Disrupting posterior cingulate connectivity disconnects consciousness from the external environment

Guillaume Herbet 1 Gilles Lafargue 1 Nicolas Menjot de Champfleur 1 Sylvie Moritz-Gasser 1 Emmanuelle Le Bars 1 François Bonnetblanc 2, 1 Hugues Duffau 1
2 DEMAR - Artificial movement and gait restoration
LIRMM - Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier, CRISAM - Inria Sophia Antipolis - Méditerranée
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 nonexistent. 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. (C) 2014 Elsevier Ltd. All rights reserved.
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Guillaume Herbet, Gilles Lafargue, Nicolas Menjot de Champfleur, Sylvie Moritz-Gasser, Emmanuelle Le Bars, et al.. Disrupting posterior cingulate connectivity disconnects consciousness from the external environment. Neuropsychologia, Elsevier, 2014, 56, pp.239-244. ⟨10.1016/j.neuropsychologia.2014.01.020⟩. ⟨hal-01159578⟩



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