Skip to main content

ORIGINAL RESEARCH article

Front. Neurol.
Sec. Neurorehabilitation
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1373750
This article is part of the Research Topic Clinical imaging, neurophysiological, neuropathology and neuroethics studies on disorders of consciousness, coma mechanisms, and theories of consciousness: a unifying attempt View all 3 articles

The integrity of the thalamo-dorsolateral prefrontal cortex tract correlates with residual consciousness in patients with disorders of consciousness Running head: Thalamo-dorsolateral prefrontal tract and consciousness

Provisionally accepted
Ji Yoon Jung Ji Yoon Jung 1YEUN JIE YOO YEUN JIE YOO 1Mi-Jeong Yoon Mi-Jeong Yoon 1Bo Young Hong Bo Young Hong 1Tae-Woo Kim Tae-Woo Kim 2Geun-Young Park Geun-Young Park 3Jong In Lee Jong In Lee 4Soo-Hwan Lee Soo-Hwan Lee 3Sun Im Sun Im 3*Seong Hoon Lim Seong Hoon Lim 4,5*
  • 1 Department of Rehabilitation Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea, Seoul, Republic of Korea
  • 2 Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Gyeongki-do, Republic of Korea, Gyeongki-do, Republic of Korea
  • 3 Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Seoul, Republic of Korea
  • 4 Department of Rehabilitation Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea, seoul, Romania
  • 5 Institute for Basic Medical Science, Catholic Medical Center, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea

The final, formatted version of the article will be published soon.

    Background: The mesocircuit model describes a complex network that includes the prefrontal cortical-striatopallidal-thalamo-cortical loop systems and is involved in the mechanism underlying consciousness in patients with disorders of consciousness (DoC). Inhibitory signals to the thalamus become hyperactive in DoC patients, leading to a loss of consciousness. Reactivating this mesocircuit system is important for recovering consciousness in these patients. We investigated how the residual integrity of the thalamo-dorsolateral prefrontal cortex tract (TDLPFCT) influences consciousness in patients with DoC. Methods: This retrospective case-control study included three groups: prolonged DoC (n=20), stroke without DoC (n=20), and healthy controls (n=20). Diffusion tensor imaging (DTI) was performed at least 4 weeks after the onset. Thalamo-DLPFC tracts were reconstructed using diffusion tensor tractography, and fractional anisotropy (FA) and tract volume (TV) were measured for each hemisphere. Consciousness was assessed using the revised coma recovery scale (CRS-R) within a week of brain imaging. Results: Significant differences in DLPFCT TV were observed across all three groups, in both affected and less-affected lobes, with the DoC group showing the greatest reduction. A significant correlation was found between the TV of the less-affected TDLPFCT and CRS-R score. Conclusion: The integrity of the TDLPFCT, particularly in the less affected hemisphere, is associated with consciousness levels in patients with prolonged DoC. This finding suggests its potential importance in assessing prognosis and further developing therapeutic strategies for patients with DoC.

    Keywords: Consciousness Disorders, Minimally Conscious State, Thalamus, dorsolateral prefrontal cortex, Diffusion Tensor Imaging, prognosis

    Received: 20 Jan 2024; Accepted: 30 Jul 2024.

    Copyright: © 2024 Jung, YOO, Yoon, Hong, Kim, Park, Lee, Lee, Im and Lim. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Sun Im, Department of Rehabilitation Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea., Seoul, Republic of Korea
    Seong Hoon Lim, Institute for Basic Medical Science, Catholic Medical Center, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.