Circuit Mechanisms Underlying Behavioral Variability during Recovery of Consciousness following Severe Brain Injury
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© 2011 by Oxford University Press, Inc. All rights reserved.Recovery of consciousness following severe brain injuries typically evolves through several stages marked by considerable behavioral variability. This chapter considers the role of 'circuit-level' mechanisms in the forebrain in the generation of behavioral variability and specifically emphasizes the contributions of the central thalamus to altered arousal regulation in neurological disorders of consciousness. Neurons within the central thalamus play a key role in forebrain arousal regulation, acting as a nexus for the influence of ascending brainstem/basal forebrain neuronal populations ('arousal systems') and control signals descending from frontal cortical systems. Clinical distinctions among neurological disorders of consciousness and some observations of wide fluctuations in behavioral responsiveness in severely brain-injured patients can be organized by considering the possible role of circuit-level alterations of function involving the central thalamus, striatum and frontal cortical systems.
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