Thalamic and extrathalamic mechanisms of consciousness after severe brain injury

Lutkenhoff, Chiang, Tshibanda, Kamau, Kirsch, Pickard, Laureys, Owen, Monti · Annals of Neurology · 2015 · neuroscience · 10.1002/ana.24423 · record lutkenhoff2015-thalamic-and-extrathalamic-mechani
tag layer · index · concepts · authors · עברית
Where this record's text came from. faceted 2026-08 by reading the locally held text (pdftext); every evidence string verified as an exact substring of that text before merging. The paper also reports a null result — almost no atrophy differences between VS, MCS- and MCS+ — and argues it is not merely a power failure; I kept claim type as 'mechanism' because the framing claim of the paper is the thalamic/extrathalamic division of labour, with the null across clinical entities as a supporting finding. The first stated limitation ('our measure of atrophy is actually a measure of local tissue displacement') was omitted because the sentence is broken across a page-header in the extraction and could not be quoted verbatim as one string. 2026-08-14 and 2026-08-15 schema-0.3 passes: every quote verified as an exact substring of the staged text and anchored at merge time; concept terms verified present; every edge endpoint an existing node.
How to read this page. The article itself is not reproduced here — this paper is not cleared for redistribution, so what follows is the tag layer alone. The evidence sentences are withheld with the article. The table at the foot lists every tag the record carries; each row names the facet it belongs to, and the whose words column says whether the tag records the paper's own wording or the tagger's sentence about the paper. Every tag links to each other paper in the corpus carrying it. The machine-readable edition of the same thing is the TEI file beside this one, where the tags live in standOff, and the article is at its publisher via the link below. When we have changed our mind. Some entries in the table begin with a word in capitals and the reason for it. EVIDENCE CORRECTED — the finding still stands, but we had quoted the wrong sentence from the paper, and the quotation has been replaced with the right one. RETRACTED — the entry itself was wrong; it stays on the page, marked, with the reason, rather than being deleted. WITHDRAWN AND REPLACED — the entry was wrong, and a corrected version of it appears in the entries below. Each mark carries its own reason, in brackets, because the reasons differ from one entry to the next. An entry we have WITHDRAWN is removed from this page and kept in the record, with its reason. A line reading Audit and a date is a later re-reading of the entry against its whole sentence: DOUBTFUL means it was kept, and the reason says what is loose about it. Quotation marks inside the tagger's sentence. Where a tag is the tagger's own sentence, a phrase in quotation marks inside it is borrowed from the paper — the tagger's wording around it is not. The paper's own sentence is the evidence quote for that row; on this page it is withheld with the article, and the article is at its publisher. Nothing inside quotation marks anywhere on this page is ours: if it is quoted, it is the paper's. Whose words a concept carries. A concept entry records a term the paper itself uses, so the term, the sense given for it, and its evidence are the paper's own words, quoted where the paper fixes them. This is the opposite of a sense entry in the tag table, which is the tagger's sentence about how the paper uses a term. Where a concept entry could not be grounded in the paper's words, the entry says so on its own row.
Other fields define these differently the same word, defined another way in another discipline
principal component analysis 5 fields · standard deviation 3 fields · arousal 2 fields · gender 2 fields

Tags on this paper

Every tag the record carries, each linking to every other paper in the corpus that carries it. A tag appears here whether or not its words occur in the article — the spans below are only the ones a sentence in this paper licenses. Of the 5 concept tags on this paper, all 5 are grounded in a quoted sentence.
parabrachial/precoeruleus complex CRS-R subscales multicollinearity basal forebrain arousal Willful behaviour and arousal are supported by separate circuits, so thalamic damage removes organised willful behaviour while extrathalamic (basal ganglia) damage removes behavioural and electrocortical arousal Loss of corticopetal thalamo-prefrontal projections (the mesocircuit) removes the drive that sustains organised behaviour and integrates information across cortex Partial basal forebrain atrophy spares the coma-inducing threshold but impairs the fast cortical disinhibition that transiently amplifies sensory processing shape (or vertex) analysis minimum common denominator total CRS-R score injury etiology local brain atrophy total normalized brain volume age gender principal component analysis principal component analysis [PCA], with varimax rotation of the loading matrix permutation test nonparametric permutation testing multiple regression a multiple regression approach t-statistic t statistic p-value correlation correlated inversely Bayesian estimation in a Bayesian framework standard deviation observational-study

Legend

relation to other workclaim_relationshow this paper stands to another: agrees, contradicts, extends, qualifies
claim typeclaim_typethe shape of the claim: existence, mechanism, method, critique, prediction, null
concept edgeconcept_edgesan asserted relation between two concepts, with the sentence asserting it
conceptconceptsan idea the paper works with, quoted where the paper uses it
content tagcontent_tagsa finding, definition, quantity, statistic or variable named in the paper
controlcontrolsan experiment run to eliminate a rival explanation
limitationlimitationswhat the paper says its evidence cannot support
mechanismmechanismshow the reported effect is said to come about
methodmethodhow the paper produced its evidence
phenomenonphenomenonthe effect or regularity under study
sensesensesa distinct use of a term, quoted where the paper fixes it

The paper

The full text is not reproduced here. This article is not cleared for redistribution, so the page carries the tag layer only. Its evidence sentences are withheld; the grounding status remains with each tag, and the article itself is at https://doi.org/10.1002/ana.24423. The reading view exists for the papers whose licence permits it.

Every tag on this page

claim_relations 2 · claim_type 1 · concept_edges 1 · concepts 5 · content_tags 34 · controls 1 · limitations 7 · mechanisms 3 · method 1 · phenomenon 1 · senses 3

Relations on this page carry a quotation for the claim. Where a relation was separately evidenced — and so tested against the vocabulary for its type — the row says so; none of 1 relation here carry that mark. The rest are the tagger’s reading of the sentence quoted beside them.

facettagfieldconf.whose words
claim_typemechanism
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
claim_typethe paper's words
phenomenondisorders of consciousness after severe brain injury
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
phenomenonthe paper's words
methodobservational-study
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
methodthe paper's words
mechanismsmechanisms
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
mechanisms[0]the tagger's words
mechanismsmechanisms
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
mechanisms[1]the tagger's words
mechanismsmechanisms
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
mechanisms[2]the tagger's words
limitationsStructural neuroimaging is descriptive, so the findings cannot be given a causal interpretation
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
what this limits: any causal reading of the neuroanatomical findings: THE USE OF STRUCTURAL NEUROIMAGING, A DESCRIPTIVE METHODOLOGY ... DOES NOT ALLOW A CAUSAL INTERPRETATION OF OUR FINDINGS
limitations[0]the tagger's words
limitationsThe atlas-based segmentation relies on priors estimated mostly from healthy volunteers
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
what this limits: every segmentation and volume in patients: THE ATLAS-BASED COMPONENT ... IS BOTH AN ASSET ... AND A LIABILITY, GIVEN ITS RELIANCE ON PRIORS ESTIMATED MOSTLY FROM HEALTHY VOLUNTEERS
limitations[1]the tagger's words
limitationsThe proposed model is an approximation that omits corticosubcortical connectivity, temporal dynamics, neurotransmitter action and further arousal-related regions
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
what this limits: the mechanistic model offered: OUR PROPOSAL, AS WELL AS THE MESOCIRCUIT MODEL OF DOC, ARE TO BE UNDERSTOOD AS APPROXIMATIONS THAT DO NOT TAKE INTO FULL ACCOUNT THE EXTENT OF CORTICOSUBCORTICAL CONNECTIVITY, TEMPORAL DYNAMICS
limitations[2]the tagger's words
limitationsAdditional clinical factors that shape a given patient's atrophy pattern could not be addressed and would need larger samples
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
what this limits: any individual patient's atrophy pattern: THERE ARE A NUMBER OF ADDITIONAL FACTORS THAT MIGHT WELL PLAY AN IMPORTANT ROLE ... THAT WE COULD NOT ADDRESS
limitations[3]the tagger's words
limitationsA structure the literature calls crucial could not be assessed by the technique used.
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
what this limits: any map of which structures support this process drawn from this study: the parabrachial/precoeruleus complex has previously been shown to be crucial for it and could not be assessed with the present technique
limitations[4]1.0the tagger's words
limitationsThe outcome analysed is a set of rotated components, not the clinical subscales themselves.
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
what this limits: any statement here relating a brain region to a clinical function: because of correlations between the CRS-R subscales and the effects of multicollinearity on regression, the authors performed a data reduction by principal component analysis with varimax rotation
limitations[5]1.0the tagger's words
limitationsOne region entered the analysis on the strength of evidence from animal models.
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
what this limits: the set of subcortical regions examined here: this region was added to the analysis because of its causal role in the maintenance of cortical and behavioral arousal in animal models
limitations[6]1.0the tagger's words
controlsa multiple-regression approach across a deliberately HETEROGENEOUS patient sample, controlling the factors known to drive variability in disorders of consciousness
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
eliminates: aetiology, time since injury and the other known sources of between-patient variance, so that what remains is the 'minimum common denominator' the paper is after rather than a property of whichever patients were available · outcome: partial
controls[0]0.95the tagger's words
conceptsparabrachial/precoeruleus complex
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
concepts[0]the paper's words
conceptsCRS-R subscales
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
concepts[1]the paper's words
conceptsmulticollinearity
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
concepts[2]the paper's words
conceptsbasal forebrain
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
concepts[3]the paper's words
conceptsarousal
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
also in: arousal
concepts[4]the paper's words
sensesthe region set - BOUNDED BY THE INSTRUMENT, NOT BY THE BIOLOGY: one structure previously shown to be crucial for the process under study could not be assessed with the technique used, so the map of which regions matter is drawn from the regions the method can see
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
senses[0]1.0the tagger's words
sensesthe clinical outcome - COMPONENTS, NOT SUBSCALES: the six CRS-R subscales are correlated, so a principal component analysis with varimax rotation was performed and the regression is run on the components; every later claim linking a region to a function is a claim about a component
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
senses[1]1.0the tagger's words
sensesthe basal forebrain's role - ESTABLISHED ELSEWHERE, MEASURED HERE: the paper reports its own negative association with sensory responsiveness and, in the next clause, that the region is well known to play a causal role in arousal and to induce a comalike state when extensively lesioned - the causal claim is inherited, the association is measured
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
senses[2]1.0the tagger's words
claim_relationsbuilds-on → the mesocircuit theory of disorders of consciousness
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
claim_relations[0]the tagger's words
claim_relationsreplicates → postmortem examinations of thalamic damage after nontraumatic brain injury
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
claim_relations[1]the tagger's words
concept_edgesbasal forebrain —causes→ arousal
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
strength of the relation: 0.7 Audit 2026-09-28: DOUBTFUL - read against its span and kept, but the span says the basal forebrain is associated with responsiveness and known for arousal; causes is loose.
concept_edges[0]the tagger's words
content_tagsprincipal component analysis
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.statistics[0]the tagger's words
content_tagspermutation test
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.statistics[1]the tagger's words
content_tagsmultiple regression
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.statistics[2]the tagger's words
content_tagst-statistic
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
also in: t-statistic
content_tags.statistics[3]the tagger's words
content_tagsp-value
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
also in: p-value
content_tags.statistics[4]the tagger's words
content_tagscorrelation
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
also in: correlation
content_tags.statistics[5]the tagger's words
content_tagsBayesian estimation
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.statistics[6]the tagger's words
content_tagsstandard deviation
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.statistics[7]the tagger's words
content_tagsCompared with healthy volunteers, patients with disorders of consciousness showed significant atrophy in every subcortical structure examined.
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.findings[0]the tagger's words
content_tagsThe behaviourally defined diagnostic categories were not distinguishable by subcortical pathology: vegetative-state, MCS-minus and MCS-plus patients did not differ from one another in any region.
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.findings[1]the tagger's words
content_tagsTotal CRS-R score varied inversely with atrophy in the left globus pallidus, left putamen and small ventromedial parts of the basal forebrain.
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.findings[2]the tagger's words
content_tagsMotor and communication ability tracked thalamic pathology: the Motor-Communication component correlated negatively with atrophy in bilateral anterior and dorsomedial thalamus, left putamen and right hippocampus.
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.findings[3]the tagger's words
content_tagsArousal tracked basal ganglia rather than thalamic pathology: the Arousal component correlated negatively with atrophy in bilateral putamen and globus pallidus.
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.findings[4]the tagger's words
content_tagsPatients' level of arousal showed no association with thalamic atrophy.
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.findings[5]the tagger's words
content_tagsSensory (audiovisual) responsiveness was associated specifically with atrophy of small ventromedial segments of the basal forebrain.
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.findings[6]the tagger's words
content_tagsPatients with nontraumatic injury had more widespread and left-lateralised thalamic atrophy than patients with traumatic injury, mirroring the worse prognosis of nontraumatic aetiology.
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.findings[7]the tagger's words
content_tagsVegetative-state patients showed more atrophy than eMCS patients in left putamen, globus pallidus and a small part of right hippocampus.
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.findings[8]the tagger's words
content_tagsshape (or vertex) analysis
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.definitions[0]the tagger's words
content_tagsminimum common denominator
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.definitions[1]the tagger's words
content_tagstotal CRS-R score
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.variables[0]the tagger's words
content_tagsinjury etiology
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.variables[1]the tagger's words
content_tagslocal brain atrophy
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.variables[2]the tagger's words
content_tagstotal normalized brain volume
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.variables[3]the tagger's words
content_tagsage
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
also in: age
content_tags.variables[6]the tagger's words
content_tagsgender
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
also in: gender
content_tags.variables[7]the tagger's words
content_tags143 — consecutive patients with disorders of consciousness recruited
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.quantities[0]the tagger's words
content_tags96 — healthy volunteers providing control images
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.quantities[1]the tagger's words
content_tags28 — patient datasets discarded for low image quality before any analysis
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.quantities[2]the tagger's words
content_tags115 / 38 / 63 / 14 — patients analysed, split into vegetative state, minimally conscious state and emerging-from-MCS
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.quantities[3]the tagger's words
content_tags90% — total variance in the CRS-R subscales explained by the four retained PCA components
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.quantities[4]the tagger's words
content_tags100% and 99% — proportion of right and left globus pallidus vertices showing significant atrophy in patients versus volunteers
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.quantities[5]the tagger's words
content_tags47% — share of patients whose injury was nontraumatic
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.quantities[6]the tagger's words
content_tags56% of vertices — extent of left thalamus showing extra atrophy in nontraumatic relative to traumatic injury
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.quantities[7]the tagger's words
content_tags84% vs 9.6% and 6% — proportions of bilateral, left- and right-lateralised injuries in the sample, used to rule out a trivial explanation of the left-lateralised thalamic finding
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
content_tags.quantities[8]the tagger's words

Interpretive choices

Tags that could not be placed in the text:

What was deliberately not tagged, and why, is recorded per paper by the tagger. Where a paper has no such record, this page says so rather than implying that nothing was declined.

© 2026 Shir Sivroni · ORCID 0009-0000-2597-2824