Relationship between the Consciousness State and the Default Mode Network in Traumatic Brain Injury

Abstract

Introduction: This study investigated the relationship between Coma Recovery Scale-Revised (CRS-R) and the neural networks between the medial prefrontal cortex (mPFC) and precuneus (PCun)/posterior cingulate cortex (PCC) in disorders of consciousness (DOC) patients with a traumatic brain injury (TBI) using diffusion tensor tractography (DTT). Measures: Twenty-five consecutive patients with TBI admitted to the rehabilitation department of a university hospital were enrolled in this study. The Coma Recovery Scale-Revised (CRS-R) was used to evaluate the consciousness state. The pathway of the neural networks between the mPFC and the PCun (mPFC-PCun DMN)/PCC (mPFC-PCC DMN) were reconstructed using DTT. Fractional anisotropy (FA) and the tract volume (TV) were obtained to assess the diffusion tensor imaging parameters. Results: The CRS-R score had strong positive correlations with the FA value and TV of the mPFC-PCun DMN (p < 0.05), while it showed a moderate positive correlation with the TV of the mPFC-PCC DMN (p < 0.05). In addition, the FA value of the mPFC-Pcun DMN showed that it could explain the variability in the CRS-R score. Conclusions: The close correlation was noted between the consciousness state and the mPFC-PCun DMN and mPFC-PCC DMN in DOC patients with TBI. On the other hand, the mPFC-PCun DMN appeared to be more closely correlated with the consciousness state than the mPFC-PCC DMN.

Keywords

• traumatic brain injury
• coma recovery scale-revised
• default mode network
• diffusion tensor tractography
• disorders of consciousness