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Neuropsychologia. 2014 Apr;56:239-44. doi: 10.1016/j.neuropsychologia.2014.01.020. Epub 2014 Feb 4.

Disrupting posterior cingulate connectivity disconnects consciousness from the external environment.

Author information

  • 1Department of Neurosurgery, Montpellier University Medical Center, Montpellier 34295, France; Institute for Neuroscience of Montpellier, INSERM U-1051, Hôpital Saint Eloi, Montpellier 34298, France; University of Montpellier 1, Montpellier 34967, France. Electronic address: guillaume.herbet@gmail.com.
  • 2Functional Neuroscience and Pathologies Lab, EA-4559, Université Lille Nord de France, Loos 59120, France.
  • 3Institute for Neuroscience of Montpellier, INSERM U-1051, Hôpital Saint Eloi, Montpellier 34298, France; Department of Neuroradiology, Montpellier University Medical Center, Montpellier 34295, France.
  • 4Institute for Neuroscience of Montpellier, INSERM U-1051, Hôpital Saint Eloi, Montpellier 34298, France; Department of Neurology, Montpellier University Medical Center, Montpellier 34295, France.
  • 5Cognition, Action and Sensorimotor Plasticity Lab, INSERM U-1093, UFR STAPS, Dijon 21078, France; University of Montpellier 2, LIRMM, DEMAR Team, CNRS, INRIA, Montpellier 34095, France.
  • 6Department of Neurosurgery, Montpellier University Medical Center, Montpellier 34295, France; Institute for Neuroscience of Montpellier, INSERM U-1051, Hôpital Saint Eloi, Montpellier 34298, France.

Abstract

Neurophysiological and neuroimaging studies including both patients with disorders of consciousness and healthy subjects with modified states of consciousness suggest a crucial role of the medial posteroparietal cortex in conscious information processing. However no direct neuropsychological evidence supports this hypothesis and studies including patients with restricted lesions of this brain region are almost non-existent. Using direct intraoperative electrostimulations, we showed in a rare patient that disrupting the subcortical connectivity of the left posterior cingulate cortex (PCC) reliably induced a breakdown in conscious experience. This acute phenomenon was mainly characterized by a transient behavioral unresponsiveness with loss of external connectedness. In all cases, when he regained consciousness, the patient described himself as in dream, outside the operating room. This finding suggests that functional integrity of the PPC connectivity is necessary for maintaining consciousness of external environment.

Copyright © 2014 Elsevier Ltd. All rights reserved.

KEYWORDS:

Consciousness disorders; Electrical stimulations; External awareness; Posterior cingulate; Precuneus

PMID:
24508051
[PubMed - indexed for MEDLINE]
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