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New 'map of consciousness' could help to wake up coma patients

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Despite being a fundamental part of human existence, we know very little about consciousness and how it happens. Now, scientists have just brought us one step closer to finding out with a new 'map of consciousness' - and their results could help to wake up coma patients.

Human consciousness is made from two crucial building blocks: arousal and awareness. In a groundbreaking new study, published in the journal Science Translational Medicine, a team of scientists have mapped out how these two states join up.

The result? A 'map of wakefulness' that charts the connectivity of the brain and reveals where consciousness takes place.

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Using MRI scans, the researchers from Massachusetts General Hospital and Boston Children's Hospital were able to study three post-mortem human brains at resolutions of less than a millimetre.

The map revealed previously unseen pathways between key areas of the brain. When joined together, the researchers called these pathways the 'default network' of the brain. This, they say, is the part of your brain that is active during a resting state of consciousness.

Just like when you plan your route to a destination, the researchers also used the map to work out the 'route' that is vital to firing up self-awareness.

In the top panel, the red and blue tracts show where scientists previously thought consciousness came from, based on animal studies from the mid-20th Century. These tracts come from the midbrain and pontine reticular formations, respectively. But the pink and yellow tracts in the bottom panel come from additional 'extrareticular' brainstem nuclei that scientists now believe contribute to wakefulness in the human brain. - Image credit: Edlow et al., Sci. Trans. Med., 16 eadj4303 (2024).

"Our goal was to map a human brain network that is critical to consciousness and to provide clinicians with better tools to detect, predict, and promote recovery of consciousness in patients with severe brain injuries," said lead author and Harvard University associate professor Brian Edlow.

These brain injuries include those that lead to comas. In fact, the researchers think these findings could even help patients recover from comas - highlighting key sites where stimulation could 'wake up' connections with other regions of the brain that are critical to consciousness.

The authors are currently conducting clinical trials to see if they can reactivate the default network and restore consciousness in coma patients.

According to senior author Hannah Kinney, the results themselves could be used as their own kind of map "to better understand a broad range of neurological disorders associated with altered consciousness".

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