Cognitive Neuroimaging Unit, CEA, INSERM, Université Paris-Saclay, NeuroSpin Center, 91191 Gif/Yvette, France.
Department of Anesthesiology and Critical Care, Necker Hospital, AP-HP, Université de Paris, Paris, France.
Sci Adv. 2022 Mar 18;8(11):eabl5547. doi: 10.1126/sciadv.abl5547.
Loss of consciousness is associated with the disruption of long-range thalamocortical and corticocortical brain communication. We tested the hypothesis that deep brain stimulation (DBS) of central thalamus might restore both arousal and awareness following consciousness loss. We applied anesthesia to suppress consciousness in nonhuman primates. During anesthesia, central thalamic stimulation induced arousal in an on-off manner and increased functional magnetic resonance imaging activity in prefrontal, parietal, and cingulate cortices. Moreover, DBS restored a broad dynamic repertoire of spontaneous resting-state activity, previously described as a signature of consciousness. None of these effects were obtained during the stimulation of a control site in the ventrolateral thalamus. Last, DBS restored a broad hierarchical response to auditory violations that was disrupted under anesthesia. Thus, DBS restored the two dimensions of consciousness, arousal and conscious access, following consciousness loss, paving the way to its therapeutical translation in patients with disorders of consciousness.
意识丧失与长程丘脑皮质和皮质皮质脑通讯中断有关。我们检验了这样一个假设,即深部脑刺激(DBS)中央丘脑可能会在意识丧失后恢复觉醒和意识。我们应用麻醉来抑制非人类灵长类动物的意识。在麻醉过程中,中央丘脑刺激以开-关的方式诱导觉醒,并增加前额叶、顶叶和扣带回皮质的功能磁共振成像活动。此外,DBS 恢复了广泛的自发静息状态活动的动态范围,先前被描述为意识的特征。在腹外侧丘脑的对照部位刺激时,没有获得这些效果。最后,DBS 恢复了对听觉违规的广泛分层反应,而这种反应在麻醉下被打断。因此,DBS 在意识丧失后恢复了意识的两个维度,即觉醒和意识通达,为其在意识障碍患者中的治疗转化铺平了道路。
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