title: Synchronization between the anterior and posterior cortex determines consciousness level in patients with traumatic brain injury (TBI).
abstract: Survivors of traumatic brain injury (TBI) often suffer disorders of consciousness as a result of a breakdown in cortical connectivity. However, little is known about the neural discharges and cortical areas working in synchrony to generate consciousness in these patients. In this study, we analyzed cortical connectivity in patients with severe neurocognitive disorder (SND) and in the minimally conscious state (MCS). We found two synchronized networks subserving consciousness; one retrolandic (cognitive network) and the other frontal (executive control network). The synchrony between these networks is severely disrupted in patients in the MCS as compared to those with better levels of consciousness and a preserved state of alertness (SND). The executive control network could facilitate the synchronization and coherence of large populations of distant cortical neurons using high frequency oscillations on a precise temporal scale. Consciousness is altered or disappears after losing synchrony and coherence. We suggest that the synchrony between anterior and retrolandic regions is essential to awareness, and that a functioning frontal lobe is a surrogate marker for preserved consciousness. This article is part of a Special Issue entitled: Brain Integration.
authors.affiliation: Human Neuropsychology Laboratory, University of Seville, Spain; Center for Brain Injury Rehabilitation (C.RE.CER.), Seville, Spain. leoncarrion@us.es
authors.forename: Jose
authors.initials: J
authors.lastname: Leon-Carrion
authors.forename: Umberto
authors.initials: U
authors.lastname: Leon-Dominguez
authors.forename: Luca
authors.initials: L
authors.lastname: Pollonini
authors.forename: Meng-Hung
authors.initials: MH
authors.lastname: Wu
authors.forename: Richard E
authors.initials: RE
authors.lastname: Frye
authors.forename: Maria Rosario
authors.initials: MR
authors.lastname: Dominguez-Morales
authors.forename: George
authors.initials: G
authors.lastname: Zouridakis
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000473:pathology / Q000523:psychology; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000473:pathology / Q000503:physiopathology*; D003072:Cognition Disorders / Q000209:etiology; D003243:Consciousness / Q000502:physiology*; D004569:Electroencephalography; D058407:Electroencephalography Phase Synchronization / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D009434:Neural Pathways / Q000503:physiopathology; D018458:Persistent Vegetative State / Q000209:etiology