Cerebral electrometabolic coupling in disordered and normal states of consciousness.

We assess cerebral integrity with cortical and subcortical FDG-PET and cortical electroencephalography (EEG) within the mesocircuit model framework in patients with disorders of consciousness (DoCs). The mesocircuit hypothesis proposes that subcortical activation facilitates cortical function. We find that the metabolic balance of subcortical mesocircuit areas is informative for diagnosis and is associated with four EEG-based power spectral density patterns, cortical metabolism, and α power in healthy controls and patients with a DoC. Last, regional electrometabolic coupling at the cortical level can be identified in the θ and α ranges, showing positive and negative relations with glucose uptake, respectively. This relation is inverted in patients with a DoC, potentially related to altered orchestration of neural activity, and may underlie suboptimal excitability states in patients with a DoC. By understanding the neurobiological basis of the pathophysiology underlying DoCs, we foresee translational value for diagnosis and treatment of patients with a DoC. [Display omitted] • Biologically founded EEG spectral regimes are related to cortical glucose uptake • Subcortical metabolism correlates with cortical α power, glucose uptake, and consciousness • Cortical α is negatively and θ is positively related to cortical glucose uptake in controls • Cortical electrometabolic coupling is inverted in patients with a severe brain injury Patients with disorders of consciousness are characterized by reduced cerebral function as measured by glucose uptake and electrical activity. Annen et al. characterize the role of subcortical areas in sustaining cortical function and quantify electrometabolic coupling in healthy conscious and reduced conscious states after coma. [ABSTRACT FROM AUTHOR]