Differential engagement of thalamic nuclei orchestrates consciousness states across anesthesia, sleep, and disorders of consciousness.
Fa Lu, Juan Wang, Xuewei Qin, Xuanling Chen, Taotao Liu, Xiaoli Li, Xiangyang Guo, Yao Lan, Zhenhu Liang
Communications Biology December 18, 2025 DOI: 10.1038/s42003-025-09205-2 (opens in new tab) via PubMed
Summary
AI-generated from the abstractAltered 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.
Study at a glance
| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Population | Participants under general anesthesia (propofol N=12, sevoflurane N=12), patients with disorders of consciousness (minimally conscious state N=9, unresponsive wakefulness syndrome N=9), and sleeping participants (wakefulness N=31, NREM1 N=24, NREM2 N=19) |
| Key finding | Thalamic nuclei show state-specific alterations in connectivity and local fluctuation across anesthesia, sleep, and disorders of consciousness, with higher-order nuclei more consistently involved. |
Abstract
Consciousness alterations occur across various states, encompassing changes in both arousal and awareness. The contributions of thalamic nuclei of consciousness remain incompletely understood. We analyzed fMRI data across general anesthesia (propofol N = 12, sevoflurane N = 12), disorders of consciousness (DoC) (minimally conscious state N = 9, unresponsive wakefulness syndrome N = 9), and sleep stages (wakefulness N = 31, NREM1 N = 24, NREM2 N = 19), investigating thalamocortical connectivity, local fluctuation (complexity/variability), and their coupling. In our results, propofol affected pulvinar-cortical connections; sleep transitions involved ventral lateral posterior (VLp), medial geniculate, and centromedian nuclei; DoC showed extensive disconnections. Five key nuclei demonstrated state- specific alterations: two first-order (VLp, ventral posterolateral) and three higher-order nuclei (pulvinar, centromedian, mediodorsal), with higher-order nuclei showing more consistent involvement. Decreased complexity/variability occurred in 4-6 nuclei during anesthesia and 4-5 in DoC patients. Nucleus-specific coupling between local fluctuation and connectivity systematically varied with consciousness state. This framework advances understanding of thalamic consciousness orchestration and provides potential therapeutic targets.