Original Article

A role for the default mode network in the bases of disorders of consciousness

  1. Davinia Fernández-Espejo PhD1,2,3,*,
  2. Andrea Soddu PhD4,
  3. Damian Cruse PhD1,
  4. Eva M. Palacios MSc2,
  5. Carme Junque PhD2,
  6. Audrey Vanhaudenhuyse PhD4,
  7. Eva Rivas MD5,
  8. Virginia Newcombe MD, PhD3,6,
  9. David K. Menon MD, PhD3,6,
  10. John D. Pickard FMedSci, MChir, FRCS3,7,
  11. Steven Laureys MD, PhD4,
  12. Adrian M. Owen PhD1

Article first published online: 2 OCT 2012

DOI: 10.1002/ana.23635

Issue

Annals of Neurology

Annals of Neurology

Volume 72, Issue 3, pages 335–343, September 2012

Additional Information

How to Cite

Fernández-Espejo, D., Soddu, A., Cruse, D., Palacios, E. M., Junque, C., Vanhaudenhuyse, A., Rivas, E., Newcombe, V., Menon, D. K., Pickard, J. D., Laureys, S. and Owen, A. M. (2012), A role for the default mode network in the bases of disorders of consciousness. Ann Neurol., 72: 335–343. doi: 10.1002/ana.23635

Author Information

  1. 1

    Brain and Mind Institute, University of Western Ontario, London, Ontario, Canada

  2. 2

    Department of Psychiatry and Clinical Psychobiology, IDIBAPS, University of Barcelona, Barcelona, Spain

  3. 3

    Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom

  4. 4

    Coma Science Group, Cyclotron Research Centre and Neurology Department, University and University Hospital of Liège, Liège, Belgium

  5. 5

    Anesthesiology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain

  6. 6

    Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge,United Kingdom

  7. 7

    Division of Academic Neurosurgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom

*Brain and Mind Institute, Natural Sciences Centre, University of Western Ontario, London, Ontario, N6A 5B7, Canada

Publication History

  1. Issue published online: 2 OCT 2012
  2. Article first published online: 2 OCT 2012
  3. Accepted manuscript online: 24 APR 2012 12:14PM EST
  4. Manuscript Accepted: 20 APR 2012
  5. Manuscript Revised: 12 APR 2012
  6. Manuscript Received: 1 JAN 2012

Funded by

  • Spanish Ministries of Science and Innovation. Grant Number: SAF2007-66077
  • Education. Grant Number: AP2006-00862
  • Medical Research Council. Grant Number: U.1055.01.002.00001.01
  • McDonnell Foundation
  • Canada Excellence Research Chairs Program
  • European Commission
  • Fonds de la Recherche Scientifique
  • Mind Science Foundation, Belgian French-Speaking Community Concerted Research Action. Grant Number: ARC 06/11_340
  • University Hospital of Liège, University of Liège, and Gates Cambridge Trust

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article with Supporting Information (HTML) Get PDF (350K)

Abstract

Objective:

Functional connectivity in the default mode network (DMN) is known to be reduced in patients with disorders of consciousness, to a different extent depending on their clinical severity. Nevertheless, the integrity of the structural architecture supporting this network and its relation with the exhibited functional disconnections are very poorly understood. We investigated the structural connectivity and white matter integrity of the DMN in patients with disorders of consciousness of varying clinical severity.

Methods:

Fifty-two patients—19 in a vegetative state (VS), 27 in a minimally conscious state (MCS), and 6 emerging from a minimally conscious state (EMCS)—and 23 healthy volunteers participated in the study. Structural connectivity was assessed by means of probabilistic tractography, and the integrity of the resulting fibers was characterized by their mean fractional anisotropy values.

Results:

Patients showed significant impairments in all of the pathways connecting cortical regions within this network, as well as the pathway connecting the posterior cingulate cortex/precuneus with the thalamus, relative to the healthy volunteers. Moreover, the structural integrity of this pathway, as well as that of those connecting the posterior areas of the network, was correlated with the patients' behavioral signs for awareness, being higher in EMCS patients than those in the upper and lower ranges of the MCS patients, and lowest in VS patients.

Interpretation:

These results provide a possible neural substrate for the functional disconnection previously described in these patients, and reinforce the importance of the DMN in the genesis of awareness and the neural bases of its disorders. Ann Neurol 2012;72:335–343.

View Full Article with Supporting Information (HTML) Get PDF (350K)