Network Mapping of Connectivity Alterations in Disorder of Consciousness: Towards Targeted Neuromodulation.
Lucia MencarelliMaria Chiara BiagiRicardo SalvadorSara RomanellaGiulio RuffiniSimone RossiEmiliano SantarnecchiPublished in: Journal of clinical medicine (2020)
Disorder of consciousness (DoC) refers to a group of clinical conditions that may emerge after brain injury, characterized by a varying decrease in the level of consciousness that can last from days to years. An understanding of its neural correlates is crucial for the conceptualization and application of effective therapeutic interventions. Here we propose a quantitative meta-analysis of the neural substrate of DoC emerging from functional magnetic resonance (fMRI) and positron emission tomography (PET) studies. We also map the relevant networks of resulting areas to highlight similarities with Resting State Networks (RSNs) and hypothesize potential therapeutic solutions leveraging network-targeted noninvasive brain stimulation. Available literature was reviewed and analyzed through the activation likelihood estimate (ALE) statistical framework to describe resting-state or task-dependent brain activation patterns in DoC patients. Results show that task-related activity is limited to temporal regions resembling the auditory cortex, whereas resting-state fMRI data reveal a diffuse decreased activation affecting two subgroups of cortical (angular gyrus, middle frontal gyrus) and subcortical (thalamus, cingulate cortex, caudate nucleus) regions. Clustering of their cortical functional connectivity projections identify two main altered functional networks, related to decreased activity of (i) the default mode and frontoparietal networks, as well as (ii) the anterior salience and visual/auditory networks. Based on the strength and topography of their connectivity profile, biophysical modeling of potential brain stimulation solutions suggests the first network as the most feasible target for tES, tDCS neuromodulation in DoC patients.
Keyphrases
- resting state
- functional connectivity
- positron emission tomography
- brain injury
- end stage renal disease
- magnetic resonance
- computed tomography
- newly diagnosed
- chronic kidney disease
- ejection fraction
- high resolution
- peritoneal dialysis
- subarachnoid hemorrhage
- single cell
- gene expression
- physical activity
- working memory
- machine learning
- white matter
- rna seq
- pet ct
- mass spectrometry
- deep learning
- cerebral ischemia
- deep brain stimulation