Evidence map›Paper›PMID 32053587›Full record

ArticlePloS one2020

Fractal dimension of cortical functional connectivity networks & severity of disorders of consciousness.

Thomas F Varley, Michael Craig, Ram Adapa, Paola Finoia, Guy Williams, Judith Allanson, John Pickard, David K Menon, Emmanuel A Stamatakis

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 1 pooled it
4.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.

  1. Guideline
  2. Article
  3. Article
  4. Review
  5. Structured Dynamics in the Algorithmic Agent.Entropy (Basel, Switzerland) · 2025
    Article
  6. Article
  7. Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. Review
  13. Clinical Sensitivity of Fractal Neurodynamics.Advances in neurobiology · 2024
    Article
  14. Prognosis of consciousness disorders in the intensive care unit.Presse medicale (Paris, France : 1983) · 2023
    Review
  15. Article
  16. The Fractal Viewpoint of Tumors and Nanoparticles.Current medicinal chemistry · 2023
    Review
  17. Review
  18. Review
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 2 countries.

Thomas F VarleyDivision of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom.ORCID 0000-0002-3317-9882
Michael CraigDivision of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom.
Ram AdapaDivision of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom.
Paola FinoiaDivision of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom.
Guy WilliamsWolfson Brain Imaging Center, University of Cambridge, Cambridgeshire, England, United Kingdom.
Judith AllansonDepartment of Neurorehabilitation, Addenbrooke's Hospital, Cambridgeshire, England, United Kingdom.
John PickardWolfson Brain Imaging Center, University of Cambridge, Cambridgeshire, England, United Kingdom.
David K MenonDivision of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom.ORCID 0000-0002-3228-9692
Emmanuel A StamatakisDivision of Anaesthesia, School of Clinical Medicine, University of Cambridge, Cambridgeshire, England, United Kingdom.
University of Cambridge · GBAddenbrooke's Hospital · GB

Funding

Department of HealthMedical Research Council U.1055.01.002.00001.01Wellcome TrustWellcome Trust 083660/Z/07/Z
6 · The paper itself

Abstract

Recent evidence suggests that the quantity and quality of conscious experience may be a function of the complexity of activity in the brain and that consciousness emerges in a critical zone between low and high-entropy states. We propose fractal shapes as a measure of proximity to this critical point, as fractal dimension encodes information about complexity beyond simple entropy or randomness, and fractal structures are known to emerge in systems nearing a critical point. To validate this, we tested several measures of fractal dimension on the brain activity from healthy volunteers and patients with disorders of consciousness of varying severity. We used a Compact Box Burning algorithm to compute the fractal dimension of cortical functional connectivity networks as well as computing the fractal dimension of the associated adjacency matrices using a 2D box-counting algorithm. To test whether brain activity is fractal in time as well as space, we used the Higuchi temporal fractal dimension on BOLD time-series. We found significant decreases in the fractal dimension between healthy volunteers (n = 15), patients in a minimally conscious state (n = 10), and patients in a vegetative state (n = 8), regardless of the mechanism of injury. We also found significant decreases in adjacency matrix fractal dimension and Higuchi temporal fractal dimension, which correlated with decreasing level of consciousness. These results suggest that cortical functional connectivity networks display fractal character and that this is associated with level of consciousness in a clinically relevant population, with higher fractal dimensions (i.e. more complex) networks being associated with higher levels of consciousness. This supports the hypothesis that level of consciousness and system complexity are positively associated, and is consistent with previous EEG, MEG, and fMRI studies.

Indexed as

Models, NeurologicalAdultAlgorithmsBrainBrain InjuriesConsciousnessFemaleFractalsHealthy VolunteersHumansMagnetic Resonance ImagingNerve NetPersistent Vegetative StateSeverity of Illness Index

Identifiers

PMID32053587
PMCPMC7017993
OpenAlexW3006226797

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.