Functional neuroanatomy underlying the clinical subcategorization of minimally conscious state patients
Open accessAbstract
Patients in a minimally conscious state (MCS) show restricted signs of awareness but are unable to communicate. We assessed cerebral glucose metabolism in MCS patients and tested the hypothesis that this entity can be subcategorized into MCS- (i.e., patients only showing nonreflex behavior such as visual pursuit, localization of noxious stimulation and/or contingent behavior) and MCS+ (i.e., patients showing command following).Patterns of cerebral glucose metabolism were studied using [(18)F]-fluorodeoxyglucose-PET in 39 healthy volunteers (aged 46 ± 18 years) and 27 MCS patients of whom 13 were MCS- (aged 49 ± 19 years; 4 traumatic; 21 ± 23 months post injury) and 14 MCS+ (aged 43 ± 19 years; 5 traumatic; 19 ± 26 months post injury). Results were thresholded for significance at false discovery rate corrected p < 0.05.We observed a metabolic impairment in a bilateral subcortical (thalamus and caudate) and cortical (fronto-temporo-parietal) network in nontraumatic and traumatic MCS patients. Compared to MCS-, patients in MCS+ showed higher cerebral metabolism in left-sided cortical areas encompassing the language network, premotor, presupplementary motor, and sensorimotor cortices. A functional connectivity study showed that Broca's region was disconnected from the rest of the language network, mesiofrontal and cerebellar areas in MCS- as compared to MCS+ patients.The proposed subcategorization of MCS based on the presence or absence of command following showed a different functional neuroanatomy. MCS- is characterized by preserved right hemispheric cortical metabolism interpreted as evidence of residual sensory consciousness. MCS+ patients showed preserved metabolism and functional connectivity in language networks arguably reflecting some additional higher order or extended consciousness albeit devoid of clinical verbal or nonverbal expression.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Relative regional variations in metabolism correlate with preservation of specific behavioral or perceptual functions in minimally conscious state patients.
“relative regional variations in metabolism correlate with the preservation of specific behavioral or perceptual functions in MCS patients [7, 8]”
From The Minimal Energetic Requirement of Sustained Awareness after Brain Injury (2016) · cites this paper as [7]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The minimally conscious state: Definition and diagnostic criteria
Giacino, J. T., Ashwal, S., Childs, N., Cranford, R., Jennett, B., Katz, D. I., Kelly, J. P., Rosenberg, J. H., Whyte, J., Zafonte, R. D., et al. (2002) · Neurology · doi:10.1212/wnl.58.3.349 · Cited by 2,422 · see citing works
Vanhaudenhuyse, A., Noirhomme, Q., Tshibanda, L. J.-F., Bruno, M.-A., Boveroux, P., Schnakers, C., Soddu, A., Perlbarg, V., Ledoux, D., Brichant, J.-F., et al. (2010) · Brain · doi:10.1093/brain/awp313 · Cited by 911 · cited 1× · see citing works
“We found a positive linear correlation between metabolism in frontoparietal cortices and the CRS-R total scores, in line with our previous study showing a correlation between this behavioral score and spontaneous ‘‘default network’’ brain activity as measured by functional MRI in ‘‘resting state’’ conditions [11].”
ResultSelf-citationThe neural correlate of (un)awareness: lessons from the vegetative state
Laureys, S. (2005) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2005.10.010 · Cited by 813 · see citing works
Self-citationMeasuring consciousness: relating behavioural and neurophysiological approaches
Seth, A. K., Dienes, Z., Cleeremans, A., Overgaard, M., & Pessoa, L. (2008) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2008.04.008 · Cited by 458 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- [28]28. Zhang J, Mitsis EM, Chu K, Newmark RE et al (2010) Statistical parametric mapping and cluster counting analysis of [18F] FDGPET imaging in traumatic brain injury. J Neurotrauma 27(1):35-49
- [37]37. Edelman GM (2004) Wider than the sky: The phenomenal gift of consciousness. Yale University Press, New Haven and London
- [41]41. Monti MM, Vanhaudenhuyse A, Coleman MR et al (2010) Willful modulation of brain activity in disorders of consciousness. N. Engl J Med 362(7):579-589
Cited by
Sorted by citations
Network hubs in the human brain
van den Heuvel, M. P., & Sporns, O. (2013) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2013.09.012 · Cited by 2,123 · see citing works
Consciousness in humans and non-human animals: recent advances and future directions
Boly, M., Seth, A. K., Wilke, M., Ingmundson, P., Baars, B., Laureys, S., Edelman, D. B., & Tsuchiya, N. (2013) · Frontiers in Psychology · doi:10.3389/fpsyg.2013.00625 · Cited by 291 · see citing works
Self-citationConsciousness supporting networks
Demertzi, A., Soddu, A., & Laureys, S. (2013) · Current Opinion in Neurobiology · doi:10.1016/j.conb.2012.12.003 · Cited by 196 · see citing works
Self-citationMinimally conscious state or cortically mediated state?
Naccache, L. (2018) · Brain · doi:10.1093/brain/awx324 · Cited by 181 · see citing works
The Minimal Energetic Requirement of Sustained Awareness after Brain Injury
Stender, J., Mortensen, K. N., Thibaut, A., Darkner, S., Laureys, S., Gjedde, A., & Kupers, R. (2016) · Current Biology · doi:10.1016/j.cub.2016.04.024 · Cited by 131 · see citing works
Self-citationA voice without a mouth no more: The neurobiology of language and consciousness
Skipper, J. I. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104772 · Cited by 31 · see citing works
Hermann, B., Sangaré, A., Munoz-Musat, E., Salah, A. B., Perez, P., Valente, M., Faugeras, F., Axelrod, V., Demeret, S., Marois, C., et al. (2021) · Neuroscience of Consciousness · doi:10.1093/nc/niab048 · Cited by 24 · see citing works
- Authors
- Bruno, M.-A., Majerus, S., Boly, M., Vanhaudenhuyse, A., Schnakers, C., Gosseries, O., Boveroux, P., Kirsch, M., Demertzi, A., Bernard, C., Hustinx, R., Moonen, G., & Laureys, S.
- Affiliations
- University of Liège (BE)
- Centre Hospitalier Universitaire de Liège (BE)
- Corresponding author
- Laureys, Steven
- ORCID
- Venue
- Journal of Neurology
- Published
- 2011-11-12
- Volume
- 259
- Issue
- 6
- Pages
- 1087-1098
- ISSN
- 0012-1037 (ISSN-L)
- 0340-5354
- 1432-1459
- OpenAlex
- W1990688218
- Cited by
- 239
- References
- 4
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 22 · 2023: 13 · 2022: 13 · 2021: 19 · 2020: 16 · 2019: 19 · 2018: 13 · 2017: 26 · 2016: 16 · 2015: 21 · 2014: 27 · 2013: 14 · 2012: 5
- FWCI
- 10.98
- Type
- journal article
- Language
- en
- Open access
- green
- orbi.uliege.be
- Licence
- other-oa
- www.springer.com/tdm (tdm)
- Locations
- Journal of Neurology (publishedVersion)
- PubMed (publishedVersion)
- ORBi (University of Liège) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Keywords
- minimally conscious state, command following, brain glucose metabolism, functional connectivity, language network, Broca's area, thalamus, caudate nucleus, traumatic brain injury, extended consciousness
- MeSH terms
- Adult, Aged, Aged, 80 and over, Brain, Female, Humans, Male, Middle Aged, Persistent Vegetative State, Positron-Emission Tomography, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
