Altered Effective Connectivity Measured by Resting-State Functional Magnetic Resonance Imaging in Posterior Parietal-Frontal-Striatum Circuit in Patients With Disorder of Consciousness

Abstract

ObjectiveDisorder of consciousness (DoC) resulting from severe brain injury is characterized by cortical and subcortical dysconnectivity. However, research on seed-based effective connectivity (EC) of DoC might be questioned as to the heterogeneity of prior assumptions.MethodsFunctional MRI data of 16 DoC patients and 16 demographically matched healthy individuals were analyzed. Revised coma recovery scale (CRS-R) scores of patients were acquired. Seed-based d mapping permutation of subject images (SDM-PSI) of meta-analysis was performed to quantitatively synthesize results from neuroimaging studies that evaluated resting-state functional activity in DoC patients. Spectral dynamic causal modeling (spDCM) was used to assess how EC altered between brain regions in DoC patients compared to healthy individuals.ResultsWe found increased effective connectivity in left striatum and decreased effective connectivity in bilateral precuneus (preCUN)/posterior cingulate cortex (PCC), bilateral midcingulate cortex and left middle frontal gyrus in DoC compared with the healthy controls. The resulting pattern of interaction in DoC indicated disrupted connection and disturbance of posterior parietal-frontal-striatum, and reduced self-inhibition of preCUN/PCC. The strength of self-inhibition of preCUN/PCC was negatively correlated with the total score of CRS-R.ConclusionThis impaired EC in DoC may underlie disruption in the posterior parietal-frontal-striatum circuit, particularly damage to the cortico-striatal connection and possible loss of preCUN/PCC function as the main regulatory hub.

Brain Metabolic Connectivity Patterns in Patients with Prolonged Disorder of Consciousness after Hypoxic-Ischemic Injury: A Preliminary Study

“…In addition, the functional disconnection between cortex and subcortical is also considered to be one of the biological mechanisms of DOC [ 15 ]. Patients with DOC have interruption and disorder of the effective connectivity between the left striatum and bilateral precuneus, cingulate gyrus and left middle frontal gyrus [ 16 ]. The thalamus is also an important subcortical nucleus for consciousness maintenance.…”

Transcriptome Profiling of the Dorsomedial Prefrontal Cortex in Suicide Victims

“…The other node in the DMN is present in the medial posterior parietal cortex, including the precuneus and the posterior cingulate cortex [16][17][18]. The precuneus plays a significant role in the human brain's mental imagination, individualization of cognitive processes, as reflections of signals from the external world, introspection, self-awareness, creativity and intelligence [19][20][21][22][23].…”

“…One of the outputs of the DMN is connected to the cortico-striato (including nucleus accumbens/ventral striatum)-thalamocortical loop (circuit) that connects the DMPFC and the precuneus with the reward-association system [3,17,27]. Dysfunction in the rewardassociation system results in major depression [17,28,29].…”

Transcriptome profiling of the dorsomedial prefrontal cortex in suicide victims

“…The other node in the DMN is present in the MPPC including the precuneus and the posterior cingulate cortex (Figley et al 2015, Chen et al 2021, Utevsky, Smith, and Huettel 2014). The precuneus plays a significant role in the human brain mental imagination, individualization of cognitive processes, as reflexions to signals from the external world, introspection, self-awareness, creativity and intelligence (Bruner et al 2017, Bruner et al 2014, Bruton 2021, Cavanna 2007, Margulies et al 2009).…”

“…One of the outputs of the RSN is connected with the cortico-striato (including nucleus accumbens/ventral striatum)-thalamo-cortical loop (circuit) that connects the DMPFC and the precuneus with the reward-association system (Chen et al 2021, Haber and Knutson 2010, Isaacs et al 2018). Dysfunction in the reward-association system results in major depression (Coenen et al 2018, Xu, Nan, and Lan 2020, Chen et al 2021).…”