed no DMN correlations. All 8 patients assessed longitudinally recovered beyond the confusional state by 6 months post-injury and showed normal DMN correlations and anticorrelations, indistinguishable from those of healthy subjects. Collectively, these findings suggest that recovery of consciousness after acute severe TBI is associated with partial preservation of DMN correlations in the ICU, followed by long-term normalization of DMN correlations and anticorrelations. Both intra-network DMN correlations and inter-network DMN anticorrelations may be necessary for full recovery of consciousness after acute severe TBI

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