The default mode network in consciousness

Brain injury management has improved considerably in recent years with resulting significant improvements in outcome. Nevertheless, a small but significant group of survivors do not fully emerge after acute coma and remain in a prolonged disorder of consciousness (DoC), including the vegetative (VS) and minimally conscious (MCS) states. Long range resting brain networks, such as the default mode network (DMN), have been shown to be disrupted in VS, and are partially or fully restored when patients recover cognitive capacity. The functional role of the DMN remains unclear. Although it was initially considered to be a task negative network, recent studies from our group and others have revealed DMN activity/connectivity during a wide range of self-referential and memory-based tasks, as well as altered DMN integrity in a variety of neuropsychiatric disorders. Such data provide support for inferences on the role of the DMN in cognitive capacity and consciousness. An emerging theory is that the DMN acts as global workspace integrating information from a variety of sources through associations, to make sense of the world at present. The major hubs of the DMN are multisynaptic and are connected to both cortical and subcortical regions rendering the DMN a suitable candidate for integrating information. Within this emerging theoretical framework this project will utilise fMRI to focus on the role of the DMN at rest but also importantly during tasks in a cohort of DoC patients and healthy volunteers.

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