Evidence map›Paper›PMID 41933510›Full record

Observational studyAnnals of neurology2026

Supratentorial Brain Lesions in Unconscious Patients Map to a Common Human Brain Circuit.

Joshua Kahan, Rafael Vignoli Lippert, Bassam Al-Fatly, Qi Shen, Vedant Kansara, Mohamad J Alshikho, Batool Rizvi, Heather Shouel, Satoshi Egawa, Jerina Carmona and 18 more

Abstract readObservational StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Annals of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

28 authors.

Joshua KahanDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.ORCID 0000-0002-1443-9837
Rafael Vignoli LippertDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.ORCID 0000-0001-5653-5301
Bassam Al-FatlyMovement Disorders and Neuromodulation Unit, Department of Neurology with Experimental Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Qi ShenDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
Vedant KansaraDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
Mohamad J AlshikhoDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
Batool RizviDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
Heather ShouelDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
Satoshi EgawaDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
Jerina CarmonaDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
Lucie KrugerDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
You-Lim SongDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
Angela VelazquezDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
Alex J KleinDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.ORCID 0000-0002-4194-1996
Danielle H BassDepartment of Neurology, University of Miami, Miami, FL.
Daniel Samano Martin Del CampoDepartment of Neurology, University of Miami, Miami, FL.ORCID 0000-0003-0670-2647
Ana Karen Bolanos SaavedraDepartment of Neurology, University of Miami, Miami, FL.
Elizabeth E CarrollDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
Vincent PerlbargBraintale, Strasbourg, France.ORCID 0000-0002-3438-2479
Louis PuybassetDepartment of Anesthesiology and Critical Care, Sorbonne Université, GRC 29, Assistance Publique Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Paris, France.
Shivani GhoshalDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
Sachin AgarwalDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
David RohDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.ORCID 0000-0003-1927-7686
Soojin ParkDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
E Sander ConnollyNewYork Presbyterian Hospital, New York, NY.
Ayham AlkhachroumDepartment of Neurology, University of Miami, Miami, FL.ORCID 0000-0003-0352-5913
Adam M BrickmanDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.
Jan ClaassenDepartment of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY.ORCID 0000-0002-5893-8531

Funding

Clinical and Translational Science AwardUL1TR001873 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI REILLY, MUREDACH P · 2016 to 2025
$99.0M
RECONFIG - REcovery of CONsciousness Following Intracerebral hemorrhaGeR01NS106014 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI CLAASSEN, JAN · 2019 to 2023
$3.6M
NCATS NIH HHS UL1 TR001873NINDS NIH HHS R01 NS106014
6 · The paper itself

Abstract

objectiveImpairment of consciousness is frequent in patients with supratentorial brain injury, but underlying mechanisms are poorly understood. Large-scale network dysfunction has been suggested as a unifying concept for the diverse focal infra- and supratentorial brain lesions associated with unconsciousness. Functional imaging studies have revealed that lesions in different locations that cause the same symptom can be linked to common networks using lesion network mapping (LNM).

methodsTo identify a commonly injured network for impaired consciousness, LNM was used in a prospective, bi-center observational cohort of 115 humans suffering from focal brain injury due to supratentorial intracerebral hemorrhage (ICH).

resultsContrasting patients with preserved (n = 45) and impaired consciousness (n = 70), we identified a common network of brain regions more likely to be connected to focal brain lesions associated with impaired consciousness. Lesions in unconscious patients were more likely connected to a network including fronto-insulo-limbic association cortex, subcortical arousal and neuromodulatory nodes, and the ventral striato-pallidal circuitry. Data suggested preferential connectivity to a combination of arousal circuitry and association cortices.

interpretationPatients with impaired consciousness shared a common pattern of distributed network involvement that we infer to be mechanistically relevant to the regulation of consciousness that may serve as promising targets of neuromodulatory therapies. ANN NEUROL 2026;100:206-221.

Indexed as

BrainBrain MappingCerebral HemorrhageNerve NetUnconsciousnessAdultAgedCohort StudiesFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedNeural PathwaysProspective Studies

Identifiers

PMID41933510
PMCPMC13519938

What OpenQuestion holds

Textmetadata
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Registered trials

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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.