Center for the Study of Applied Psychology, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, 510631, China.
Centre for Hyperbaric Oxygen and Neurorehabilitation, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, 510010, China.
Neurosci Bull. 2018 Aug;34(4):647-658. doi: 10.1007/s12264-018-0250-6. Epub 2018 Jun 29.
A number of studies have indicated that disorders of consciousness result from multifocal injuries as well as from the impaired functional and anatomical connectivity between various anterior forebrain regions. However, the specific causal mechanism linking these regions remains unclear. In this study, we used spectral dynamic causal modeling to assess how the effective connections (ECs) between various regions differ between individuals. Next, we used connectome-based predictive modeling to evaluate the performance of the ECs in predicting the clinical scores of DOC patients. We found increased ECs from the striatum to the globus pallidus as well as from the globus pallidus to the posterior cingulate cortex, and decreased ECs from the globus pallidus to the thalamus and from the medial prefrontal cortex to the striatum in DOC patients as compared to healthy controls. Prediction of the patients' outcome was effective using the negative ECs as features. In summary, the present study highlights a key role of the thalamo-basal ganglia-cortical loop in DOCs and supports the anterior forebrain mesocircuit hypothesis. Furthermore, EC could be potentially used to assess the consciousness level.
许多研究表明，意识障碍是由多灶性损伤以及各种前脑区域之间功能和解剖连接受损引起的。然而，将这些区域联系起来的具体因果机制仍不清楚。在这项研究中，我们使用频谱动态因果建模来评估不同个体之间的各个区域之间的有效连接（EC）有何不同。接下来，我们使用基于连接组的预测建模来评估 EC 预测意识障碍患者临床评分的性能。与健康对照组相比，我们发现意识障碍患者纹状体到苍白球以及苍白球到后扣带回的 EC 增加，而苍白球到丘脑和内侧前额叶皮层到纹状体的 EC 减少。使用负 EC 作为特征可以有效地预测患者的预后。总之，本研究强调了丘脑基底神经节皮质回路在意识障碍中的关键作用，并支持前脑中区回路假说。此外，EC 可能可用于评估意识水平。
