Altmayer Victor, Sangare Aude, Calligaris Charlotte, Puybasset Louis, Perlbarg Vincent, Naccache Lionel, Sitt Jacobo Diego, Rohaut Benjamin
Sorbonne University, Paris, F-75013, France.
Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Neuro-ICU, Paris, F-75013, France.
Brain Struct Funct. 2024 Dec;229(9):2285-2298. doi: 10.1007/s00429-024-02839-8. Epub 2024 Jul 25.
Brain connectivity, allowing information to be shared between distinct cortical areas and thus to be processed in an integrated way, has long been considered critical for consciousness. However, the relationship between functional intercortical interactions and the structural connections thought to underlie them is poorly understood. In the present work, we explore both functional (with an EEG-based metric: the median weighted symbolic mutual information in the theta band) and structural (with a brain MRI-based metric: fractional anisotropy) connectivities in a cohort of 78 patients with disorders of consciousness. Both metrics could distinguish patients in a vegetative state from patients in minimally conscious state. Crucially, we discovered a significant positive correlation between functional and structural connectivities. Furthermore, we showed that this structure-function relationship is more specifically observed when considering structural connectivity within the intra- and inter-hemispheric long-distance cortico-cortical bundles involved in the Global Neuronal Workspace (GNW) theory of consciousness, thus supporting predictions of this model. Altogether, these results support the interest of multimodal assessments of brain connectivity in refining the diagnostic evaluation of patients with disorders of consciousness.
大脑连接性能够使信息在不同的皮质区域之间共享，从而以整合的方式进行处理，长期以来一直被认为对意识至关重要。然而，人们对功能性皮质间相互作用与被认为是其基础的结构连接之间的关系了解甚少。在本研究中，我们在78名意识障碍患者队列中探索了功能性连接（基于脑电图的指标：θ波段的中位数加权符号互信息）和结构性连接（基于脑磁共振成像的指标：分数各向异性）。这两种指标都能够区分植物状态患者和最低意识状态患者。至关重要的是，我们发现功能性连接和结构性连接之间存在显著的正相关。此外，我们表明，当考虑参与意识的全局神经元工作空间（GNW）理论的半球内和半球间长距离皮质-皮质束内的结构连接时，这种结构-功能关系更为具体地被观察到，从而支持了该模型的预测。总之，这些结果支持了对大脑连接性进行多模态评估在完善意识障碍患者诊断评估方面的价值。
