A proposed subcortical arousal network, crucial for wakefulness, has been mapped in the human brain, revealing connections between key areas like the brainstem and hypothalamus. Utilizing data from three neurologically normal individuals' brains and advanced imaging techniques, this study identified pathways linking the default ascending arousal network with the cortical default mode network. Notably, the dopaminergic ventral tegmental area emerged as a central hub connecting these networks. This work enhances our understanding of how arousal and awareness integrate in human consciousness.
Among 696 adults with disorders of consciousness after severe brain injury in specialized rehabilitation programs, two-thirds improved beyond measurement error on the Coma Recovery Scale-Revised, while 23 declined and 228 showed no reliable change. Patients who began rehabilitation sooner after injury were more likely to show true improvement. Early change during the first two weeks did not predict change in the following two weeks, indicating that progress is not linear and that precise measurement is needed to guide treatment decisions.
Consciousness depends on both arousal (wakefulness) and awareness. While cortical networks for awareness are well studied, the subcortical networks supporting arousal are less understood. By combining ex vivo diffusion MRI, immunohistochemistry, and in vivo 7 Tesla functional MRI in three human brain specimens, the authors identified a default ascending arousal network (dAAN) in the brainstem, hypothalamus, thalamus, and basal forebrain. They mapped connections within the dAAN and between the dAAN and the cortical default mode network (DMN), suggesting a structural basis for integrating arousal and awareness. The data and methods are released to aid further mapping of human consciousness.