ArticleNeurology2021
Location of Subcortical Microbleeds and Recovery of Consciousness After Severe Traumatic Brain Injury.
Article in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed, 31 citations in OpenAlex.
- Traumatic Microhemorrhages Are Not Synonymous With Axonal Injury.Annals of clinical and translational neurology · 2026Article
- Adversarial AI reveals mechanisms and treatments for disorders of consciousness.Nature neuroscience · 2026Article
- Probabilistic mapping and automated segmentation of human brainstem white matter bundles.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- Article
- Advances in understanding and treating disorders of consciousness caused by brainstem injury.Chinese neurosurgical journal · 2025Review
- Automated MRI Segmentation of Brainstem Nuclei Critical to Consciousness.Human brain mapping · 2025Observational
- Common Data Elements for Disorders of Consciousness: Recommendations from the Working Group on Neuroimaging.Neurocritical care · 2023Article
- Alteration in ventral tegmental area and default mode network interplay and prediction of coma recovery in patients with sTBI.Heliyon · 2023Article
- In vivo structural connectome of arousal and motor brainstem nuclei by 7 Tesla and 3 Tesla MRI.Human brain mapping · 2022Article
- Return to Work Within Four Months of Grade 3 Diffuse Axonal Injury.The Neurohospitalist · 2022Article
- New diagnosis of cancer in mild and moderate/severe traumatic brain injury patients in a 12-year population-based study.BMC cancer · 2022Article
- Dopaminergic modulation of human consciousness via default mode network connectivity.Proceedings of the National Academy of Sciences of the United States of America · 2021Article
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5 authors at 1 institution in 1 country.
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Abstract
backgroundIn patients with severe traumatic brain injury (TBI), coma is associated with impaired subcortical arousal mechanisms. However, it is unknown which nuclei involved in arousal (arousal nuclei) are implicated in coma pathogenesis and are compatible with coma recovery.
methodsWe mapped an atlas of arousal nuclei in the brainstem, thalamus, hypothalamus, and basal forebrain onto 3 tesla susceptibility-weighted images (SWI) in 12 patients with acute severe TBI who presented in coma and recovered consciousness within 6 months. We assessed the spatial distribution and volume of SWI microbleeds and evaluated the association of microbleed volume with the duration of unresponsiveness and functional recovery at 6 months.
resultsThere was no single arousal nucleus affected by microbleeds in all patients. Rather, multiple combinations of microbleeds in brainstem, thalamic, and hypothalamic arousal nuclei were associated with coma and were compatible with recovery of consciousness. Microbleeds were frequently detected in the midbrain (100%), thalamus (83%), and pons (75%). Within the brainstem, the microbleed incidence was largest within the mesopontine tegmentum (e.g., pedunculotegmental nucleus, mesencephalic reticular formation) and ventral midbrain (e.g., substantia nigra, ventral tegmental area). Brainstem arousal nuclei were partially affected by microbleeds, with microbleed volume not exceeding 35% of brainstem nucleus volume on average. Compared to microbleed volume within nonarousal brainstem regions, the microbleed volume within arousal brainstem nuclei accounted for a larger proportion of variance in the duration of unresponsiveness and 6-month Glasgow Outcome Scale-Extended scores.
conclusionThese results suggest resilience of arousal mechanisms in the human brain after severe TBI.
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