Internal medicine

Neuroscience

Consciousness

Minimally conscious state

Disease

Prefrontal cortex

Developmental psychology

Cognition

Psychology

Level of consciousness

Stimulation

Functional magnetic resonance imaging

Parkinson's disease

Persistent vegetative state

Primate

Deep brain stimulation

Thalamus

Arousal

Medicine

Science Advances

Loss of consciousness is associated with the disruption of long-range thalamocortical and corticocortical brain communication. We tested the hypothesis that deep brain stimulation (DBS) of central thalamus might restore both arousal and awareness following consciousness loss. We applied anesthesia to suppress consciousness in nonhuman primates. During anesthesia, central thalamic stimulation induced arousal in an on-off manner and increased functional magnetic resonance imaging activity in prefrontal, parietal, and cingulate cortices. Moreover, DBS restored a broad dynamic repertoire of spontaneous resting-state activity, previously described as a signature of consciousness. None of these effects were obtained during the stimulation of a control site in the ventrolateral thalamus. Last, DBS restored a broad hierarchical response to auditory violations that was disrupted under anesthesia. Thus, DBS restored the two dimensions of consciousness, arousal and conscious access, following consciousness loss, paving the way to its therapeutical translation in patients with disorders of consciousness.

Deep brain stimulation of the thalamus restores signatures of consciousness in a nonhuman primate model