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Presentation

Subcortical regions associated with consciousness level have high measures of resting state functional network integration
Description
Background and Purpose: Reintegration of connectivity between subcortical and cortical networks is essential for recovery of arousal and awareness in patients with disorders of consciousness (DoC). Few therapies that promote recovery of consciousness currently exist partially due to the lack of therapeutic targets. This study aimed to map subcortical functional connectivity hubs that modulate cortical networks in the healthy, conscious human brain and identify regions linked to multiple cortical resting state networks.

Methods: We applied the NASCAR network identification pipeline to 168 healthy control 7 Tesla resting-state functional MRI (rs-fMRI) data from the Human Connectome Project. We identified canonical cortical networks, including the default mode (DMN), executive control (ECN), dorsal attention (DAN), salience (SN), visual (VN), and somatomotor (SMN) networks. The subcortical components of each of these networks were normalized based on the cumulative distribution of the connectivity values within the subcortex. We created volumetric maps showing network overlap at each subcortical voxel and defined subcortical hubs as the voxels whose rs-fMRI signal was correlated with multiple (≥4) cortical networks.

Results: We identified subcortical connectivity hubs within the ventral tegmental area (VTA), central lateral thalamus (CL), and perifascicular nucleus (PF) of the thalamus. We also identified a hub within the pontine tegmentum, overlapping the pontine reticular formation, dorsal raphe, and locus coeruleus, that overlapped with a brainstem coma-causing “hotspot” previously reported by Parvizi (Brain, 2003) and Fischer (Neurology, 2016). Notably all subcortical hubs had contributions from the DMN and the SN, as well as two additional networks from either the DAN, ECN, or VN.

Conclusion: We identified subcortical connectivity hubs in the pons, midbrain and thalamus that modulate the functional connectivity of multiple cortical networks contributing to human consciousness. These subcortical hubs are potential targets for pharmacologic and device-based modulation of brain function in patients with DoC.

Event Type
Late-Breaking Abstract
TimeThursday, October 17th9:55am - 10:15am PDT
LocationHarbor Ballrooms B-C
Tracks
Science of Neurocritical Care
Focus Areas
Head and Spine Trauma
Seizures/EEG
Curing Coma
Target Audiences
Intermediate