ArticleFrontiers in neurology
Morphological and electroencephalographic correlates in patients with disorders of consciousness following primary brainstem hemorrhage: a retrospective analysis.
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Abstract
Background: Primary brainstem hemorrhage (PBSH) frequently results in prolonged disorders of consciousness (DOC). Disruption of the ascending reticular activating system (ARAS) is a central pathophysiological mechanism linking brainstem injury to secondary cortical structural and functional changes. In the current study, we employed surface-based morphometry (SBM) and electroencephalography (EEG) spectral analyses to investigate the structure-function interaction in PBSH-induced DOC within the ARAS-mesocircuit framework. Methods: We retrospectively analyzed the data of 24 PBSH-induced DOC patients and 29 healthy controls. Cortical thickness was assessed via SBM, while EEG spectral powers across different bands were also calculated. Relationships between cortical thickness and EEG spectral metrics in patients with PBSH-induced DOC were explored using a General Linear Model. The correlations between EEG spectral powers and scores on the Chinese version of the Coma Recovery Scale-Revised (CRS-R) were also explored. Results: Patients with PBSH-induced DOC demonstrated widespread cortical thinning compared to controls, predominantly affecting frontal and temporal regions that constitute primary cortical targets of ARAS projections ( Conclusion: This study demonstrates that PBSH-induced DOC is associated with widespread cortical thinning, particularly in ARAS-dependent frontal and temporal regions, and that these structural alterations are reflected in characteristic EEG spectral signatures. These findings offer novel insights into the ARAS-mediated pathophysiological mechanisms underlying PBSH-induced DOC and may inform the development of structure-informed diagnostic and therapeutic biomarkers.
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