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Abstract:

Disorders of consciousness (DOC) are related to an altered capacity of the brain to successfully integrate and segregate information. Alterations in brain functional networks structure have been found in fMRI studies, which could account for the incapability of the brain to efficiently manage internally and externally generated information. Here we assess the modulation of neural activity in areas of the networks related to active introspective or extrospective processing in 9 patients with DOC and 17 controls using fMRI. In addition, we assess the functional connectivity between those areas in resting state. Patients were experimentally studied in an early phase after the event of brain injury (3±1 months after the event) and subsequently in a second session 4±1 months after the first session. The results showed that the concerted modulation of the default mode network (DMN) and attentional network (AN) in response to the active involvement in the task improved with the level of consciousness, reflecting an integral recovery of the brain in its ability to be engaged in cognitive processes. In addition, functional connectivity decreased between the DMN and AN with recovery. Our results help to further understand the neural underpins of the disorders of consciousness. © 2016 Elsevier Ltd.

Registro:

Documento: Artículo
Título:Modulation of the default-mode network and the attentional network by self-referential processes in patients with disorder of consciousness
Autor:Mäki-Marttunen, V.; Castro, M.; Olmos, L.; Leiguarda, R.; Villarreal, M.
Filiación:Institute for Neurological Research, F.L.E.N.I., Montañeses 2325, Buenos Aires, 1428, Argentina
CONICET, Buenos Aires, Argentina
Departamento de Física, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Argentina
Palabras clave:Attentional network; Consciousness disorders; Default mode network; Functional connectivity; Functional magnetic resonance imaging; Self-reflection; adolescent; adult; Article; attentional network; brain function; clinical article; connectome; consciousness disorder; consciousness level; controlled study; convalescence; default mode network; female; functional magnetic resonance imaging; human; male; neuropathology; resting state network; task performance; young adult; attention; brain injury; brain mapping; complication; Consciousness Disorders; nerve tract; nuclear magnetic resonance imaging; pathophysiology; physiology; self concept; Adult; Attention; Brain Injuries; Brain Mapping; Consciousness Disorders; Female; Humans; Magnetic Resonance Imaging; Male; Neural Pathways; Self Concept; Young Adult
Año:2016
Volumen:82
Página de inicio:149
Página de fin:160
DOI: http://dx.doi.org/10.1016/j.neuropsychologia.2016.01.022
Título revista:Neuropsychologia
Título revista abreviado:Neuropsychologia
ISSN:00283932
CODEN:NUPSA
Registro:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00283932_v82_n_p149_MakiMarttunen

Referencias:

  • Andreasen, N.C., O'Leary, D.S., Cizadlo, T., Arndt, S., Rezai, K., Watkins, G.L., Hichwa, R.D., Remembering the past: two facets of episodic memory explored with positron emission tomography (1995) Am. J. Psychiatry, 152 (11), pp. 1576-1585
  • Ashwal, S., Cranford, R., Bernat, J.L., Celesia, G., Coulter, D., Eisenberg, H., Medical aspects of the persistent vegetative state. 1 (1994) N. Engl. J. Med., 330 (21), pp. 1499-1508
  • Baars, B.J., Global workspace theory of consciousness: toward a cognitive neuroscience of human experience (2005) Prog. Brain Res., 150, pp. 45-53
  • Bardin, J.C., Schiff, N.D., Voss, H.U., Pattern classification of volitional functional magnetic resonance imaging responses in patients with severe brain injury (2012) Arch. Neurol., 69 (2), pp. 176-181
  • Bekinschtein, T.A., Manes, F.F., Villarreal, M., Owen, A.M., Della Maggiore, V., Functional imaging reveals movement preparatory activity in the vegetative state (2011) Front. Hum. Neurosci., 5, p. 5
  • Binder, J.R., Desai, R.H., Graves, W.W., Conant, L.L., Where is the semantic system? A critical review and meta-analysis of 120 functional neuroimaging studies (2009) Cereb. Cortex, 19 (12), pp. 2767-2796
  • Boly, M., Garrido, M.I., Gosseries, O., Bruno, M.-A., Boveroux, P., Schnakers, C., Friston, K., Preserved feedforward but impaired top-down processes in the vegetative state (2011) Science, 332 (6031), pp. 858-862
  • Boly, M., Tshibanda, L., Vanhaudenhuyse, A., Noirhomme, Q., Schnakers, C., Ledoux, D., Functional connectivity in the default network during resting state is preserved in a vegetative but not in a brain dead patient. (2009) Hum. Brain Mapp., 30 (8), pp. 2393-2400
  • Bonnelle, V., Ham, T.E., Leech, R., Kinnunen, K.M., Mehta, M.A., Greenwood, R.J., Sharp, D.J., Salience network integrity predicts default mode network function after traumatic brain injury (2012) Proc. Natl. Acad. Sci. USA, 109 (12), pp. 4690-4695
  • Boveroux, P., Vanhaudenhuyse, A., Bruno, M.-A., Noirhomme, Q., Lauwick, S., Luxen, A., Breakdown of within-and between-network resting state functional magnetic resonance imaging connectivity during propofol-induced loss of consciousness (2010) Anesthesiology, 113 (5), pp. 1038-1053
  • Broyd, S.J., Demanuele, C., Debener, S., Helps, S.K., James, C.J., Sonuga-Barke, E.J., Default-mode brain dysfunction in mental disorders: a systematic review (2009) Neurosci. Biobehav. Rev., 33 (3), pp. 279-296
  • Cauda, F., Micon, B.M., Sacco, K., Duca, S., D'Agata, F., Geminiani, G., Canavero, S., Disrupted intrinsic functional connectivity in the vegetative state (2009) J. Neurol. Neurosurg. Psychiatry, 80 (4), pp. 429-431
  • Chai, X.J., Castañón, A.N., Öngür, D., Whitfield-Gabrieli, S., Anticorrelations in resting state networks without global signal regression (2012) Neuroimage, 59 (2), pp. 1420-1428
  • Coleman, M.R., Davis, M.H., Rodd, J.M., Robson, T., Ali, A., Owen, A.M., Pickard, J.D., Towards the routine use of brain imaging to aid the clinical diagnosis of disorders of consciousness (2009) Brain, 132 (9), pp. 2541-2552
  • Corbetta, M., Shulman, G.L., Control of goal-directed and stimulus-driven attention in the brain (2002) Nat. Rev. Neurosci., 3 (3), pp. 201-215
  • Crone, J.S., Ladurner, G., Höller, Y., Golaszewski, S., Trinka, E., Kronbichler, M., Deactivation of the default mode network as a marker of impaired consciousness: an fMRI study (2011) PLoS One, 6 (10), p. e26373
  • Cruse, D., Chennu, S., Chatelle, C., Fernández-Espejo, D., Bekinschtein, T.A., Pickard, J.D., Owen, A.M., Relationship between etiology and covert cognition in the minimally conscious state (2012) Neurology, 78 (11), pp. 816-822
  • Damoiseaux, J.S., Rombouts, S., Barkhof, F., Scheltens, P., Stam, C.J., Smith, S.M., Beckmann, C.F., Consistent resting-state networks across healthy subjects (2006) Proc. Natl. Acad. Sci. USA, 103 (37), pp. 13848-13853
  • D'Argembeau, A., Collette, F., Van der Linden, M., Laureys, S., Del Fiore, G., Degueldre, C., Salmon, E., Self-referential reflective activity and its relationship with rest: a PET study (2005) Neuroimage, 25 (2), pp. 616-624
  • Deco, G., Corbetta, M., The dynamical balance of the brain at rest (2011) Neuroscientist, 17 (1), pp. 107-123
  • Dehaene, S., Sergent, C., Changeux, ßJ.-P., A neuronal network model linking subjective reports and objective physiological data during conscious perception (2003) Proc. Natl. Acad. Sci. USA, 100 (14), pp. 8520-8525
  • Dehaene, S., Changeux, J.-P., Experimental and theoretical approaches to conscious processing (2011) Neuron, 70 (2), pp. 200-227
  • Demertzi, A., Gomez, F., Crone, J.S., Vanhaudenhuyse, A., Tshibanda, L., Noirhomme, Q., Multiple fMRI system-level baseline connectivity is disrupted in patients with consciousness alterations (2014) Cortex, 52, pp. 35-46
  • Demertzi, A., Soddu, A., Laureys, S., Consciousness supporting networks (2013) Curr. Opin. Neurobiol., 23 (2), pp. 239-244
  • Dixon, M.L., Fox, K.C., Christoff, K., A framework for understanding the relationship between externally and internally directed cognition (2014) Neuropsychologia, 62, pp. 321-330
  • Edelman, G.M., Naturalizing consciousness: a theoretical framework (2003) Proc. Natl. Acad. Sci. USA, 100 (9), pp. 5520-5524
  • Fair, D.A., Dosenbach, N.U., Church, J.A., Cohen, A.L., Brahmbhatt, S., Miezin, F.M., Schlaggar, B.L., Development of distinct control networks through segregation and integration (2007) Proc. Natl. Acad. Sci. USA, 104 (33), pp. 13507-13512
  • Fernández-Espejo, D., Bekinschtein, T., Monti, M.M., Pickard, J.D., Junque, C., Coleman, M.R., Owen, A.M., Diffusion weighted imaging distinguishes the vegetative state from the minimally conscious state (2011) Neuroimage, 54 (1), pp. 103-112
  • Fox, M.D., Raichle, M.E., Spontaneous fluctuations in brain activity observed with functional magnetic resonance imaging (2007) Nat. Rev. Neurosci., 8 (9), pp. 700-711
  • Fransson, P., How default is the default mode of brain function?: further evidence from intrinsic BOLD signal fluctuations (2006) Neuropsychologia, 44 (14), pp. 2836-2845
  • Friston, K.J., Functional and effective connectivity: a review (2011) Brain Connect., 1 (1), pp. 13-36
  • Giacino, J.T., Ashwal, S., Childs, N., Cranford, R., Jennett, B., Katz, D.I., The minimally conscious state definition and diagnostic criteria (2002) Neurology, 58 (3), pp. 349-353
  • Giacino, J.T., Kalmar, K., Whyte, J., The JFK coma recovery scale-revised: measurement characteristics and diagnostic utility (2004) Arch. Phys. Med. Rehabil., 85 (12), pp. 2020-2029
  • Goldberg, I.I., Harel, M., Malach, R., When the brain loses its self: prefrontal inactivation during sensorimotor processing (2006) Neuron, 50 (2), pp. 329-339
  • Goldfine, A.M., Victor, J.D., Conte, M.M., Bardin, J.C., Schiff, N.D., Determination of awareness in patients with severe brain injury using EEG power spectral analysis (2011) Clin. Neurophysiol., 122 (11), pp. 2157-2168
  • Graham, K.S., Lee, A.C., Brett, M., Patterson, K., The neural basis of autobiographical and semantic memory: new evidence from three PET studies (2003) Cogn. Affect. Behav. Neurosci., 3 (3), pp. 234-254
  • Greicius Michael, D., Krasnow, B., Reiss, A.L., Menon, V., Functional Connectivity in the Resting Brain: a network analysis of the default mode hypothesis (2003) Proc. Natl. Acad. Sci. USA, 100 (1), pp. 253-258
  • Greicius, M.D., Menon, V., Default-mode activity during a passive sensory task: uncoupled from deactivation but impacting activation (2004) J. Cogn. Neurosci., 16 (9), pp. 1484-1492
  • Gusnard, D.A., Akbudak, E., Shulman, G.L., Raichle, M.E., Medial prefrontal cortex and self-referential mental activity: relation to a default mode of brain function (2001) Proc. Natl. Acad. Sci. USA, 98 (7), pp. 4259-4264
  • Gusnard, D.A., Raichle, M.E., Searching for a baseline: functional imaging and the resting human brain (2001) Nat. Rev. Neurosci., 2 (10), pp. 685-694
  • Ham, T.E., Bonnelle, V., Hellyer, P., Jilka, S., Robertson, I.H., Leech, R., Sharp, D.J., The neural basis of impaired self-awareness after traumatic brain injury (2013) Brain
  • He, Y., Chen, Z.J., Alan, C.E., Small-world anatomical networks in the human brain revealed by cortical thickness from MRI (2007) Cereb. Cortex, 17, pp. 2407-2419
  • Heine, L., Soddu, A., Gómez, F., Vanhaudenhuyse, A., Tshibanda, L., Thonnard, M., Demertzi, A., Resting state networks and consciousness: alterations of multiple resting state network connectivity in physiological, pharmacological, and pathological consciousness states (2012) Front. Psychol., 3
  • Huang, Z., Dai, R., Wu, X., Yang, Z., Liu, D., Hu, J., The self and its resting state in consciousness: an investigation of the vegetative state (2014) Hum. Brain Mapp., 35 (5), pp. 1997-2008
  • Ino, Brain activation during autobiographical memory retrieval with special reference to default mode network (2011) Open Neuroimaging J., 5, p. 14
  • Johnson, S.C., Baxter, L.C., Wilder, L.S., Pipe, J.G., Heiserman, J.E., Prigatano, G.P., Neural correlates of self-reflection (2002) Brain, 125 (8), pp. 1808-1814
  • Johnson, S.C., Schmitz, T.W., Kawahara-Baccus, T.N., Rowley, H.A., Alexander, A.L., Lee, J., Davidson, R.J., The cerebral response during subjective choice with and without self-reference (2005) J. Cogn. Neurosci., 17 (12), pp. 1897-1906
  • Kelley, W.M., Macrae, C.N., Wyland, C.L., Caglar, S., Inati, S., Heatherton, T.F., Finding the self? an event-related fMRI study (2002) J. Cogn. Neurosci., 14 (5), pp. 785-794
  • Kennedy, D.P., Courchesne, E., Functional abnormalities of the default network during self-and other-reflection in autism (2008) Soc. Cogn. Affect. Neurosci., 3 (2), pp. 177-190
  • Laureys, S., Celesia, G.G., Cohadon, F., Lavrijsen, J., León-Carrión, J., Sannita, W.G., Unresponsive wakefulness syndrome: a new name for the vegetative state or apallic syndrome (2010) BMC Med., 8 (1), p. 68
  • Laureys, S., Goldman, S., Phillips, C., Van Bogaert, P., Aerts, J., Luxen, A., Maquet, P., Impaired effective cortical connectivity in vegetative state: preliminary investigation using PET (1999) Neuroimage, 9 (4), pp. 377-382
  • Laureys, S., Lemaire, C., Maquet, P., Phillips, C., Franck, G., Cerebral metabolism during vegetative state and after recovery to consciousness (1999) J. Neurol. Neurosurg. Psychiatry, 67 (1), pp. 121-122
  • Laureys, S., Faymonville, M.E.E., Ferring, M., Differences in brain metabolism between patients in coma, vegetative state, minimally conscious state and locked-in syndrome (2003) Eur. J. Neurol., 10, p. 224
  • Laureys, S., Owen, A.M., Schiff, N.D., Brain function in coma, vegetative state, and related disorders (2004) Lancet Neurol., 3 (9), pp. 537-546
  • Laureys, S., Perrin, F., Brédart, S., Self-consciousness in non-communicative patients (2007) Conscious. Cogn., 16 (3), pp. 722-741
  • Mantini, D., Vanduffel, W., Emerging roles of the brain's default network (2013) Neuroscientist, 19 (1), pp. 76-87
  • Mason, M.F., Norton, M.I., Van Horn, J.D., Wegner, D.M., Grafton, S.T., Macrae, C.N., Wandering minds: the default network and stimulus-independent thought (2007) Science, 315 (5810), pp. 393-395
  • Mäki-Marttunen, V., Cortes, J.M., Villarreal, M.F., Chialvo, D.R., Disruption of transfer entropy and inter-hemispheric brain functional connectivity in patients with disorder of consciousness (2013) BMC Neurosci., 14, p. P83
  • McKiernan, K.A., D'Angelo, B.R., Kaufman, J.N., Binder, J.R., Interrupting the "stream of consciousness": an fMRI investigation (2006) Neuroimage, 29 (4), pp. 1185-1191
  • Mesulam, M.M., Large-scale neurocognitive networks and distributed processing for attention, language, and memory (1990) Ann. Neurol., 28, pp. 597-613
  • Mesulam, M.-M., From sensation to cognition (1998) Brain, 121 (6), pp. 1013-1052
  • Monti, M.M., Rosenberg, M., Finoia, P., Kamau, E., Pickard, J.D., Owen, A.M., Thalamo-frontal connectivity mediates top-down cognitive functions in disorders of consciousness (2015) Neurology, 84 (2), pp. 167-173
  • Murphy, K., Birn, R.M., Handwerker, D.A., Jones, T.B., Bandettini, P.A., The impact of global signal regression on resting state correlations: are anti-correlated networks introduced? (2009) Neuroimage, 44 (3), pp. 893-905
  • Nie, L., Yang, X., Matthews, P.M., Xu, Z., Guo, Y., Minimum partial correlation: an accurate and parameter-free measure of functional connectivity in fMRI (2015), pp. 125-134. , In: Brain Informatics and Health. Springer International Publishing; Norton, L., Hutchison, R.M., Young, G.B., Lee, D.H., Sharpe, M.D., Mirsattari, S.M., Disruptions of functional connectivity in the default mode network of comatose patients (2012) Neurology, 78 (3), pp. 175-181
  • Oldfield, R.C., The assessment and analysis of handedness: the Edinburgh inventory (1971) Neuropsychologia, 9 (1), pp. 97-113
  • Ovadia-Caro, S., Nir, Y., Soddu, A., Ramot, M., Hesselmann, G., Vanhaudenhuyse, A., Reduction in inter-hemispheric connectivity in disorders of consciousness (2012) PLoS One, 7 (5), p. e37238
  • Owen, A.M., Disorders of consciousness (2008) Ann. N. Y. Acad. Sci., 1124 (1), pp. 225-238
  • Owen, A.M., Coleman, M.R., Boly, M., Davis, M.H., Laureys, S., Pickard, J.D., Detecting awareness in the vegetative state (2006) Science, 313 (5792). , 1402-1402
  • Phillips, C.L., Bruno, M.-A., Maquet, P., Boly, M., Noirhomme, Q., Schnakers, C., Relevance vector machine" consciousness classifier applied to cerebral metabolism of vegetative and locked-in patients (2011) Neuroimage, 56 (2), pp. 797-808
  • Plum, F., Posner, J.B., (1966) The Diagnosis of Stupor and Coma, , FA Davis, Philadelphia, PA
  • Qin, P., Wu, X., Huang, Z., Duncan, N.W., Tang, W., Wolff, A., Northoff, G., How are different neural networks related to consciousness? (2015) Ann. Neurol.
  • Schacter, D.L., Addis, D.R., Buckner, R.L., Remembering the past to imagine the future: the prospective brain (2007) Nat. Rev. Neurosci., 8 (9), pp. 657-661
  • Seeley, W.W., Menon, V., Schatzberg, A.F., Keller, J., Glover, G.H., Kenna, H., Greicius, M.D., Dissociable intrinsic connectivity networks for salience processing and executive control. (2007) J. Neurosci., 27 (9), pp. 2349-2356
  • Seth, A.K., Baars, B.J., Edelman, D.B., Criteria for consciousness in humans and other mammals (2005) Conscious. Cogn., 14 (1), pp. 119-139
  • Seth, A.K., Izhikevich, E., Reeke, G.N., Edelman, G.M., Theories and measures of consciousness: an extended framework (2006) Proc. Natl. Acad. Sci. USA, 103 (28), pp. 10799-10804
  • Smith, E., Delargy, M., Locked-in syndrome (2005) Br. Med. J., 330 (7488), pp. 406-409
  • Soddu, A., Vanhaudenhuyse, A., Bahri, M.A., Bruno, M.-A., Boly, M., Demertzi, A., Identifying the default-mode component in spatial IC analyses of patients with disorders of consciousness (2012) Hum. Brain Mapp., 33 (4), pp. 778-796
  • Soddu, A., Vanhaudenhuyse, A., Demertzi, A., Bruno, M.A., Tshibanda, L., Di, H., Noirhomme, Q., Resting state activity in patients with disorders of consciousness (2011) Funct. Neurol., 26 (1), p. 37
  • Sonuga-Barke, E.J., Castellanos, F.X., Spontaneous attentional fluctuations in impaired states and pathological conditions: a neurobiological hypothesis (2007) Neurosci. Biobehav. Rev., 31 (7), pp. 977-986
  • Spreng, R.N., Grady, C.L., Patterns of brain activity supporting autobiographical memory, prospection, and theory of mind, and their relationship to the default mode network (2010) J. Cogn. Neurosci., 22 (6), pp. 1112-1123
  • Spreng, R.N., Mar, R.A., Kim, A.S., The common neural basis of autobiographical memory, prospection, navigation, theory of mind, and the default mode: a quantitative meta-analysis (2009) J. Cogn. Neurosci., 21 (3), pp. 489-510
  • Spreng, R.N., Sepulcre, J., Turner, G.R., Stevens, W.D., Schacter, D.L., Intrinsic architecture underlying the relations among the default, dorsal attention, and frontoparietal control networks of the human brain (2013) J. Cogn. Neurosci., 25 (1), pp. 74-86
  • Thibaut, A., Bruno, M.-A., Chatelle, C., Gosseries, O., Vanhaudenhuyse, A., Demertzi, A., Metabolic activity in external and internal awareness networks in severely brain-damaged patients (2012) J. Rehabil. Med., 44 (6)
  • Tononi, G., Consciousness as integrated information: a provisional manifesto (2008) Biol. Bull., 215 (3), pp. 216-242
  • Tononi, G., Edelman, G.M., Consciousness and complexity (1998) Science, 282 (5395), pp. 1846-1851
  • Van Den Heuvel, M.P., Hulshoff Pol, H.E., Exploring the brain network: a review on resting-state fMRI functional connectivity (2010) Eur. Neuropsychopharmacol., 20 (8), pp. 519-534
  • Vanhaudenhuyse, A., Demertzi, A., Schabus, M., Noirhomme, Q., Bredart, S., Boly, M., Two distinct neuronal networks mediate the awareness of environment and of self (2011) J. Cogn. Neurosci., 23 (3), pp. 570-578
  • Vanhaudenhuyse, A., Noirhomme, Q., Tshibanda, L.J.-F., Bruno, M.-A., Boveroux, P., Schnakers, C., Default network connectivity reflects the level of consciousness in non-communicative brain-damaged patients (2009) Brain
  • Vigneau, M., Beaucousin, V., Herve, P.-Y., Duffau, H., Crivello, F., Houde, O., Tzourio-Mazoyer, N., Meta-analyzing left hemisphere language areas: phonology, semantics, and sentence processing (2006) Neuroimage, 30 (4), pp. 1414-1432
  • Weissman, D.H., Roberts, K.C., Visscher, K.M., Woldorff, M.G., The neural bases of momentary lapses in attention (2006) Nat. Neurosci., 9 (7), pp. 971-978
  • Whitfield-Gabrieli, S., Moran, J.M., Nieto-Castañón, A., Triantafyllou, C., Saxe, R., Gabrieli, J.D., Associations and dissociations between default and self-reference networks in the human brain (2011) Neuroimage, 55 (1), pp. 225-232
  • Young, G.B., (2009), 1157, pp. 32-47. , http://dx.doi.org/10.1111/j.1749-6632.2009.04471.x, Coma. Annals of the New York Academy of Sciences; Zeman, A., (2006), Consciousness. Encyclopedia of Cognitive Science

Citas:

---------- APA ----------
Mäki-Marttunen, V., Castro, M., Olmos, L., Leiguarda, R. & Villarreal, M. (2016) . Modulation of the default-mode network and the attentional network by self-referential processes in patients with disorder of consciousness. Neuropsychologia, 82, 149-160.
http://dx.doi.org/10.1016/j.neuropsychologia.2016.01.022
---------- CHICAGO ----------
Mäki-Marttunen, V., Castro, M., Olmos, L., Leiguarda, R., Villarreal, M. "Modulation of the default-mode network and the attentional network by self-referential processes in patients with disorder of consciousness" . Neuropsychologia 82 (2016) : 149-160.
http://dx.doi.org/10.1016/j.neuropsychologia.2016.01.022
---------- MLA ----------
Mäki-Marttunen, V., Castro, M., Olmos, L., Leiguarda, R., Villarreal, M. "Modulation of the default-mode network and the attentional network by self-referential processes in patients with disorder of consciousness" . Neuropsychologia, vol. 82, 2016, pp. 149-160.
http://dx.doi.org/10.1016/j.neuropsychologia.2016.01.022
---------- VANCOUVER ----------
Mäki-Marttunen, V., Castro, M., Olmos, L., Leiguarda, R., Villarreal, M. Modulation of the default-mode network and the attentional network by self-referential processes in patients with disorder of consciousness. Neuropsychologia. 2016;82:149-160.
http://dx.doi.org/10.1016/j.neuropsychologia.2016.01.022