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The integrity of thalamo-dorsolateral prefrontal cortex tract: a key in consciousness disorders

Poster No:

2463 

Submission Type:

Abstract Submission 

Authors:

Seonghoon Lim1, Ji Yoon Jung1, Sun Im2, Tae-Woo Kim3

Institutions:

1Seoul St.Mary’s Hospital College of Medicine, The Catholic University of Korea, Seoul, Korea, Republic of, 2Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic, Bucheon, Korea, Republic of, 3National Traffic Injury Rehabilitation Hospital, Gyeongki-do, Republic of Korea, Gyeongki-do, Korea, Republic of

First Author:

Seonghoon Lim  
Seoul St.Mary’s Hospital College of Medicine, The Catholic University of Korea
Seoul, Korea, Republic of

Co-Author(s):

Ji Yoon Jung  
Seoul St.Mary’s Hospital College of Medicine, The Catholic University of Korea
Seoul, Korea, Republic of
Sun Im  
Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic
Bucheon, Korea, Republic of
Tae-Woo Kim  
National Traffic Injury Rehabilitation Hospital, Gyeongki-do, Republic of Korea
Gyeongki-do, Korea, Republic of

Introduction:

The mesocircuit model describes a complex network that includes the prefrontal cortical-striatopallidal thalamocortical loop systems and is involved in the mechanism of 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 key to recovering consciousness in these patients.
We hypothesized that residual integrity of thalamo-dorsolateral prefrontal cortex tract (TDLPFCT) integrity may be key factor of consciousness in patients with DoC.

Methods:

This retrospective case-control study included three groups: prolonged DoC (n=20), stroke without DoC (n=20), and normal 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 revised coma recovery scale (CRS-R) within a week of brain imaging.

Results:

All three groups exhibited significant differences in DLPFCT TV in both affected and less-affected lobes, with the DoC group showing greatest reduction(p = 0.002). We found a significant correlation between the TV of the TDLPFCT in unaffected lobe, which can be referred to more preserved TDLPFCT, and the CRS-R score, as indicated by a Spearman's correlation coefficient of r = 0.628 (p = 0.003).

Conclusions:

The integrity of the TDLPFCT, particularly in the less affected hemisphere, appears to play a crucial role in determining consciousness levels in prolonged DoC patients. Highlighting its potential importance in assessing prognosis and further developing therapeutic strategies for patients with DoC.

Neuroanatomy, Physiology, Metabolism and Neurotransmission:

White Matter Anatomy, Fiber Pathways and Connectivity 2

Perception, Attention and Motor Behavior:

Consciousness and Awareness 1

Keywords:

Consciousness
WHITE MATTER IMAGING - DTI, HARDI, DSI, ETC

1|2Indicates the priority used for review
Supporting Image: figure3.jpg
   ·Representative diffusion tensor tractography images of the TDLPFCT. (A) Normal, (B) Stroke, (C) Disorders of consciousness with high CRS-R, (D) Disorders of consciousness with low CRS-R
 

Provide references using author date format

1. Schiff ND. Recovery of consciousness after brain injury: a mesocircuit hypothesis. Trends Neurosci. 2010;33(1):1-9.
2. Schiff ND. Mesocircuit mechanisms in the diagnosis and treatment of disorders of consciousness. Presse Med. 2022;52(2):104161.