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  A human brain network derived from coma-causing brainstem lesions

Fischer, D., Boes, A., Demertzi, A., Evrard, H., Laureys, S., Edlow, B., et al. (2016). A human brain network derived from coma-causing brainstem lesions. Neurology, 87(23), 2427-2434. doi:10.1212/WNL.0000000000003404.

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Item Permalink: http://hdl.handle.net/21.11116/0000-0000-7939-9 Version Permalink: http://hdl.handle.net/21.11116/0000-0000-793A-8
Genre: Journal Article

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 Creators:
Fischer, DB, Author
Boes, AD, Author
Demertzi, A, Author
Evrard, HC1, 2, 3, Author              
Laureys, S, Author
Edlow, BL, Author
Liu, H, Author
Saper, CB, Author
Pascual-Leone, A, Author
Fox, MD, Author
Geerling, JC, Author
Affiliations:
1Department Physiology of Cognitive Processes, Max Planck Institute for Biological Cybernetics, Max Planck Society, ou_1497798              
2Dept. Empirical Inference, Max Planck Institute for Intelligent System, Max Planck Society, ou_1497647              
3Max Planck Institute for Biological Cybernetics, Max Planck Society, ou_1497794              

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 Abstract: 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.

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 Dates: 2016-12
 Publication Status: Published in print
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 Identifiers: DOI: 10.1212/WNL.0000000000003404
BibTex Citekey: FischerBDELELSPFG2016
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Title: Neurology
Source Genre: Journal
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Pages: - Volume / Issue: 87 (23) Sequence Number: - Start / End Page: 2427 - 2434 Identifier: -