A human brain network derived from coma-causing brainstem lesions

[en] OBJECTIVE To characterize a brainstem location specific to coma-causing lesions, and its functional connectivity network. METHODS We compared 12 coma-causing brainstem lesions to 24 control brainstem lesions using voxel-based lesion-symptom mapping in a case-control design to identify a site significantly associated with coma. We next used resting-state functional connectivity from a healthy cohort to identify a network of regions functionally connected to this brainstem site. We further investigated the cortical regions of this network by comparing their spatial topography to that of known networks and by evaluating their functional connectivity in patients with disorders of consciousness. RESULTS A small region in the rostral dorsolateral pontine tegmentum was significantly associated with coma-causing lesions. In healthy adults, this brainstem site was functionally connected to the ventral anterior insula (AI) and pregenual anterior cingulate cortex (pACC). These cortical areas aligned poorly with previously defined resting-state networks, better matching the distribution of von Economo neurons. Finally, connectivity between the AI and pACC was disrupted in patients with disorders of consciousness, and to a greater degree than other brain networks. CONCLUSIONS Injury to a small region in the pontine tegmentum is significantly associated with coma. This brainstem site is functionally connected to 2 cortical regions, the AI and pACC, which become disconnected in disorders of consciousness. This network of brain regions may have a role in the maintenance of human consciousness

Disciplines :

Neurology

Author, co-author :

Fischer, David

Boes, A.D

Demertzi, Athina ; Université de Liège > Centre de recherches du cyclotron

Evrard, H.C

Laureys, Steven ; Université de Liège > GIGA : Coma Group

Edlow, B.L.

Liu, H

Saper, C

Pascual-Leone, A

Fox, M.D.

Geerling, J.C

Language :

English

Title :

A human brain network derived from coma-causing brainstem lesions

Publication date :

2016

Journal title :

Neurology

ISSN :

0028-3878

eISSN :

1526-632X

Publisher :

Lippincott Williams & Wilkins, Hagerstown, United States - Maryland

Volume :

Issue :

Pages :

2427-2434

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 04 January 2017

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Scopus citations^®

166

Scopus citations^®
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114

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122

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