Thalamic burst and tonic firing selectively indicate patients’ consciousness level and recovery
Bibliographic record
Abstract
Abstract Patients with disorders of consciousness exhibit severe declines in arousal and awareness, alongside anomalous functional brain connections and aberrant neuronal activities 1–4 . Yet, the diagnostic error of patients’ consciousness states can reach up to forty percent 5,6 , resulting in a worse prognosis. Neuronal mechanisms underlying the disorders are indispensable for identifying objective and intrinsic markers of consciousness. As the principal relay station between the brainstem arousal nuclei and the cerebral cortex, the thalamus has been empirically inferred to maintain consciousness and wakefulness within the brain connectome 7–12 . Here, we investigated thalamic spiking, brain connections, consciousness states, and outcomes following deep brain stimulation in 29 patients. Our study reveals that thalamic activities can signal their consciousness states. Patients diagnosed with vegetative state/unresponsive wakefulness syndrome exhibited less active neurons with longer and more variable burst discharges compared to those in a minimally conscious state. Furthermore, as a direct deep brain stimulation site, neuronal profiles in the centromedian/parafascicular complex of the thalamus indicated whether electrostimulation here improved outcomes. Stronger tonic firing was associated with enhanced thalamocortical connections and better recovery outcomes in patients. These findings suggest that thalamic spiking signatures, including single-neuron burst discharge and tonic firing, selectively indicate the representation and alteration of consciousness. These findings provide direct neuronal and clinical evidence for understanding of thalamic contributions to disorders of consciousness.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".