Limbic hyperconnectivity in the vegetative state

Neurology. 2013 Oct 15;81(16):1417-24. doi: 10.1212/WNL.0b013e3182a43b78. Epub 2013 Sep 18.

Abstract

Objective: To investigate functional connectivity between the default mode network (DMN) and other networks in disorders of consciousness.

Methods: We analyzed MRI data from 11 patients in a vegetative state and 7 patients in a minimally conscious state along with age- and sex-matched healthy control subjects. MRI data analysis included nonlinear spatial normalization to compensate for disease-related anatomical distortions. We studied brain connectivity data from resting-state MRI temporal series, combining noninferential (independent component analysis) and inferential (seed-based general linear model) methods.

Results: In DMN hypoconnectivity conditions, a patient's DMN functional connectivity shifts and paradoxically increases in limbic structures, including the orbitofrontal cortex, insula, hypothalamus, and the ventral tegmental area.

Conclusions: Concurrently with DMN hypoconnectivity, we report limbic hyperconnectivity in patients in vegetative and minimally conscious states. This hyperconnectivity may reflect the persistent engagement of residual neural activity in self-reinforcing neural loops, which, in turn, could disrupt normal patterns of connectivity.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cerebrum / physiopathology*
  • Female
  • Functional Neuroimaging / instrumentation
  • Functional Neuroimaging / methods
  • Humans
  • Limbic System / physiopathology*
  • Magnetic Resonance Imaging / instrumentation
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Nerve Net / physiopathology*
  • Persistent Vegetative State / physiopathology*
  • Young Adult