ArticleScientific reports2024
Deep brain stimulation of the central thalamus restores arousal and motivation in a zolpidem-responsive patient with akinetic mutism after severe brain injury.
Article in Scientific reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 12 citations in OpenAlex.
- Recovery from disorders of consciousness: Lesions and GABAergic modulation in a biologically inspired spiking neural network.Proceedings of the National Academy of Sciences of the United States of America · 2026Article
- Transcranial temporal interference stimulation of the thalamus in a patient with disorders of consciousness: a case report.Frontiers in human neuroscience · 2026Article
- A thalamic perspective of (un)consciousness in pharmacological and pathological states in humans.Brain communications · 2026Article
- Transcranial Focused Ultrasound Modulates Visual Thalamus in a Nonhuman Primate Model.IEEE transactions on bio-medical engineering · 2025Article
- A human brain network linked to restoration of consciousness after deep brain stimulation.Nature communications · 2025Article
- Shared subcortical arousal systems across sensory modalities during transient modulation of attention.NeuroImage · 2025Article
- Thalamic burst and tonic firing selectively indicate patients' consciousness level and recovery.Innovation (Cambridge (Mass.)) · 2025Article
- Shared subcortical arousal systems across sensory modalities during transient modulation of attention.bioRxiv : the preprint server for biology · 2024Article
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9 authors at 3 institutions in 1 country.
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Abstract
After severe brain injury, zolpidem is known to cause spectacular, often short-lived, restorations of brain functions in a small subgroup of patients. Previously, we showed that these zolpidem-induced neurological recoveries can be paralleled by significant changes in functional connectivity throughout the brain. Deep brain stimulation (DBS) is a neurosurgical intervention known to modulate functional connectivity in a wide variety of neurological disorders. In this study, we used DBS to restore arousal and motivation in a zolpidem-responsive patient with severe brain injury and a concomitant disorder of diminished motivation, more than 10 years after surviving hypoxic ischemia. We found that DBS of the central thalamus, targeted at the centromedian-parafascicular complex, immediately restored arousal and was able to transition the patient from a state of deep sleep to full wakefulness. Moreover, DBS was associated with temporary restoration of communication and ability to walk and eat in an otherwise wheelchair-bound and mute patient. With the use of magnetoencephalography (MEG), we revealed that DBS was generally associated with a marked decrease in aberrantly high levels of functional connectivity throughout the brain, mimicking the effects of zolpidem. These results imply that 'pathological hyperconnectivity' after severe brain injury can be associated with reduced arousal and behavioral performance and that DBS is able to modulate connectivity towards a 'healthier baseline' with lower synchronization, and, can restore functional brain networks long after severe brain injury. The presence of hyperconnectivity after brain injury may be a possible future marker for a patient's responsiveness for restorative interventions, such as DBS, and suggests that lower degrees of overall brain synchronization may be conducive to cognition and behavioral responsiveness.
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