Synchronization between the anterior and posterior cortex determines consciousness level in patients with traumatic brain injury (TBI)

Jose Leon-Carrion, Umberto Leon-Dominguez, Luca Pollonini, Meng Hung Wu, Richard E. Frye, Maria Rosario Dominguez-Morales, George Zouridakis

Research output: Contribution to journalArticlepeer-review

40 Citations (Scopus)


Survivors of traumatic brain injury (TBI) often suffer disorders of consciousness as a result of a breakdown in cortical connectivity. However, little is known about the neural discharges and cortical areas working in synchrony to generate consciousness in these patients. In this study, we analyzed cortical connectivity in patients with severe neurocognitive disorder (SND) and in the minimally conscious state (MCS). We found two synchronized networks subserving consciousness; one retrolandic (cognitive network) and the other frontal (executive control network). The synchrony between these networks is severely disrupted in patients in the MCS as compared to those with better levels of consciousness and a preserved state of alertness (SND). The executive control network could facilitate the synchronization and coherence of large populations of distant cortical neurons using high frequency oscillations on a precise temporal scale. Consciousness is altered or disappears after losing synchrony and coherence. We suggest that the synchrony between anterior and retrolandic regions is essential to awareness, and that a functioning frontal lobe is a surrogate marker for preserved consciousness. This article is part of a Special Issue entitled: Brain Integration.

Original languageEnglish
Pages (from-to)22-30
Number of pages9
JournalBrain Research
Publication statusPublished - 2 Oct 2012
Externally publishedYes

Bibliographical note

Funding Information:
Funding for this study was made possible through grants from the Center for Brain Injury Rehabilitation [(CRECER) ( )], the Spanish Ministry of Science and Innovation (PSI-2008-04218/PSIC), the Fundación CajaSol de Sevilla, Spain, and the Fundación Plenum, Sevilla, Spain.

Copyright 2013 Elsevier B.V., All rights reserved.

All Science Journal Classification (ASJC) codes

  • General Neuroscience
  • Molecular Biology
  • Clinical Neurology
  • Developmental Biology


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