Disrupting posterior cingulate connectivity disconnects consciousness from the external environment

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 evidenc...

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Bibliographic Details
Published in:Neuropsychologia 2014-04, Vol.56, p.239-244
Main Authors: Herbet, Guillaume, Lafargue, Gilles, de Champfleur, Nicolas Menjot, Moritz-Gasser, Sylvie, le Bars, Emmanuelle, Bonnetblanc, François, Duffau, Hugues
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Biological and medical sciences
Brain Mapping
Consciousness disorders
Consciousness Disorders - etiology
Consciousness Disorders - pathology
Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes
Electrical stimulations
Engineering Sciences
Epilepsy, Absence - complications
Epilepsy, Absence - pathology
Epilepsy, Absence - surgery
External awareness
Glioma - complications
Glioma - pathology
Glioma - surgery
Gyrus Cinguli - pathology
Gyrus Cinguli - physiopathology
Humans
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Nervous system (semeiology, syndromes)
Neural Pathways - physiopathology
Neurology
Neuropsychological Tests
Neurosurgery - methods
Organic mental disorders. Neuropsychology
Photic Stimulation
Posterior cingulate
Precuneus
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
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Summary: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. •Disrupting posterior cingulate connectivity induces a loss of external connectedness.•This suggests that this connectivity may be involved in external awareness.•This finding is especially relevant for consciousness-related theories.•Medial parietal damage is associated with body schema alterations.
ISSN:0028-3932
1873-3514
DOI:10.1016/j.neuropsychologia.2014.01.020