Differential engagement of thalamic nuclei orchestrates consciousness states across anesthesia, sleep, and disorders of consciousness.
Communications Biology December 18, 2025 Fa Lu, Juan Wang, Xuewei Qin et al.
Altered consciousness—from anesthesia and sleep to disorders of consciousness—involves distinct changes in thalamic nuclei. Analyzing fMRI data across these states, the authors found that propofol anesthesia disrupted pulvinar-cortical connections, sleep transitions affected specific nuclei (VLp, medial geniculate, centromedian), and disorders of consciousness showed widespread disconnections. Five key nuclei showed state-specific alterations, with higher-order nuclei (pulvinar, centromedian, mediodorsal) more consistently involved. Decreased local brain signal complexity occurred in 4–6 nuclei during anesthesia and 4–5 in patients with disorders of consciousness. The coupling between local fluctuation and connectivity varied systematically with consciousness state, suggesting potential therapeutic targets.