This study uncovers hidden signatures of brain networks that could support consciousness in patients who are unresponsive and seemingly vegetative, but who demonstrate signs of covert awareness.
University of Cambridge researchers Dr Srivas Chennu, Dr Tristan Bekinschtein and their collaborators employ the science of networks to characterise the brain networks that support human consciousness and how they are affected in pathological states of low awareness, like the vegetative state.
In a study publishing this week in PLOS Computational Biology, the authors analyse brain networks in 32 patients diagnosed as vegetative and minimally conscious, measured with electroencephalography, and compare them to healthy adults. They show that the rich and diversely connected networks that support awareness in the healthy brain are characteristically impaired in patients. However, some unresponsive vegetative patients (who show signs of hidden awareness by following commands like imagining playing tennis) have well-preserved brain networks that look similar to those of healthy adults.
Identifying the neural signatures of consciousness remains an elusive yet fascinating challenge to current cognitive neuroscience, but it takes on an immediate clinical and societal significance in patients diagnosed as vegetative and minimally conscious. This research could improve clinical assessment and help identify patients who might be covertly aware despite being uncommunicative.
The researchers say: "Being able to detect the recovery of brain networks in patients, alongside or even before they show behavioural signs of improvement, is very promising. However, further work is essential to translate these scientific advances into viable tools that can be reliably used at the patients' bedsides to accurately inform and guide their clinical care."
Striking Image Legend: Brain networks in two behaviourally similar vegetative patients (left and middle), but one of whom imagined playing tennis (middle panel), alongside a healthy adult (right panel).
Image credit: Srivas Chennu
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Contact: Srivas Chennu
Department of Clinical Neurosciences,
University of Cambridge,
Cambridge Biomedical Campus,
CB2 0QQ, UK
Citation: Chennu S, Finoia P, Kamau E, Allanson J, Williams GB, et al. (2014) Spectral Signatures of Reorganised Brain Networks in Disorders of Consciousness. PLoS Comput Biol 10(10): e1003887. doi:10.1371/journal.pcbi.1003887
Funding: This work was supported by grants from the Wellcome Trust [WT093811MA to TB]; the James S. McDonnell Foundation [to AMO and JDP]; the UK Medical Research Council [U.1055.01.002.00001.01 to AMO and JDP]; the Canada Excellence Research Chairs program [to AMO]; the Evelyn Trust, Cambridge [to JA], the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre and Senior Investigator Award [to JDP], and the British Oxygen Professorship of the Royal College of Anaesthetists [to DKM]. The research was also supported by the NIHR Brain Injury Healthcare Technology Co-operative based at Cambridge University Hospitals NHS Foundation Trust and University of Cambridge. The views expressed are those of the authors and not necessarily those of the UK National Health Service, the NIHR or the UK Department of Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
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