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A human brain network linked to restoration of consciousness after deep brain stimulation
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A human brain network linked to restoration of consciousness after deep brain stimulation
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Journal Article
A human brain network linked to restoration of consciousness after deep brain stimulation
2025
Overview
Disorders of consciousness are characterized by severe impairments in arousal and awareness. Deep brain stimulation is a potential treatment, but outcomes vary—possibly due to differences in patient characteristics, electrode placement, or the specific brain network engaged. We describe 40 patients with disorders of consciousness undergoing deep brain stimulation targeting the thalamic centromedian-parafascicular complex. Improvements in consciousness are associated with better-preserved gray matter, particularly in the striatum. Electric field modeling reveals that stimulation is most effective when it extends below the centromedian nucleus, engaging the inferior parafascicular nucleus and the adjacent ventral tegmental tract—a pathway that connects the brainstem and hypothalamus and runs along the midbrain-thalamus border. External validation analyses show that effective stimulation engages a brain network overlapping with disrupted patterns of brain activity observed in two independent cohorts with impaired consciousness: one with arousal-impairing stroke lesions and the other with awareness-impairing seizures. Together, these findings advance the field by informing patient selection, refining stimulation targets, and identifying a brain network linked to recovery that may have broader therapeutic relevance across consciousness-impairing conditions.
In people with severe brain injuries, stimulation restored consciousness by engaging a deep brain circuit for wakefulness—revealing a target that may also guide treatment in stroke and epilepsy.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ 59/36
/ 59/57
/ 9/26
/ Adult
/ Aged
/ Arousal
/ Brain
/ Coma
/ Consciousness Disorders - diagnostic imaging
/ Consciousness Disorders - physiopathology
/ Consciousness Disorders - therapy
/ Deep Brain Stimulation - methods
/ Epilepsy
/ Female
/ Gray Matter - diagnostic imaging
/ Humanities and Social Sciences
/ Humans
/ Male
/ Patients
/ Science
/ Seizures
/ Stroke
/ Thalamus
/ Tissues
